Introduction: An anastomotic leak is a life-threatening complication after gastrectomy. A fully covered, self-expandable, metal stent (FC-SEMS) can be used as an alternative to traditional surgical re-intervention. However, stent migration can be worrisome.Aim: To evaluate the feasibility and effectiveness of anchoring of the distal flare of the FC-SEMS to the jejunum by using through-the-scope (TTS) endoclips to prevent stent migration.Material and methods: Patients, who received a FC-SEMS capable of being fixed to the jejunum by using TTS endoclips due to an anastomotic leak after gastrectomy, were reviewed retrospectively. Demographic and clinical characteristics, the properties of the deployed stents, and outcomes were evaluated.Results: A total of 7 patients underwent FC-SEMS placement. The mean age was 59 ±13.8 years, and the mean body mass index was 29.8 ±8.4 kg/m 2 . All patients' American Society of Anesthesiologists scores were between II and IV. The mean time between gastrectomy and stent insertion was 6.7 ±6.1 days. Technical success was achieved in all patients. Stent migration was not observed in any of the patients. All but one were removed between 4 and 6 weeks after placement. The mean stent removal time was 37 ±4.6 days. Complete resolution of the leak was achieved in 6 patients.Conclusions: Anchoring of the distal flare of the FC-SEMS to the jejunum with TTS endoclips is feasible and may reduce the risk of migration. This inexpensive and safe technique may be proposed to patients with factors predictive of FC-SEMS migration.

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Aim: To perform a retrospective evaluation of the morbidity and mortality rates and reliability of venous resection with pancreaticoduodenectomy (PD) procedures in our clinic. Material and Method: The records of 11 patients who underwent PD with venous resection between May 2016 and May 2021 in the Eskişehir Osmangazi University Faculty of Medicine Department of General Surgery were analyzed retrospectively. Results: Eleven patients (five women and six men) were included. The patients’ mean age was 64.09±9.27 years (range 47-78). Four (36.36%) patients underwent type 1 reconstruction, one (9.09%) type 2 reconstruction, five (45.45%) type 3 reconstruction and one (9.09%) type 4 reconstruction. Eight (72.73%) patients experienced venous invasion according to the histopathology reports. Mean time between diagnosis and surgery was 14.91±11.33 days, and the mean follow-up time was 17.64±13.31 months. Grade C pancreatic fistula was observed in one (9.09%) patient, who died on the 17th postoperative day. No patients experienced recurrence or metastasis during surveillance. Conclusion: Pancreaticoduodenectomy with venous resection-reconstruction is safe and the only curative option in patients with pancreatic cancer and venous invasion.

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Erkeklerde meme kanseri görülme sıklığı yaklaşık %1'in altında olup oldukça nadirdir. Kadınlardan farklı olarak yaşla birlikte görülme sıklığı artmaktadır. Erkeklerde meme karsinomunun klinikopatolojik özelliklerini, cerrahi ve rekonstrüktif tekniklerini, adjuvan tedavilerini ve klinik sonuçlarını değerlendirmeyi amaçladık GEREÇ VE YÖNTEM: Ocak 2010-ağustos 2020 tarihleri arasında Osmangazi Üniversitesi Genel Cerrahi Kliniğinde ve Yunus Emre Devlet Hastanesi Genel Cerrahi Bölümünde tedavi edilmiş meme kanseri hastaları retrospektif olarak incelendi. BULGULAR: 16 erkek meme kanseri olgusuna rastlandı. Hastaların klinik, patolojik, adjuvan tedavi, nüks ve sağ kalımlarına ait özellikler kayıt edildi. Ortanca yaş 62 idi. En sık prezentasyon şekli sağ memede retroareolar (%62) bölgede ele gelen kitleydi (%68). Hormon reseptör pozitif (%75-95) ve grade 2 (%62) yaygın görülen özellikti. Küratif cerrahi 15 hastaya yapıldı, 1 hasta metastatik olması nedeniyle palyatif tuvalet mastektomi yapıldı. En yaygın cerrahi işlem olarak modifiye radikal mastektomi (MRM) (%88) yapıldı. Bir hastaya muskülokütanöz flep ile rekonstrüksiyon yapıldı. Ortanca takip süresi 53 aydı. Takip süresince 3 hastada (%19) lokal nüks görülürken 6 hasta (%38) kaybedilmiştir. Bunlardan 4 hastanın (%25) kansere bağlı öldüğü kaydedildi. SONUÇ: Erkeklerde meme kanseri nadir görüldüğü, jinekomasti gibi benign hastalıklarla karışabildiği ve erkeklerde meme kanserinin görülmediği algısı yüzünden geç fark edilir. Bu nedenle de tanı konduğunda sıklıkla ileri evrede karşılaşılabilmekte, lokal nüks ve mortalite oranları daha yüksek gözlenmektedir. Bu durum, erkeklerin dikkatini çekmeyi ve bu hastalığın prevalansı ve risk faktörleri konusunda bilinçlenmeyi gerektirir.