Faculty of Medicine

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Author: search.filters.author.Ulusoy, CemalHas files: Yes

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    Protective ileostomy in rectal cancer surgery - is it really temporary?
    (2023-03-27)
    Ulusoy, Cemal
    ;
    Duman, Mehmet Güray
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    Güçlü Mete, Sıla
    ;
    Demirel, Ali İlbey
    ;
    Aim: This single-center retrospective study aimed to evaluate the rate of protective ileostomy closure in patients with rectosigmoid junction/rectal cancer and to investigate the factors that prevent ileostomy reversal. Material and Method: Patients with rectal cancer treated with/without neoadjuvant chemoradiotherapy were included in this study. All were treated with anterior rectal resection and temporary protective ileostomy creation. Decision for ileostomy closure was brought upon predefined ileostomy closure protocol. Results: Total number of 115 patients (17 with rectosigmoid junction and 98 with rectal cancer) were operated. Neoadjuvant chemoradiotherapy was conducted in 90 of them. Ileostomy closure rate was 73.9%. Mean time for stoma closure in patients with chemoradiotherapy conduction was 227.8 days, while in the rest, time was shorter (168.3 days), without statistical difference. Multivariate analysis revealed that endoscopic examination of the anastomosis during its creation was independent prognostic factor that affected ileostomy closure. Conclusion: More than one quarter of the patients with protective ileostomy experienced non-closure of their stoma due to various events after index rectal cancer surgery. Endoscopic examination of the anastomosis during its creation presented as independent factor affecting ileostomy closure.
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    Analysis of Survival in Complete Pathological Response after Long-Course Chemoradiotherapy in Patients with Advanced Rectal Cancer
    (MDPI AG, 2023-01-12)
    Ulusoy, Cemal
    ;
    Kamalı, Gülçin Harman
    ;
    <jats:p>Background: Neoadjuvant chemoradiotherapy prior to surgery is the standard treatment for locally advanced rectal cancer. This consists in the patient’s complete pathological response being achieved with no residual tumor presence in the resected specimen, which results in survival improvement. Methods: This retrospective study aimed to examine the rate of complete pathological response in patients with advanced rectal cancer treated with neoadjuvant long-course chemoradiotherapy and to examine the survival differences between the different tumor regression grade (TRG) scores. Results: A total of 154 patients were operated prior to long-course chemoradiotherapy with a total of 50 Gy plus FOLFOX protocol. Complete pathologic response was achieved in 29 (18.8%) patients. There was no statistical difference for the different pathologic responses according to gender, type of surgery, and number of harvested lymph nodes. Mean survival for all the groups was 37.2 months. Survival within a different TRG score exhibited statistical significance (p = 0.006). Overall, the survival rate during the follow-up period was of 81.8%. Conclusions: The complete pathological response rate in this study was of 18.8%. High tumor regression grade scores (TRG0 and TRG1) had a survival rate of over 90% during follow-up. Multivariate analysis identified perineural invasion and tumor regression grade as independent factors that affect survival.</jats:p>