INTRODUCTION: During the Coronavirus Disease 2019 (COVID-19) pandemic, widespread vaccination efforts played a critical role in controlling the global health crisis, yet the long-term effects of these vaccines remain unclear. Helicobacter pylori (HP) infections, which can worsen under altered gastric mucosal defenses, pose significant challenges during this period. This study aims to explore the impact of COVID-19 vaccination history on HP eradication success, comparing outcomes between standard triple therapy (TT) and quadru-ple therapy (QT) with bismuth supplementation.
METHODS: 116 patients diagnosed with Helicobacter pylori via gastroscopic biopsies between January 2020 and December 2021 included. Patients were divided into two groups based on eradication therapy: standard TT and QT. Treatment regimens lasted two weeks, followed by six weeks of PPI use, and eradication was evaluated through stool antigen tests or control gastroscopy. Demographic data, comorbidities, COVID-19 history, vaccination status, and treatment side effects were recorded.
RESULTS: The treatment success rate was 81.5% in the TT group and 96% in the QT group (p=0.017). Non-smokers demonstrated significantly higher treatment success compared to smokers (71.4% vs. 31.3%; p=0.003). Similarly, patients with a history of COVID-19 infection had lower treatment response rates compared to those without (28.5% vs. 7.8%; p=0.017). Multivariate regression analysis identified receiving TT (OR: 5.547, p=0.033), smoking (OR: 5.226, p=0.019), and a history of COVID-19 infection (OR: 4.712, p=0.042) as independent risk factors for eradication failure.
DISCUSSION AND CONCLUSION: It was demonstrated that the types and doses of COVID-19 vaccines didn’t influence HP eradication outcomes. However, patients with a history of COVID-19 infection exhibited resistance to eradication treatments comparable to those who smoked or didn’t receive bismuth-based therapy. For patients with a history of COVID-19, the selection of eradication treatment should be determined in consideration of other risk factors.

INTRODUCTION: To evaluate the three types of hysterectomy performed at our clinic over the previous 10 years and to compare their operative outcomes.
METHODS: A total of 5,731 patients who underwent abdominal hysterectomy (AH, n=2,552), vaginal hysterectomy (VH, n=309), and laparoscopic hysterectomy (LH, n=2,870) procedures between January 2010 and December 2024 were included in the study. Age, body mass index, parity, uterine weight, operative time, blood loss, length of hospital stay, days of analgesia requirement, conversion rates from laparoscopy to laparotomy, surgical indications, additional surgical procedures, and major and minor intra- or postoperative complications were recorded and compared.
RESULTS: AH procedures predominated in 2015, although the rate of application decreased rapidly over the following two years. From 2017 onward, LH became the predominant method. Statistically significant differences were observed in terms of age (AH 51.14±3.72 vs. VH 57.12±5.32 vs. LH 56.26±5.84, respectively; p<0.05), operative time (76.91±14.41 vs. 73.03±12.35 vs. 85.02±19.27, respectively; p<0.05), blood loss (247.02±65.49 vs. 187.88±56.07 vs. 159.38±63.73; p<0.05), length of hospitalization (3.84±0.88 vs. 2.61±0.76 vs. 2.36±0.52; p<0.05), analgesia requirements (4.05±1.68 vs. 3.57±1.02 vs. 3.29±1.23; p<0.05), and uterine weight (251.84±86.48 vs. 128.76±52.79 vs. 204.30±71.67; p<0.05). No significant differences were detected between the groups in terms of major or minor intra- or postoperative complications.
DISCUSSION AND CONCLUSION: The study findings show that LH should be preferred by gynecologists as the primary type of hysterectomy due to its less invasive nature, faster postoperative recovery, and shorter hospital stay.

INTRODUCTION: This study aims to reveal the use and advantages of the laparoscopic protective drape mechanism, designed to prevent contamination in minimally invasive surgeries.
METHODS: The laparoscopic protective drape is formed by passing a surgical thread around the circular transparent polyurethane material. It prevents intra-abdominal contamination by laying on the operation area from the trocar; then, it is taken out of the abdomen by pulling the thread. The findings were evaluated by comparing two groups. According to G*Power (v3.1.7) analysis, a total of 60 laparoscopic cholecystectomy-appendectomy cases were examined. IBM SPSS Statistics 26 (IBM SPSS, Türkiye) was used. Significance was evaluated at the p<0.05 level.
RESULTS: The material was found useful in 76.67% (n=23) of the cases in which it was used. Preoperative and perioperative findings were similar (p>0.05). In the group in which the material was used, peristalsis was more frequent, drain usage was lower, and the hospital stay was shorter (p=0.001, p=0.001). The decrease in temperature and CRP, and an increase in CRP for those who didn’t use the material, were significant (p=0.001; p=0.013).
DISCUSSION AND CONCLUSION: The laparoscopic protective drape, designed to prevent contamination in minimally invasive surgeries, is expected to reduce intra-abdominal infectious complications, drain use, postoperative ileus, and shorten hospital stays. It is predicted that it will reduce outcomes such as tumor implantation.

INTRODUCTION: This study aims to evaluate the role of bronchoscopy in the donor lung assessment process and its impact on the availability of transplantable lungs.
METHODS: This single-center retrospective study includes potential lung donors presented to our clinic between January 2021 and December 2023. All donors underwent a comprehensive evaluation, including demographic data, thoracic measurements, chest imaging, and the PaO2/FiO2 ratio. Bronchoscopy was performed for donors deemed suitable for on-site evaluation, focusing on identifying airway secretions, foreign bodies, and signs of infection. Clinical and demographic data were analyzed, and reasons for rejection were documented.
RESULTS: A total of 109 donors were presented to our clinic, with 24 undergoing on-site evaluation. Among these, 19 were accepted for transplantation, while 5 were rejected. Common reasons for rejection included compromised lung function, such as insufficient oxygenation, infection, and radiological abnormalities such as pulmonary artery thrombosis and interstitial lung changes. Bronchoscopy identified crucial factors like purulent secretions and poor lung collapse, contributing significantly to the decision to reject certain donor lungs.
DISCUSSION AND CONCLUSION: This study highlights the importance of a comprehensive donor evaluation process, including the critical role of bronchoscopy in assessing donor lung suitability. Identifying infections and airway abnormalities through bronchoscopy can help prevent the transplantation of unsuitable organs, thus improving post-transplant outcomes. Optimizing donor selection criteria, including advanced imaging and bronchoscopy, could increase the availability of suitable organs for lung transplantation.

INTRODUCTION: Bronchoscopy in the Intensive Care Unit (ICU) is essential for managing respiratory failure, secretions, airway obstructions, and pulmonary infections. This study aimed to evaluate the indications, frequency, and clinical outcomes of bronchoscopy in the ICU.
METHODS: This retrospective study analyzed patients who underwent bronchoscopy in the ICU of Koþuyolu High Specialization Training and Research Hospital from January 1, 2022, to December 31, 2024. Data were obtained from the hospital’s automation system. Patients from the cardiology, cardiovascular surgery, chest surgery, and gastroenterology departments who underwent bronchoscopy were included. Pediatric ICU patients, non-ICU ward patients, and lung transplant recipients were excluded. A total of 258 procedures were analyzed. Data were analyzed using IBM SPSS 26, with Chi-square and Kruskal-Wallis tests. A p-value of < 0.05 was considered significant.
RESULTS: A total of 258 bronchoscopy procedures were performed on 162 patients (62.3% male, median age 60.4 years). The most common diagnoses were coronary artery bypass graft (CABG) (30.2%), non-surgical cardiovascular diseases (21.6%), and heart valve surgery (16.7%). The main indications for bronchoscopy were increased secretions (41.1%), atelectasis (25.9%), and hemoptysis (9.7%). Increased secretions (53.5%) were the most common finding, with 9.3% of procedures reported as normal. Of the patients, 62.8% required mechanical ventilation, and 7.4% received ECMO. Lavage for culture was performed in 63.4%, with microbial growth detected in 43%. Klebsiella pneumoniae was the most common microorganism.
DISCUSSION AND CONCLUSION: Our study confirms the safe use of bronchoscopy in patients with major cardiac surgery or advanced heart failure. Bronchoscopy is frequently used in the ICU for managing secretion accumulation and atelectasis. Bronchoalveolar lavage is crucial for identifying infectious agents like Klebsiella pneumoniae and Pseudomonas aeruginosa in specific patient groups.

INTRODUCTION: Chronic venous insufficiency (CVI) is a common vascular disorder significantly affecting patients’ quality of life. Radiofrequency ablation (RFA) has become a key treatment, offering minimally invasive options with faster recovery. The reverse Trendelenburg (RT) position is frequently used to enhance venous dilation, facilitating vascular access during the procedure. However, the optimal RT angle remains unclear, particularly regarding vascular access success and hemodynamic stability. This study evaluated the effects of 15° and 30° reverse Trendelenburg (RT) angles on venous dilation, vascular access success, and hemodynamic stability during radiofrequency ablation (RFA) of the great saphenous vein (GSV) under spinal anesthesia for chronic venous insufficiency (CVI). The aim was to balance improved venous access against the risk of hemodynamic complications.
METHODS: In this retrospective analysis, 521 patients undergoing RFA for GSV insufficiency were assigned to group A (15° RT, n=264) or group B (30° RT, n=257). The primary outcomes included changes in GSV diameter, incidence of hypotension, bradycardia, and vasoactive medication requirements. Secondary outcomes included the rate of complete vein closure, confirmed by duplex ultrasound 24 h post-procedure.
RESULTS: The 30° RT position led to a significantly larger increase in GSV diameter than the 15° position (24.5% vs. 16.0%, p=0.019). However, the 30° angle was also linked to a higher occurrence of hypotension (20.6% vs. 7.5%, p<0.001) and bradycardia (10.5% vs. 2.2%, p<0.001). No significant differences were observed between the groups regarding the secondary outcome of vein closure (p>0.05).
DISCUSSION AND CONCLUSION: Although a 30° RT angle enhanced venous dilation, it also increased the risk of hemodynamic instability. Tailoring patient positioning based on individual risk factors is essential for balancing venous access and procedural safety in RFA for CVI.

INTRODUCTION: Colorectal cancer (CRC) is the third most common cancer worldwide with early detection being crucial for improving survival rates. Systemic inflammatory biomarkers such as the neutrophil-to-lympho-cyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and mean platelet volume (MPV) have gained attention as potential diagnostic tools in CRC.
This study aimed to evaluate the diagnostic value of NLR, PLR, MPV, red blood cell distribution width (RDW), hemoglobin (HB), white blood cell (WBC), platelet (PLT) in CRC screening.
METHODS: A retrospective, single-center study was conducted on 1,090 patients who under-went colonoscopy between January 2020, and January 2024. Patients were categorized into malignant, premalignant, and control groups. Hematological parameters including NLR, PLR, MPV, RDW, hemoglobin (HB), white blood cell (WBC), platelet (PLT) counts were analyzed. ROC curve analysis was performed to determine diagnostic cut-off values sensitivity, and specificity.
RESULTS: NLR and PLR values were significantly higher in the malignant and premalignant groups compared to the control group (p<0.001). NLR demonstrated the highest diagnostic performance, with an AUC of 0.629, sensitivity of 50.56%, and specificity of 73.13%. PLR had lower diagnostic accuracy (AUC: 0.579, sensitivity: 40.42%, specificity: 37.04%). MPV was significantly elevated in the premalignant group but lacked strong diagnostic value due to its susceptibility to systemic diseases. RDW levels were significantly elevated in both the malignant and premalignant groups but were not sufficient as standalone diagnostic markers.
DISCUSSION AND CONCLUSION: NLR emerged as the most reliable biomarker for CRC screening, while PLR demonstrated weaker diagnostic accuracy. MPV showed limited value in CRC diagnosis, and RDW, despite its statistical significance, was influenced by other systemic factors, limiting its diagnostic utility.

INTRODUCTION: Anastomotic leakage remains a significant complication in rectal cancer surgery. Perirenal Fat Distance (PrFD), an anthropometric measure correlated with visceral fat, has been shown to impact outcomes in various laparoscopic procedures. However, its relationship with anastomotic leakage in laparoscopic rectal cancer surgery has not been well established.
METHODS: This retrospective study included patients who underwent Laparoscopic Low Anterior Resection with Loop Ileostomy for rectal cancer between December 2022 and December 2024. PrFD was measured from preoperative contrast-enhanced CT scans, and anastomotic leakage was classified using the International Study Group of Rectal Cancer (ISREC) criteria. ROC curves were generated to determine the optimal cutoff values for PrFD. Multivariate Cox regression analysis used for determining indipendent prognostic factors for anastomosis leak.
RESULTS: PrFD was found to be significantly associated with anastomotic leakage in laparoscopic rectal cancer surgeries. ROC analysis demonstrated that a PrFD cutoff of 22.35 mm had good sensitivity (72.7%) and specificity (70.0%), with an AUC of 0.815 (p=0.002). Patients with shorter PrFD had a higher incidence of hypoalbuminemia (59.1% vs. 30.0%; p=0.050) and perineural invasion (41.9% vs. 0.0%; p<0.001). Univariate analysis identified PrFD>22.35 mm as a significant risk factor for anastomotic leakage (OR: 6.222; p=0.016).
DISCUSSION AND CONCLUSION: PrFD has been identified as an independent risk factor for anastomotic leakage. Its role in anastomotic leakage development in rectal cancer could be further established through prospective studies with larger cohorts, potentially leading to its widespread clinical use.