Publications by authors named "Ipek Sapci"

Article Synopsis
  • The study aims to evaluate surgical techniques for treating rectovaginal fistulas in Crohn's disease patients, highlighting the effectiveness of operations in the context of new biological treatments.
  • Over a decade, 20 out of 80 patients who underwent surgery were examined, revealing a healing rate of 70%, with a common procedure being the transanal rectal advancement flap, which had an 85% success rate.
  • The findings suggest that rectovaginal fistulas are tough to treat, often requiring multiple surgeries, and indicate the potential benefit of considering perioperative diversion along with various surgical options for motivated patients.
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Background: 3D laparoscopy has been proposed with the aim of improving the depth perception and overall operative performance. To aim of this study is to compare 3D laparoscopy with conventional 2D laparoscopy in terms of operative time and visual parameters.

Methods: This is a prospective, randomized, single-center trial designed to determine 10% reduction in the mean operative time.

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Background: Advanced endoscopy can be used for the complete removal of large colorectal polyps. To date, few surgeons perform advanced endoscopy, and it is unknown how many procedures are needed to reach proficiency.

Objective: This study aimed to determine the learning curve for colorectal advanced endoscopy.

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Background: The surface morphology of colorectal polyps is well correlated with submucosal invasion in Eastern Countries but not in North America. We aimed to investigate associations between the Paris classification, surface morphology, and Kudo pit pattern to submucosal invasion in advanced endoscopic resection techniques.

Methods: We retrospectively analyzed prospectively collected data of consecutive advanced endoscopic procedures conducted by a single surgeon between August 2017 and October 2018.

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Objective: To investigate the predictors of postoperative mortality in coronavirus disease 2019 (COVID-19)-positive patients.

Background: COVID-19-positive patients have more postoperative complications. Studies investigating the risk factors for postoperative mortality in COVID-19-positive patients are limited.

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Background: Although endoscopic submucosal dissection provides higher en-bloc resection rates for larger colorectal lesions, it has not been widely adopted because of technical difficulties. Here we present our initial experience with a novel device facilitating endoluminal surgery.

Impact Of Innovation: The impact of innovation is the development of an endoluminal device increasing the utilization of the endoscopic submucosal dissection technique with higher success rates and lower complications.

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Background: Colorectal resections have relatively high rates of surgical site infections causing significant morbidity. Incisional negative pressure wound therapy was introduced to improve wound healing of closed surgical incisions and to prevent surgical site infections.

Objective: This randomized controlled trial aimed to investigate the effect of incisional NPWT on superficial surgical site infections in high-risk, open, reoperative colorectal surgery.

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Background: Flap-based reconstruction following abdominoperineal resection has been used to address the resultant soft tissue defect and reduce postoperative wound complications. Vertical rectus abdominis myocutaneous flaps have been the traditional choice, but locoregional flaps have attracted attention in minimally invasive resection because they avoid additional abdominal dissection. However, few data exist comparing flap types.

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Background: There exists conflicting data in the literature with regard to adequate adenoma detection rate (ADR) as well as other quality metrics during colonoscopy based on the time of day that the procedure is performed. The aim of this study was to investigate the effect of time of day on quality metrics in patients undergoing screening colonoscopy.

Methods: Screening colonoscopies performed between January 2010 and September 2018 by twenty-eight colorectal surgeons were queried from a prospectively maintained database.

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Background: Although the risk of colorectal cancer increases with advancing age, there remains a lack of guidelines for surveillance colonoscopy in the octogenarian and older population. Our objective is to document the diagnostic yield of surveillance colonoscopies, and to analyze adenoma characteristics, complications, and short-term survival in asymptomatic octogenarian and older patients undergoing adenoma surveillance colonoscopy.

Methods: Surveillance colonoscopies performed at a tertiary level hospital colorectal surgery department between January 2010 and September 2018 were queried from a prospectively maintained institutional colonoscopy database.

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Background: Perineal hernia is a well-known, rare complication following abdominoperineal resection for rectal cancer. Due to its rarity, the literature on its surgical repair is comprised of case reports and small case series, and not one surgical approach has been established as superior.

Objective: This study aimed to identify the repair methods used at our institution and their outcomes.

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Background: Colectomy for nonmalignant polyps (NMP) is common in the United States. We aimed to study the rate of colectomies performed for NMP and postoperative outcomes. We hypothesized that the annual colectomy rate for NMP is high despite the rare occurrence of invasive cancer found on final pathology.

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Background Or Purpose: Enteric Crohn's disease (CD) is characterized by transmural inflammation resulting in inflammatory, stricturing, or penetrating phenotypes. However, data regarding the relationship between stricturing and penetrating behavior is lacking. The incidence of penetrating CD in the absence of a stricture is unclear.

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Background: Surgical treatment of recurrent rectovaginal fistulas is notoriously difficult. Placement of the gracilis muscle between the vagina and anus is an advanced technique used to close persistent fistulas. We have utilized this procedure for recalcitrant fistulas and hypothesized that a gracilis interposition would offer a good treatment option for patients with refractory rectovaginal fistulas, regardless of underlying etiology.

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Background: Surgical intervention for Crohn's disease involving the colon is often a total proctocolectomy with end ileostomy. There are limited data regarding postoperative small bowel recurrence rates in the recent era.

Objective: The purpose of this study was to determine the rate of small bowel Crohn's disease recurrence following total proctocolectomy and secondarily define risk factors for disease recurrence.

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Background: Endoscopic submucosal dissection is an established advanced polypectomy technique to manage large colorectal polyps.

Objective: The purpose of this study was to evaluate patients who had endoscopic submucosal dissection in the setting of significant scarring attributed to a previous intervention to determine whether this is safe and feasible.

Design: The study used a prospectively maintained database.

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Background: The surgical management of large bowel obstruction (LBO) is heterogeneous and influenced by multiple variables. The aim of this study was to analyze and compare the surgical interventions and outcomes of patients necessitating surgery for LBO.

Methods: Patients with LBO between 2000 and 2017 were included.

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Advanced Colonic Polypectomy.

Surg Clin North Am

December 2020

Advanced colonic polypectomy techniques are endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD), and they aim at organ preservation with low complication rates. Main goal of endoscopic submucosal dissection (ESD) is to accomplish en-bloc resection that will subsequently allow accurate histopathological evaluation. It consists of injection, circumferential incision, and dissection of the lesion.

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Background: Performing colonoscopies is an integral component of colorectal surgery residency training. There exists a paucity of literature regarding colonoscopy quality metrics with colorectal trainee involvement.

Objective: This study aimed to investigate the effect of colorectal surgery resident participation on quality metrics in screening colonoscopy.

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