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    Impact of the COVID-19 Pandemic on parathyroid adenoma surgery: a single-center comparative experience
    (Bmc, 2026) Ondes, Bahadir; Gokdere, Osman Gokhan
    Objective The COVID-19 pandemic profoundly disrupted healthcare delivery worldwide, leading to delays and uncertainties in the management of various endocrine disorders, including primary hyperparathyroidism. This study aimed to assess the impact of the pandemic on surgical outcomes by comparing the clinical, biochemical, and perioperative results of patients undergoing parathyroidectomy during and after the pandemic. Methods A retrospective review was conducted of patients who underwent surgery for primary hyperparathyroidism between March 2020-June 2021 (COVID period) and July 2022-December 2023 (post-COVID period). Demographic characteristics, clinical presentation, biochemical markers, radiological findings, operative time, length of hospital stay, and postoperative complications were analyzed. Results Operative times were significantly longer during the COVID period, whereas hospital stays were shorter. While overall biochemical control was achieved in the majority of patients, persistent postoperative hyperparathyroidism was significantly more frequent during the pandemic period. Conclusion Although the COVID-19 pandemic was associated with delayed presentation and increased perioperative challenges, parathyroidectomy remained an effective treatment option. However, higher rates of hypercalcemic crisis and persistent postoperative hyperparathyroidism highlight the clinical consequences of delayed surgical care during public health crises.
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    Incidental pathological findings in cholecystectomy: A single-center retrospective analysis
    (Bayrakol Medical Publisher, 2025) Gokdere, Osman Gokhan; Ondes, Bahadir
    Aim: Chronic cholecystitis and cholelithiasis are the most frequently encountered pathologies in cholecystectomy specimens; however, additional histopathological findings that are not clinically suspected may incidentally be detected. This study aimed to evaluate the frequency and distribution of incidental pathological findings in patients who underwent cholecystectomy at a single center. Materials and Methods: The data of 3,084 patients who underwent cholecystectomy at our institution between January 2021 and December 2024, and for whom pathology reports were available, were retrospectively analyzed. Histopathological diagnoses other than chronic cholecystitis, acute cholecystitis, and cholelithiasis were considered incidental findings. These findings were classified according to their types, and their proportions were calculated. Results: Incidental pathological findings were detected in 390 of 3,084 cases (12.65%). The most frequent incidental lesions were metaplasia (n=182, 46.6%), adenomyomatous hyperplasia (n=79, 20.3%), and cholesterol polyps (n=77, 19.7%). Less common findings included xanthogranulomatous cholecystitis (n = 23, 5.9%), dysplasia (n = 18, 4.6%), and adenocarcinoma (n = 11, 2.8%). Among the adenocarcinoma cases, 81.8% occurred in women, with a mean age of 67.2 years. Discussion: Incidental pathological findings are observed at a noteworthy frequency in cholecystectomy specimens. The presence of clinically significant lesions such as metaplasia, dysplasia, and adenocarcinoma underscores the importance of routine histopathological examination of all gallbladder specimens.
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    Prognostic value of the lymphocyte-to-monocyte ratio in predicting axillary lymph node metastasis in breast cancer
    (Bayrakol Medical Publisher, 2026) Ondes, Bahadir; Gokdere, Osman Gokhan
    Aim: Axillary lymph node metastasis is one of the most important parameters in determining the prognosis and therapeutic approach in patients with malignant breast disease. In recent years, systemic inflammatory markers have been shown to be associated with tumor biology and metastatic potential. The objective of this study was to investigate the relationship between the lymphocyte-to-monocyte ratio and axillary lymph node metastasis. Methods: A total of 140 patients who underwent surgery for malignant breast disease between 2021 and 2024 were retrospectively evaluated. Demographic data, type of surgical procedure, number of excised lymph nodes, presence of metastatic lymph nodes, and hematological parameters were reviewed. The lymphocyte-to-monocyte ratio was calculated by dividing the absolute lymphocyte count by the absolute monocyte count obtained from the preoperative complete blood count. Patients were categorized into two groups according to the presence or absence of axillary lymph node metastasis, and the lymphocyteto-monocyte ratio values were compared between the groups. Results: Axillary lymph node metastasis was detected in 62 patients (44.3%). The mean lymphocyte-to-monocyte ratio was 3.99 in the metastasis-positive group and 5.01 in the metastasis-negative group. Although the mean lymphocyte-to-monocyte ratio was lower in patients with nodal metastasis, this difference did not reach statistical significance according to the Mann-Whitney U test. Conclusion: In breast cancer patients, those with axillary lymph node metastasis tended to have lower lymphocyte-to-monocyte ratio values. However, this difference was not statistically significant. Larger cohorts and prospective studies are warranted to clarify the potential role of the lymphocyte-to-monocyte ratio as a predictor of axillary nodal involvement.
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    Relieving the pressure: the effect of active carbon dioxide aspiration on postoperative pain after laparoscopic cholecystectomy
    (Bmc, 2026) Gokdere, Osman Gokhan; Ondes, Bahadir; Aydin, Ahmet
    Background Residual carbon dioxide (CO2) after laparoscopic cholecystectomy (LC) may contribute to early postoperative pain. Active aspiration of CO2 has been proposed as a simple adjunct, but large cohort data remain limited. Methods This non-randomized prospective cohort study included 270 patients undergoing LC between May 2025 and October 2025. Patients were allocated to either the active aspiration group (n = 135) or the passive evacuation group (n = 135). Pain was evaluated using the Visual Analog Scale (VAS) at 4 and 24 h. Statistical analyses included chi-square tests, independent and paired t-tests, and Pearson correlation. A priori power analysis determined that 266 patients (133 per group) were required (effect size d = 0.40, alpha = 0.05, power = 0.90). Results The aspiration group had significantly lower pain scores at both 4 h (3.48 +/- 1.08 vs. 5.30 +/- 1.60; p < 0.001) and 24 h (1.69 +/- 0.94 vs. 3.59 +/- 1.38; p < 0.001). Active aspiration was associated with lower pain scores at both time points (p < 0.001). Conclusion Active evacuation of residual CO2 was associated with lower postoperative pain scores following LC. Given the non-randomized design, causal inference is limited, and the findings should be interpreted cautiously.