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Bozkurt, Emre

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Doctor

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Emre

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Bozkurt

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Bozkurt, Emre

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2022 - 20235

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    Centrally-necrotic/hyalinizing demarcated (CND) carcinomas of the pancreas: a clinico-pathologically distinct group with divergent metaplastic patterns and high-grade characteristics
    (Elsevier, 2022) Bagci, Pelin; Altinmakas, Emre; Pehlivanoglu, Burcin; Bozkurtlar, Emine; Reid, Michelle; Cheng, Jeanette; Luchini, Claudio; Scarpa, Aldo; Basturk, Olca; N/A; Cengiz, Duygu; Saka, Burcu; Bozkurt, Emre; Armutlu, Ayşe; Meriçöz, Çisel Aydın; Alper, Emrah; Tellioğlu, Gürkan; Gürses, Bengi; Adsay, Nazmi Volkan; Other; Faculty Member; Doctor; Teaching Faculty; Teaching Faculty; Faculty Member; Faculty Member; Faculty Member; Faculty Member; School of Medicine; School of Medicine; N/A; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; Koç University Hospital; N/A; Koç University Hospital; N/A; N/A; N/A; N/A; N/A; N/A; 296729; 222921; N/A; 133567; 162418; 220444; 230736; 113169; 286248
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    Safety and feasibility of laparoscopic right or extended right hemi hepatectomy following modulation of the future liver remnant in patients with colorectal liver metastases: a systematic review
    (Mary Ann Liebert, Inc., 2023) Sijberden, Jasper P.; Abu Hilal, Mohammad; N/A; Bozkurt, Emre; Doctor; N/A; Koç University Hospital; N/A
    Background: major hepatectomies after future liver remnant (FLR) modulation are technically demanding procedures, especially when performed as minimally invasive surgery. The aim of this systematic review is to assess current evidence regarding the safety and feasibility of laparoscopic right or extended right hemihepatectomies after FLR modulation. Materials and Methods: the Medline, PubMed, Cochrane Library, and Embase databases were searched for studies involving laparoscopic right or extended right hemihepatectomies after FLR modulation, from their inception to December 2021. Two reviewers independently selected eligible articles and assessed their quality using the Newcastle-Ottawa Quality Assessment Scale (NOS). Baseline characteristics and outcomes were extracted from the included studies and summarized. Results: six studies were included. In these studies, the median length of stay after the second stage ranged from 4.5 to 15.5 days and postoperative complication rates between 4.5% and 42.8%. Overall, 7.4% of patients developed liver failure, and 90-day mortality occurred in 3.2% of patients. The R0 resection rate was 93.5%. Only one study reported long-term outcomes, describing comparable 3-year overall survival rates following laparoscopic and open surgery (80% versus 54%, P = .154). Conclusions: the current evidence is scarce, but it suggests that in experienced centers, laparoscopic right or extended right hemihepatectomy, following FLR modulation, is a safe and feasible procedure.
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    PublicationOpen Access
    What is the current role and what are the prospects of the robotic approach in liver surgery?
    (Multidisciplinary Digital Publishing Institute (MDPI), 2022) Sijberden, J.P.; Hilal, M.A.; Bozkurt, Emre; Koç University Hospital
    Robotic liver surgery is being applied with increasing frequency. Comparable, and in specific settings superior, perioperative outcomes compared to laparoscopic liver surgery have been reported. In its current form, the most commonly mentioned advantage of robotic surgery is improved dexterity. Important obstacles to its wider implementation in daily clinical practice are the associated costs, technical difficulties, and a scarce amount of evidence. Robotic liver surgery will likely continue to evolve in parallel with technological developments that enhance the robots' abilities. In parallel with the historical development of minimally invasive surgery, the laparoscopic and robotic approaches are now frequently utilized to perform major abdominal surgical procedures. Nevertheless, the role of the robotic approach in liver surgery is still controversial, and a standardized, safe technique has not been defined yet. This review aims to summarize the currently available evidence and prospects of robotic liver surgery. Minimally invasive liver surgery has been extensively associated with benefits, in terms of less blood loss, and lower complication rates, including liver-specific complications such as clinically relevant bile leakage and post hepatectomy liver failure, when compared to open liver surgery. Furthermore, comparable R0 resection rates to open liver surgery have been reported, thus, demonstrating the safety and oncological efficiency of the minimally invasive approach. However, whether robotic liver surgery has merits over laparoscopic liver surgery is still a matter of debate. In the current literature, robotic liver surgery has mainly been associated with non-inferior outcomes compared to laparoscopy, although it is suggested that the robotic approach has a shorter learning curve, lower conversion rates, and less intraoperative blood loss. Robotic surgical systems offer a more realistic image with integrated 3D systems. In addition, the improved dexterity offered by robotic surgical systems can lead to improved intra and postoperative outcomes. In the future, integrated and improved haptic feedback mechanisms, artificial intelligence, and the introduction of more liver-specific dissectors will likely be implemented, further enhancing the robots' abilities.
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    PublicationOpen Access
    Effects of the largest metastatic lymph node size on the outcomes of patients who underwent pancreaticoduodenectomy for pancreatic ductal adenocarcinoma
    (Kare Yayıncılık, 2022) Bilgiç, Çağrı; Bozkurt, Emre; Tüfekçi, Tutku; Sucu, Serkan; Özoran, Emre; Özata, İbrahim Halil; Kaya, Mesut; Tellioğlu, Gürkan; Bilge, Orhan; Researcher; Researcher; Teaching Faculty; Teaching Faculty; Faculty Member; Faculty Member; School of Medicine; Koç University Hospital; N/A; N/A; N/A; 307296; N/A; N/A; N/A; 176833
    Objectives: prognostic importance of metastatic lymph nodes in pancreatic cancer is always garnered attention due to dismal prognosis, with some quantitative factors drawing attention for significantly predicting outcomes. Size is one of the easy approach morphological characteristics of the lymph node, and data for effect of largest metastatic lymph node (LMLN) size on survival outcomes are lacking in pancreatic cancer. We aim to evaluate the effect of LMLN size on the prognosis of patients with pancreatic ductal adenocarcinoma (PDAC). Methods: this retrospective study evaluates the effect of LMLN size on survival outcomes by grouping the patients who were surgically treated for PDAC, according to their lymph node stage and calculated cutoff value for LMLN size, between February 2015 and May 2020. Results: in the study cohort of 131 patients, the mean age was 63.9 +/- 10.8 years and 77 patients were female. Ninety-nine of the pa-tients had pN1, 32 had pN2 stage disease. The optimal cutoff point of LMLN size for predicting the prognosis was calculated as 7.5 mm (sensitivity = 81% and specificity = 81%). 34 (34.3%) of pN1 and 7 (21.9%) of pN2-staged patients had lymph node smaller than 7.5 mm. Three-year survival was significantly longer for patients whose LMLN size was <7.5 mm (56.2-18.2%, p<0.001). Whereas, the patients with LMLN size <7.5 mm had statistically significant longer median survival rate in the subgroup of patients with pN1 lymph node stage, no significant difference in median survival rates was observed between subgroups of pN2 patients (p=0.237). Conclusion: the present study demonstrated that the LMLN size was one of the potential predictors of survival in patients with PDAC.
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    PublicationOpen Access
    The importance of a preoperative surgical strategy meeting for good patient outcomes
    (Pamukkale Üniversitesi, 2022) Ömeroğlu, Sinan; Tanal, Mert; Kaya, Cemal; Özoran, Emre; Bozkurt, Emre; Özata, İbrahim Halil; Teaching Faculty; School of Medicine; Koç University Hospital; 307296; N/A
    Purpose: interest in measures to surgical quality improvement is increasing with increased awareness of iatrogenic injuries. These injuries can be prevented by an improved organisational safety habit. We implemented preoperative surgical strategy meeting chart in the clinical and operational basis in our hospital to improve postoperative outcomes. This study was conducted as comparement of outcomes of patients with and without implementation of preoperative surgical strategy meeting forms. Material and methods: data including the demographic characteristics of patients, procedural data, and data of preoperative surgical strategy meeting were recorded retrospectively. Patients were divided into two groups according to the preoperative surgical strategy meeting chart application status. Group 1 included the patients with provided PSSM and group 2 included the remaining patients. Data related with surgical procedure and patients’ outcomes were compared between these groups. Results: one hundred and forty patients were enrolled in this study. The mean age of the patients was 45.28±17 years. The female to male ratio was 62:78. Patients were grouped according to the application status of PSSM. There was no statistically significant difference in the mean age, sex, operation type (emergent or elective) and conversion to open surgery rates. In Group 2 being ready of patient file in the operating theatre preoperatively was statistically significantly low when compared to Group 1 (p=0.021). Operation time was detected statistically significant short for patients in Group 1 (p<0.001). Conclusion: integrating this behavioural intervention into the clinical routine demonstrated the improvements in patient outcomes and adherence to the safety process. / Amaç: iyatrojenik yaralanmalar konusunda farkındalık arttıkça, cerrahi kalite gelişimi konusunda ilgi artmaktadır. Bu yaralanmalar artan organizasyonel güvenlik kültürü ile önlenebilmektedir. Hastanemizde, ameliyat sonrası sonuçlanımları geliştirmek için klinik ve ameliyathanede cerrahi strateji toplantısı şablonu oluşturulmuştur. Bu çalışmada ameliyat öncesi cerrahi strateji toplantısı şablonu uygulanan ve uygulanmayan hastaları karşılaştırmak için düzenlenmiştir. Gereç ve yöntem: hastaların demografik verileri, ameliyat verileri ve ameliyat öncesi cerrahi strateji toplantısı verileri retrospektif olarak toplandı. Hastalar ameliyat öncesi cerrahi strateji toplantısı şablonu (PSSM) uygulama durumuna göre iki gruba ayrıldı. Grup 1’deki PSSM’si olan hastaları, grup 2 diğer hastaları içermektedir. İki gruptaki cerrahi prosedürle ilgili veriler ve hastaların sonuçları karşılaştırılmıştır. Bulgular: çalışmaya 140 hasta dahil edilmiştir. Hastaların ortalama yaşı 45,28±17 idi. Çalışmaya katılan hastaların kadın erkek oranı 62:78 idi. Hastalar PSSM’nin uygulanma statüsüne göre gruplandılar. Ortanca yaş (p=0,966), cinsiyet (p=1), ameliyat tipi (acil veya elektif p=0,323) ve açık cerrahiye geçme oranları (p=0,295) arasında istatistiksel olarak farklılık saptanmadı. Grup 2’de hastaların dosyalarının ameliyathanede ameliyat öncesi hazır bulunma oranı Grup 1’e oranlar istatistiksel olarka anlamlı derecede düşüktü (p=0,021). Grup 1’deki hastaların ameliyat süreleri istatistiksel olarak anlamlı derecede kısaydı (p<0,001). Sonuç: bu davranışsal girişimin klinikte rutin olarak uygulanması hasta sonuçlarında iyileşme, güvenlik prosedürlerin uyumu arttırmaktadır.