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Öğe Burnout Among General Surgeons in Turkey(2021) Yeşilbağ, Emrah; Cakcak, İbrahim Ethem; Sağıroğlu, TamerAim: Burnout is a syndrome that is very common among surgeons. It is defined by emotional exhaustion (EE), depersonalization (DP), and decreased personal success. This study aimed to investigate burnout in general surgeons in Turkey and to determine the risk factors for burnout. Method: Of the total of 4,395 general surgeons in Turkey, 630 were included in this study. Each participant was asked to complete the Sociodemographic Data Form, Maslach Burnout Inventory, and Minnesota Satisfaction Questionnaire (MSQ) either by face-to-face interview or via electronic questionnaire. Results: Of the 630 participants included in this study, 53 (8.4%) and 577 (91.6%) was female and male, respectively. The highest participation rate was from the Marmara region (36%), while the lowest participation rate was from the Eastern Anatolia region (3.13%). Attending physicians comprised the largest number of participants (72%). Those who perceived themselves as successful, with more work experience and higher academic Mtitles, had decreased EE, personal accomplishment, and DP as well as increased general, external, and internal satisfaction. Conclusion: We observed that most of the general surgeons in Turkey experienced burnout syndrome. To address this, we suggest that health systems and working conditions in Turkey should be reviewed and that the working standards and rights of the healthcare workers should be revised.Öğe Comparison of The Number and Results of Colonoscopy Before and After The Covid 19 Pandemic(2022) Cakcak, İbrahim Ethem; Ermeydan, Meltem; Türkmen, İrem; Göktaş, Şeymanur; Altürk, LeylaObjective We aimed to investigate the effects of COVID 19 on colonoscopy and to investigate what should be considered in the following possible epidemic situations Material and Methods In our study, patients who applied to Trakya University School of Medicine and performed colonoscopy between March 2019 and March 2021 were evaluated, retrospectively Percentages, standard deviation, mean, median, and interquartile range were used as the descriptive statistics Mann Whitney U test was used for the variations which are contrary to the normal distribution range in the comparison of two groups The relations between qualitative variations were studied by the Pearson Chi Square test and Fisher's Exact test The significant value was determined as 0 05 for statistical analyses Results In our study, when we compared the pre Covid and post Covid periods, we observed that the median age did not change The number of patients decreased by 63 3 performing rectosigmoidoscopy ( increased by 8 and patients presenting symptomatic decreased by 8 5 The rates of malignancies detected after COVID 19 increased statistically significantly The mean age of the patients with malignancy was 62 8 and with normal result was 54 5 ( 0 001 In the post Covid period the rate of malignant diagnosis in patients with a previous history of malignant surgery has increased compared to those without a history of surgery ( 0 042 Conclusion In such epidemic periods patients may hesitate to apply to the hospital which may cause the progression of their disease More educated patients and planned health services will enable us to achieve much more efficient resultsÖğe Covid-19: A Retrospective Study About The Challenges for ERCP(2022) Cakcak, İbrahim Ethem; Kayabaş, Merve Yaren; Cansız, Sıla Nur; Yılmaz, Mustafa Numan; Albayrak, DoğanINTRODUCTION: We aimed to investigate the effects of Covid-19 on Endoscopic retrograde cholangiopancreatography (ERCP) and to investigate what should be considered in the next possible epidemic situations. METHODS: In our study, patients who applied to Trakya University School of Medicine, Department of General Surgery for ERCP (Endoscopic retrograde cholangiopancreatography) between March 2019 and March 2021 were evaluated, retrospectively. Percentages, mean, standard deviation, median and interquartile range were used as the descriptive statistics. Mann-Whitney U test was used for the variants which are contrary to the normal distribution range in the comparison of two groups. The relations between qualitative variants were studied by the Pearson Chi-Square test and Fisher’s Exact Chi-Square test. Significant value was determined as 0.05 for all statistical analyses. RESULTS: Prior to COVID-19, ERCP indications were in the order of stone (90.1%), stent removal (8%) and tumor (1.1%), while in the period of COVID-19, the ranking changed to stone (73.8%), tumor (13.7%), and stent removal (12.4%).. The diagnostic use of ERCP has been greatly reduced (from 0.7% to 0.0%). No perforation was detected in both periods, there was no bleeding, but a small increase (4.7% to 5.9%) was found in pancreatitis in the COVID-19 period. In the pre-COVID-19 period, stones were detected in 46.2% of the patients and all of them were successfully removed, but during the COVID-19 period, stones were detected in 50.6% of the patients and the stones could not be removed in 1.3% of the patients. DISCUSSION AND CONCLUSION: It was observed that the number of ERCPs decreased due to the delay in admissions to the hospital and the fear of coming to the hospital during the Covid-19 epidemic period, and the number of malignancies diagnosed with ERCP increased in this process. In such epidemic periods, more scheduled health services will provide better results for both patients and health personnel.Öğe Effect of COVID-19 pandemic on surgical treatment of inguinal hernia: A retrospective study in a single center(2022) Cakcak, İbrahim Ethem; Kaptan, MertAim: In this study, we aimed to examine the effect of the COVID 19 pandemic on the number, complication rates and epidemic characteristics of patients operated with the diagnosis of inguinal hernia in our institute. Methods: We analyzed all patients who underwent inguinal hernia operation in Trakya University Faculty of Medicine, Dept of General Surgery, between March 11, 2019, and March 11, 2020, and compared them with the cases between March 11, 2020, and March 11, 2021, retrospectively. Percentages, mean, standard deviation, median and interquartile range were used as the descriptive statistics. Mann-Whitney U test was used for the variations which are contrary to the normal distribution range in the comparison of two groups. The relations between qualitative variations were studied by the Pearson Chi-Square test and Fisher's Exact test. Significant value was determined as 0.05 for all statistical analyses. Results: Between March 11, 2019, and 2020, 65 patients were operated on (Group 1), and 26 patients between March 11, 2020, and 2021 (Group 2). The percentage of female patients was significantly higher in Group 2 (4.6% in Group 1, 23.1% in Group 2, p=0.008) and there was a statistically significant increase in the rate of incarceration and strangulation in Group 2 (44.6% in Group 1, 84.6% in Group 2, p=0.001). Conclusions: During the COVID-19 pandemic the incarceration and strangulation rate was higher. The increase in complication rates can be attributed to the relative decrease in elective surgeries or the increase in the number of female patients admitted during the COVID period.Öğe The Effects of NT and Adjuvant Treatments on Anastomotic Leakage in Rectal Cancer(2021) Asratova, Nigara; Cakcak, İbrahim Ethem; Coşkun, İrfanAim: Anastomosis leakage (AL) is a major complication following colorectal surgery. The present study aims to investigate the effects of adjuvant (AT) and neoadjuvant (NT) treatments on AL in surgical patients with rectal cancer. Method: The study followed 319 patients (age >18 years) who were diagnosed with rectal cancer and underwent surgery with AT or NT treatment between January 1, 2010 and December 31, 2018. We evaluated demographic data, tumor stage, metastasis status, organ and lymph node involvement, surgery type, use of AT and NT, the presence of AL, mortality status, and serum carcinoembryonic antigen levels. Results: A total of 179 (56.1%) patients were male, 140 (43.9%) were female (mean age =58.6±13.2 years). In terms of additional treatment, 48.6% (n=155) received AT and 51.4% (n=164) received NT. Data revealed that 13.1% (n=42) of the patients received only radiotherapy (RT), 10.6% (n=34) received only chemotherapy (CT), and 76.2% (n=243) received both RT and CT (CRT). Additionally, 23.5% (n=75) of the patients had AL. In terms of AL frequency, we found no difference between the patients receiving AT or NT (p=0.758). Additionally, RT and CT had no effect on the development of AL (p=0.827 and p=0.1, respectively). Finally, mortality was not higher in patients with AL. Conclusion: In terms of AL development, we found no differences between patients receiving NT or AT and those using RT or CT alone or together. We recommend that these rectal cancer treatments should be continued because of their better local control, overall survival rate, and sphincter function preservation rates.Öğe Inflammatory markers in the prognosis of gastric cancer(2022) Cakcak, İbrahim Ethem; Aytin, Yusuf Emre; Koçyiğit, Beliz; Kayabaş, Merve Yaren; Cansız, Sıla NurWe aimed to investigate whether these parameters can determine the prognosis of gastric cancer. In our study, patients who applied to Trakya University School of Medicine, Department of General Surgery for surgical treatment with a diagnosis of gastric cancer between January 2015 and March 2021 were evaluated, retrospectively. In this study, we have 219 consecutive gastric cancer patients who applied for surgical treatment between January 2015 and March 2021. There are 156 (71.2%) male patients and 63 (28.7%) female patients. The mean age is 65.6±11.2. 158 (72%) of our patients were over the age of 60. When each TNM stage was compared with each other, a statistically significant difference was found in the NLR, PLR, PNI, SIRI, and SII parameters. There was a statistically significant difference between the GPS when we compare the early stage and the advanced stage cancer. In our study, we showed that high SIRI, SII, NLR, PLR, and GPS as inflammatory and nutritional markers and low PNI value may be negative predictive factors for prognosis in gastric cancer patients.Öğe What Are the Challenges for Gastroscopy During COVID-19 Pandemic?(2022) Cakcak, İbrahim Ethem; Ermeydan, Meltem; Altürk, Leyla; Türkmen, İremObjective: We aimed to evaluate and investigate the effects of the pandemic on gastroscopy, including indications, the procedure performed, and diagnoses made as a result of the procedure. Methods: In our retrospective study, patients who came to Trakya University Hospital to have a gastroscopy between March 2019 and March 2021 were evaluated, retrospectively. Percentages, mean, median, and quartiles were used as descriptive statistics. Mann–Whitney U test was used for the variations which are contrary to the normal distribution range in the comparison of the 2 groups. The Pearson Chi-Square and Fisher’s Exact test studied the relations between qualitative variations. The significant value was determined as .05 for all statistical analyses. Results: In our study, there were 109 patients during COVID-19 period and 268 patients during the pre-COVID-19 period. The mean age was 55.5 for the pre-COVID and 56.6 for the COVID period. The rate of patients who underwent percutaneous endoscopic gastrostomy during pre-COVID was 14.17% and during COVID period, it was 19%. The rate of re-admissions to the hospital with malignant pathology of patients who had previously been operated on for malignant reasons was 5.26% during Pre-COVID and 11.81% during COVID period (P < .001). Conclusions: During the COVID-19 period, we observed that patients applied late because they were afraid of coming to the hospital even if they had symptoms. More scheduled health services will provide better results for both patients and health personnel in such epidemic periods.
