Person: GÜRLÜLER, ERCÜMENT
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GÜRLÜLER
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ERCÜMENT
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Publication High expression of SNGH16 is a candidate predictive marker of regional therapy resistance in hepatocellular carcinoma(Lippincott Williams & Wilkins, 2023-09-01) Aksoy, F.; Aksoy, S. Ak; Erçelik, M.; Tekin, C.; Tunca, B.; Gürlüler, E.; Kaya, E.; Aksoy, F.; AKSOY, SEÇİL; Erçelik, M.; Tekin, C.; TUNCA, BERRİN; GÜRLÜLER, ERCÜMENT; Kaya, E.; Tıp Fakültesi; 0000-0002-3760-9755 ; 0000-0003-0366-2424; 0000-0002-1619-6680; GNK-2142-2022; ADM-8457-2022; LRB-6135-2024; GDC-6329-2022; ABI-6078-2020; JQS-8451-2023; FDC-0395-2022Publication Effect of locoregional treatments in hepatocellular carcinoma: What are the pathologic/radiologic Milan Criteria?(Başkent Üniversitesi, 2023-10-01) Aksoy, Fuat; Dündar, Halit Ziya; Çelik, Fatih; Öngen, Gökhan; Nas, Ömer Fatih; Sağlam, Kutay; Gürlüler, Ercüment; Kıyıcı, Murat; Kaya, Ekrem; AKSOY, FUAT; DÜNDAR, HALİT ZİYA; ÇELİK, FATİH; ÖNGEN, GÖKHAN; NAS, ÖMER FATİH; SAĞLAM, KUTAY; GÜRLÜLER, ERCÜMENT; KIYICI, MURAT; KAYA, EKREM; Tıp Fakültesi; Organ Nakli Merkezi; 0000-0001-5808-9384; 0000-0003-2728-9521; HII-8895-2022; X-7425-2018; EWI-3634-2022; JYY-5340-2024; FQR-8472-2022; JJS-3965-2023; JSD-3843-2023; FHW-0015-2022; JSF-3184-2023Objectives: Milan criteria is the most commonly used criteria for patients with hepatocellular carcinoma awaiting liver transplant. The effects of locoregional therapy on downstaging or bridging before liver transplant on survival remain controversial. Considering that the tumor size may change with locoregional therapy and formalin fixation after explantation, we aimed to evaluate the effects of locoregional therapy on radiological and pathological Milan criteria and survival.Materials and Methods: Demographic data, etiology, preoperative alpha-fetoprotein value, Child-Pugh and Model for End-Stage Liver Disease-Na scores, status of being inside or outside of radiological Milan criteria, status of being inside or outside of Milan criteria in explant (pathological Milan criteria), and the locoregional therapy types and combinations were evaluated for their effects on inclusion in Milan criteria and survival.Results: During the study period, 396 patients underwent liver transplant at our center, with 97 because of cirrhosis and hepatocellular carcinoma. When we viewed patients according to preoperative radiologic evaluations, 67.9% were within Milan criteria and 32.1% were outside. When we viewed according to explant (pathological) evaluations, 80.7% of patients were within Milan criteria. Among 97 patients, 71 (73.2%) had locoregional therapy (22 [30.9%] for downstaging, 49 [69.0%] for bridging to transplant), and 12 patients (12.3%) were within Milan criteria on explant examination while outside of Milan criteria before LT. One-year, 3-year, and 5-year survival rates were 80.7%, 76.1%, and 71.6%, respectively. Conclusions: As a result of radiological evaluations, in patients who were outside of Milan criteria and underwent locoregional therapy, explant pathology within Milan criteria had a positive effect on survival; however, after locoregional therapy, there was no significant effect on survival in patients who were still outside of Milan criteria.Publication The use of Zuckerkandl's tubercle as an anatomical landmark in identifying recurrent laryngeal nerve and superior parathyroid gland during total thyroidectomy: A prospective single-surgeon study(Frontiers Media Sa, 2023-10-30) Gürlüler, Ercüment; GÜRLÜLER, ERCÜMENT; Tıp Fakültesi; Genel Cerrahi Ana Bilim Dalı; X-7425-2018Objective: To determine the incidence and characteristics of Zuckerkandl's tubercle (ZT), and its relationship with recurrent laryngeal nerve (RLN) and the superior parathyroid gland (SPG) in the setting of total thyroidectomy.Methods: A total of 421 patients (mean (min-max) age: 45.6 (18-78) years, 76.2% were females) who had total thyroidectomy were included in this prospective single-surgeon thyroidectomy series study. Patient demographics and thyroidectomy indications (benign and malignant) were recorded in each patient. The presence, grade and laterality of ZT, and its relationship with RLN and SPG were recorded during surgery.Results: Most of the thyroidectomy indications (69.1%) were related to a malignant disease. The ZT was unrecognizable in 41(9.7%) of 421 patients. In 380 patients with identifiable ZT, the grade 2 (46.3%) ZT was the most common finding. Majority of ZTs (92.9%) were unilaterally located (right-sided: 64.9%; left-sided: 35.1%). In majority of the cases (83.2%), the RLN was found to lie medial to ZT. Overall, SPG was identified in close proximity to ZT in 66.6% of patients (Class 2 [0.5-1 cm from ZT] in 46.6% and Class 3 [<0.5 cm from ZT] in 20.0%). SPG was more likely to be identified in close proximity to ZT when the grade of ZT was higher, which was found to be located 0.5-1 cm from the ZT in 56.9% and 42.7% of grade 2 and grade 3 ZTs, respectively, and <0.5 cm from the ZT in 46.1% of grade 3 ZTs.Conclusion: In conclusion, this prospective single-surgeon thyroidectomy series study indicates the likelihood of localizing the RLN medial to ZT, and the SPG in close proximity to ZT during total thyroidectomy operations. Hence, the ZT can be used as a reliable and constant landmark to localize both the RLN and the SPG during thyroid surgery, which enables minimizing the risk of iatrogenic injury to RLN, while ensuring a parathyroid-sparing thyroidectomy. The thyroid surgeon should have complete knowledge of thyroid gland anatomy and embryogenesis and should follow a careful and meticulous approach particularly for dissections around larger ZTs, given the increased likelihood of SPG and RLN to be in close proximity.Publication Evaluation of the trend of biochemical functions in the early period after cadaveric liver transplantation(Elsevier Science Inc, 2023-06-28) Aksoy, Fuat; Gürlüler, Ercüment; Çelik, Fatih; Şen, Murat; Balkan, Eyüp Anıl; Dündar, Halit Ziya; Kaya, Ekrem; AKSOY, FUAT; GÜRLÜLER, ERCÜMENT; ÇELİK, FATİH; ŞEN, MURAT; BALKAN, EYÜP ANIL; DÜNDAR, HALİT ZİYA; KAYA, EKREM; Tıp Fakültesi; Organ Nakli Merkezi; 0000-0001-5808-9384; 0000-0003-2728-9521; HII-8895-2022; X-7425-2018; AAG-7319-2021; JYY-5340-2024; JEX-7100-2023; IZR-9309-2023; EWI-3634-2022Background. Monitoring biochemical parameters to detect early complications after liver transplantation (LT) is important. Thus, we aimed to investigate parameter trends indicating liver function in patients who did not develop complications after cadaveric LT. Methods. A total of 266 cadaveric LT operations performed by a single center between 2007-2022 were included in the study. Patients with any early complications were excluded from the study. During the first 15 days, the parameters reflecting the patients' liver integrity and synthesis functions were evaluated. All parameters studied were evaluated at the same time of day and by a single laboratory. Results. Regarding synthesis functions, the coagulation parameters (prothrombin time and international normalized ratio) peaked on the first day and then decreased. Regarding tissue hypoxia, there was no significant change in lactate values. Total and direct bilirubin values also decreased after peaking on the first day. No significant change was observed in albumin, another liver synthesis value. Conclusions. Although an increase in aspartate aminotransferase, alanine aminotransferase, total and direct bilirubin, prothrombin time, and international normalized ratio, which was especially seen on the first day, is considered normal, values that do not decrease after the second day or lactate values that increase gradually should be a warning in terms of possible early complications.