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Öğe Anatomical Insights and Clinical Outcomes of the Interpectoral Pocket Technique for Exposed Cardiac Pacemaker Revision(Wolters Kluwer Medknow Publications, 2024) Akyurek, Mustafa; Cakir, Bahadir; Hafiz, GunesObjective: The objective of this study was to evaluate the effectiveness and safety of the interpectoral pocket technique in the management of exposed cardiac pacemakers, a complication increasingly observed with the rising use of cardiac implantable electronic devices (CIEDs). Materials and Methods: We conducted a retrospective study of 20 patients who underwent revision surgeries for exposed cardiac pacemakers using the interpectoral pocket technique. Data were collected regarding patient demographics, comorbidities, etiology of exposure, preoperative management, surgical procedure, postoperative care, and follow-up results. Results: The overall success rate of the interpectoral pocket technique was 95%. Out of the 20 patients, 3 patients (15%) experienced minor complications, while 1 patient (5%) required additional revision surgeries. No major complications or mortality were reported during the follow-up period. Conclusions: Our study indicates that the interpectoral pocket technique for exposed cardiac pacemaker management is effective and safe. It has the potential in reducing CIED-related complications, improving therapeutic strategies, and lessening the economic burden. However, larger prospective studies are needed to validate these findings.Öğe Complex Scalp and Calvarium Defects After Giant Basal Cell Carcinoma Excision: Management, Challanges, Outcomes(Lippincott Williams & Wilkins, 2018) Ozcan, Utku; Akyurek, Mustafa; Arslan, EmrahGiant basal cell carcinoma (GBCC) is defined as a tumor >= 5 cm in diameter. GBCC of scalp usually requires extended resection of soft tissues, calvarium, and dura. In this study, we present 5 patients with GBCC of head, who underwent a single-stage combined scalp, calvarium, and dural reconstruction. Herein, we aim to discuss reconstruction methods, cerebrospinal fluid (CSF) leakage, duration of hospital stay, and tumor recurrency. Peroperative and postoperative follow-ups, defect areas, and performed calvarium reconstruction methods of 5 patients, who underwent complex scalp and calvarium reconstruction after GBCC between year 2010 and 2017, were retrospectively maintained. We studied reconstruction methods, CSF leakage, duration of hospital stay, and tumor recurrency. All patients undergone single-stage reconstruction. Avarge duration of hospital stay was 15 days. Titanium mesh was used in 3 patients and methyl methacrylate was used in 2 patients for calvarium reconstruction. CSF leakage was seen in patients who underwent calvarium reconstruction with titanium mesh. Tumor recurrence occured next to calvarium in 1 patient who undergone calvarium reconstruction with methyl methacrylate. CSF leakage and duration of hospital stay may induce morbidity of this oncoplastic procedure. The fact of longer hospital stay of patients reconstructed with titanium mesh might be a new data presented in this study. These parameters can be related with the method of calvarium reconstruction.Öğe Does surgical treatment for complicated pilonidal cyst disease in the sacral region affect anal sphincter functions(Wolters Kluwer Medknow Publications, 2023) Akyurek, Mustafa; Benli, Caghan; Kaya, Mustafa; Surmeli, AliIntroduction: Pilonidal cyst disease is characterized by chronic abscess, discharge, and sinus openings. The anal sphincter functions of the patients, who previously undergone recurrent surgical treatment, were compared using a surgical approach. Patients were divided into two groups by whether perianal soft tissues were preserved in the surgery. Materials and Methods: Between 2014 and 2019, 21 male patients who had either undergone insufficient surgery or had complications with multiple sinus openings applied to our clinic. Excision and reconstruction of the patients were performed. The coccyx, dorsal part of sacrum, anococcygeal raphe, and ischiorectal fossa were additionally included in the excision for patients with biopsy reports of squamous cell carcinoma. All patients underwent rectoanal manometry to evaluate anal sphincter function. Preoperative, postoperative 5th week, and 6th-month anal manometry results were recorded and analyzed by the Shapiro - Wilk test and independent t-test. Results: The anal sphincter function regresses in the 5th week after the reconstruction and improves in the 6 month. The results of the independent t-test, which were used to compare the anal manometry results for each group, showed that the difference in the anal sphincter pressure of the two groups was statistically significant (P < 0.05). If the perianal soft tissues were excised, anal sphincter manometry shows poor results. Discussion: The anal sphincter function, which regresses in the 5th week after the reconstruction and improves in the 6 months, depends on the scar tissue occurring in the perianal connective tissue, while the softening caused by the maturation of the scar in the last phase of wound healing improves the function.Öğe Horizontal pillar technique: A single pedicle septum-based approach in reduction mammaplasty with a twist(Elsevier Sci Ltd, 2023) Akyurek, Mustafa; Hafiz, GunesBreast reduction surgery has proven to be a successful treatment for various conditions such as postural disorders, anxiety, dermatological problems, and body image disorders, and is tailored to accommodate each patient's needs and anatomical variations. The author presents a modified approach for reduction mammaplasty using a septum-based superomedial pedicled nipple-areola complex (NAC) flap combined with horizontal dermoglandular pillars. This adjustment enhances desired breast projection, potentially eliminating the need for alternative pedicles in most cases. The limitations and disadvantages of this new technique are discussed. Between July 2015 and July 2021, 85 patients underwent surgery using the horizontal pillar reduction mammaplasty. Clinical data obtained during follow-up visits were recorded. Patients were asked to answer the local version of the Breast-Q, version 2.0, reduction module postoperative scale questionnaire to evaluate breast shape contentment and patient satisfaction at the 1-year follow-up. Necrosis of the NAC was not observed in any patient. The most common complaints in the early postoperative period were pain along the inframammary fold and swelling that extended into the axillary region. The mean values and standard deviations of the postoperative Breast-Q scores were calculated. The postoperative satisfaction with breasts scale mean value was 84.11 +/- 12.86, and the postoperative satisfaction with outcomes scale mean value was 81.08 +/- 9.97. The horizontal pillar reduction mammaplasty technique is safe, reliable, and easy to perform in breast reduction. Although the initial findings are encouraging, future anatomical and clinical studies are necessary to fully explore this modified technique's functional limitations and long-term outcomes. (c) 2023 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.Öğe The effects of human amniotic membrane on silicone related capsule formation in rats(Taylor & Francis Ltd, 2020) Akyurek, Mustafa; Orhan, Erkan; Aydin, Mehmet Serif; Uysal, Omer; Karsidag, SemraSilicone breast implants are commonly used materials in plastic surgery for breast augmentation and reconstruction and the most severe complication of silicone implants are capsule contraction which occurs in 40% of patients. The aim of our study is to evaluate how the amniotic membrane alters the capsule formation effects of silicone 24 wistar rats were used in the study. We placed a bare silicone block into the left side (Subgroup A) and single layer amniotic membrane coated silicone block into the right side (Subgroup B) of the rats back. The rats were then separated into three groups and in group 1 rats were euthanized after 3 weeks, in group 2 after 12 weeks and in group 3 after 24 weeks. Then capsule thickness, fibroblast and lymphocyte cell counts were evaluated for each sample. In Group 2 and group 3, the capsule thickness in Subgroup B was detected to be statistically significantly lower than that in Subgroup A. In Group 1, 2, and 3, the lymphocyte count in the capsule tissue taken from Subgroup B was lower than Subgroup A but the difference was not statistically significant. In Group 2 and 3, the fibrocyte count detected in the capsule tissue in Subgroup B was found to be statistically significantly lower than Subgroup A. the amniotic membrane was demonstrated to reduce capsule thickness by the antifibrinolytic effect in our study.