Person: TAŞAR, PINAR
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TAŞAR
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PINAR
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Publication Do morphologic characteristics play a role in nodal metastatic progression of well-differentiated pancreatic neuroendocrine tumors?(Sage Publications Ltd, 2020-07-24) Hasdemir, Seçil; HASDEMİR, SEÇİL; Ugraş, Nesrin; UĞRAŞ, NESRİN; Yerci, Omer; YERCİ, ÖMER; Tasar, Pınar; TAŞAR, PINAR; Dundar, Halit Ziya; DÜNDAR, HALİT ZİYA; Macunluoğlu, Aslı Ceren; Bursa Uludağ Üniversitesi/Tıp Fakültesi/ Genel Cerrahi Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/ Bioistatistik Anabilim Dalı.; 0000-0003-1769-7484; 0000-0002-6802-5998; AAH-2716-2021Background: Pancreatic neuroendocrine neoplasms (NENs) are tumors with histopathologic and prognostic heterogeneity that pose difficulties in establishing standards for diagnosis, classification, and treatment. Among NENs, well-differentiated neuroendocrine tumors (NETs) have been classified as grade 1, 2, and 3 in the most recently released World Health Organization classification. Although well-differentiated NETs are associated with relatively better prognosis, they have a potential for malignant behavior such as extrapancreatic spread, metastasis, or recurrence. The present study aimed to evaluate clinical and histomorphologic findings of patients with well-differentiated pancreatic NETs and to identify histopathologic findings effective in predicting nodal metastatic progression. Methods: The study group consisted of 54 patients diagnosed with well-differentiated NET. All preparations and blocks of the patients were examined for the following histopathologic parameters: tumor diameter, microscopic tumor growth pattern (solid, trabecular, acinar, and mixed), cellular features (clear, eosinophilic, oncocytic, peliotic, and pseudopapillary), stromal changes (calcification, lymphocytic infiltration, and stromal hyalinization), presence of necrosis, perineural invasion, lymphovascular invasion, mitotic activity, and Ki67 proliferative index. Results: Lymph node metastasis was present in 7 patients. Lymph node metastasis was significantly associated with tumor diameter of >2 cm (p= 0.012), Ki67 proliferative index of >20% (p= 0.022), grade 3 tumors (p= 0.002), presence of dense stromal hyalinization (p= 0.034), and mild lymphocytic infiltration (p= 0.041). Conclusion: The present study revealed that the new findings such as presence of dense stromal hyalinization and absence of remarkable lymphocytic infiltration could be predictive morphologic findings for the development of lymph node metastasis.Publication Cancer stem cell markers in pancreatic ductal adenocarcinoma(Oxford Univ Press, 2018-10-01) Aksoy, Fuat; Kaya, Ekrem; Egeli, Ünal; Dündar, Halit Ziya; Taşar, Pınar; Aksoy, Seçil; Özen, Yılmaz; Tunca, Berrin; Çeçener, Gülşah; Yerci, Ömer; AKSOY, FUAT; KAYA, EKREM; EGELİ, ÜNAL; DÜNDAR, HALİT ZİYA; TAŞAR, PINAR; AKSOY, SEÇİL; ÖZEN, YILMAZ; TUNCA, BERRİN; ÇEÇENER, GÜLŞAH; YERCİ, ÖMER; 0000-0002-9562-4195; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Genel Cerrahi Bölümü; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Biyoloji Bölümü; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Bölümü; 0000-0001-5808-9384; 0000-0001-7904-883X; 0000-0002-1619-6680; 0000-0002-3820-424X; 0000-0002-3820-424X; AAH-1420-2021; AAH-3847-2021; ADM-8457-2022; HII-8895-2022; ABI-6078-2020; AAG-7319-2021; EWI-3634-2022; IIC-9825-2023; FOQ-1792-2022; AAP-9988-2020Publication Early results of conservative and surgical approach in endoscopic retrograde cholangiopancreatography (ERCP) perforations single center experience(Edizioni Luigi Pozzi, 2023-07-01) Taşar, Pınar; Kılıçturgay, Sadık Ayhan; TAŞAR, PINAR; KILIÇTURGAY, SADIK AYHAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Genel Cerrahi Bölümü; IIC-9825-2023; IDN-9824-2023Early results of conservative and surgical approach in Endoscopic Retrograde Cholangiopancreatography INTRODUCTION: Endoscopic retrograde cholangiopancreatography (ERCP) +/- endoscopic sphincterotomy, and after perforation (ERCP-P), which is a common method used for the diagnosis in the past and treatment today in hepatopancreatobiliary cases, is a rare complication with high mortality. While surgery has been at the forefront in perforations after ERCP in previous years, conservative treatment is widely accepted today, except for some special conditions. The aim of this study was to determine the incidence of ERCP-P in a hepatobiliary center, the outcome of the treatment modalities applied, and the risk factors for mortality due to perforations. MATERIALS AND METHODS: Patients hospitalized in our clinic with the diagnosis of ERCP-P were retrospectively analyzed. Age, gender, ERCP indication, method of treatment applied, time between ERCP-P diagnosis and treatment, injury class, length of stay (LOS) and early results of the patients were examined. RESULTS: 45 patients were hospitalized in our clinic upon the development of ERCP-P between the years of 2006 and 2022. 37 of these patients underwent conservative and 8 patients underwent surgical treatment. When the perforation types were examined, Stapfer Type 1 was found in 4 patients, Type II in 6 patients, Type III in 3 patients and Type IV ERCP-P in 32 patients (71.1%). LOS was longer in the surgical group than in the conservative treatment group (p=0.040). Mortality was observed in 15.56% of patients. 57.1% of these patients were in the surgical group. In the multivariate analysis, the time between diagnosis and treatment of ERCP-P, which is the only factor affecting mortality, was found. The risk of death was found to be 30.61 times higher in patients with a time elapsed between ERCP-P diagnosis and treatment exceeding 24 hours compared to patients with a time elapsed <= 24 hours (p=0.030). DISCUSSION: In our study, it was observed that the prognosis of the patients in the surgical group was poor and the length of stay was significantly longer. At the same time, the only effective factor on mortality is the time between ERCPP diagnosis and treatment.Publication Portal vein injury following endoscopic retrograde cholangiopancreatography: A case report(Turkish Assoc Trauma Emergency Surgery, 2023-03-01) Taşar, Pınar; TAŞAR, PINAR; Kılıçturgay, Sadık Ayhan; KILIÇTURGAY, SADIK AYHAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Genel Cerrahi Anabilim Dalı.Endoscopic retrograde cholangiopancreatography (ERCP) has been a widely used procedure in the diagnosis and treatment of various pancreaticobiliary disorders. Although widely considered a safe procedure, ERCP is associated morbidity and occasional mortality. The most common complications include acute pancreatitis, hemorrhage, and duodenal perforation. Portal vein cannulation is a rare complication of ERCP. We described a case of placement of an endoscopic biliary stent in the portal vein during ERCP and sphinc-terotomy. A 54-year-old female patient underwent laparoscopic cholecystectomy with a pre-diagnosis of chronic cholecystitis with gallstones. She visited emergency unit with the complaint of jaundice and itching on the 4th post-operative day. On the magnetic res-onance cholangiopancreatography, the intrahepatic and the extrahepatic bile ducts were dilated and a 7.5x5.5 mm stone at common bile duct. Sphincterotomy was performed by ERCP, the stones were removed, and then a 10F 7 cm stent was installed. Abdominopelvic computed tomography (CT) was performed on the 4th day of ERCP in the patient whose fever and total bilirubin levels persisted at 5 mg/dL, considering cholangitic abscess and/or ERCP complication. On the CT, the proximal end of the stent in the common bile duct was observed to enter into the main portal vein and the tip was observed to be thrombosed. Therefore, it was decided to remove the stent endoscopically under operating room conditions. After the anesthesia induction, the stent was endoscopically removed by the gastroenterology team. The abdominal cavity of patient was explored laparoscopically in the during of stent removal. The patient did not experience hemodynamic instability and did not require transfusion during anesthesia but had melena once on the clinical follow-up. The patient was discharged with low molecular weight heparin and oral cephalosporin and was advised to return for polyclinic control. Doppler ultrasonography (USG) was performed to evaluate the thrombosis of the portal vein in the patient who had intermittent fever during the controls. Doppler USG revealed a thrombosed appearance in the main portal vein and its branches. The patient, who was in good general condition and had no abdominal pain, was switched to high-dose low molecular weight heparin and followed under the control of the gastroenterology and general surgery outpatient clinic. This rare life-threatening complication should always be kept in mind especially during the procedure and/or in the clinical follow-up of the patient.Publication What has changed in the last 20 years in the postoperative specimen findings of the papillary thyroid cancer cases? A retrospective analysis(Turkish Surgical Assoc, 2022-12-01) Bakar, Burak; Taşar, Pınar; Kırdak, Türkay; Kılıçturgay, Sadık; BAKAR, BURAK; TAŞAR, PINAR; Kırdak, Türkay; KILIÇTURGAY, SADIK AYHANObjective: In this study, it was aimed to investigate the changes in surgical approaches and histopathological evaluation of the tumor according to years of patients who were operated on with the diagnosis of thyroid papillary cancer (PTC) in our center in the last 20 years.Material and Methods: The records of the cases who underwent thyroidectomy in our department were divided into four groups of five years each and analyzed retrospectively. Demographic characteristics, surgical procedures, presence of chronic lymphocytic thyroiditis, histopathological features of tumour and hospital stay of the cases in the groups were evaluated. Based on tumor size, PTCs were classified into five subgroups. PTCs of 10 (mm) or less were accepted as papillary thyroid microcarcinoma (PTMC).Results: There was a significant increase in PTC and multifocal tumors in the groups over the years (p<0.001). There was a significant increase between the groups in the presence of chronic lymphocytic thyroiditis (p<0.001). In contrast, the total number of metastatic lymph nodes (p=0.486) and the largest metastatic lymph node size were similar between the groups (p> 0.999). In our study, it was observed that there was a significant increase over the years in both the total/near-total thyroidectomy cases and the number of cases with a postoperative hospital stay of one day (p<0.001).Conclusion: In the present study, it was found that papillary cancer sizes decreased gradually and the frequency of papillary microcarcinoma increased gradually in last 20 years. Also, a significant increase was detected in the rates of total/near-total thyroidectomy and lateral neck dissection over the years.