Burak Giray

• Gynecological Oncology Surgery Specialist at Koc University

Shoulder Injury Related to Vaccine Administration (SIRVA) is a complication caused by improperly administered vaccinations. It triggers an inflammatory cascade that damages shoulder structures, resulting in prolonged shoulder pain and restricted range of motion. Common diagnoses in SIRVA patients include shoulder bursitis (all classified as subacro...

Introduction Endometriosis is one of the most common reproductive disorders affecting women. The pathophysiology of endometriosis is also quite complicated, and many mechanisms have been put forward. Pentraxin-3 is a glycoprotein released by leukocyte and myeloid dendritic cells in peripheral blood with the stimulation of some cytokines, especially...

Sentinel lymph node (SLN) mapping has changed the way of lymph node assessment and provided a minimal invasive option that lessens the negative effects of a full lymphadenectomy, has become a crucial tool in the treatment of endometrial cancer. Chronic lymphocytic leukemia (CLL) and endometrial cancer diagnosis at the same is a rare condition. This...

Objective: In this study, maternal and neonatal outcomes of pregnant women with positive severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) RNA tests were evaluated according to their symptomatic status. The clinical progression of SARS-CoV-2-positive pregnant women and the effect of coronavirus disease-2019 (COVID-19) on newborns was in...

Introduction/Background Background Secondary cytoreductive surgery is associated with improved overall survival and provides survival benefits in patients with recurrent endometrial carcinoma. This video aims to present metastasectomy along with the infrarenal vena cava, right nephrectomy, segmental small bowel resection, partial right psoas resect...

Introduction/Background Sentinel lymph node (SLN) procedures have emerged as a potential avenue for reducing surgical morbidity in ovarian cancer without compromising oncological outcomes. The primary objective is to assess the SLN technique, and associated outcomes, with a focus on minimizing surgical morbidity without compromising oncological eff...

Background. Adolescent pregnant women have significant risk factors in terms of preterm birth, low birth weight, gestational and neonatal complications, and neonatal and infant deaths. In many countries, living as a refugee differs from living as a local citizen regarding education level, access to health services, and lifestyle. We aimed to compar...

Introduction/Background The usage of cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (HIPEC) for advanced gynecological cancers is increasing. HIPEC has been widely investigated in patients with peritoneal carcinomatosis, including those with epithelial ovarian cancer. We aimed to evaluate the effects of re-HIPEC in pa...

Introduction/Background High-Grade Serous Ovarian Cancer (HGSOC) is the most dominant subtype of Epithelial Ovarian Cancer (EOC). Cytoreductive surgery and platinum-based chemotherapy are main treatment modalities for HGSOC. However, 25% of patients develop resistance within 6 months. Although poly (ADP-ribose) polymerase (PARP) inhibitors can be u...

Introduction/Background Ovarian cancer has the highest mortality rate among gynecologic malignant tumors. Data are lacking on the survival benefit of hyperthermic intraperitoneal chemotherapy (HIPEC) in women with ovarian cancer who underwent primary or interval cytoreductive surgery. We aimed to assess the clinical benefit of HIPEC after primary o...

Introduction/Background Population-based screening that starts at the age of 30 and ends at the age of 65 is applied, and HPV DNA screening is not recommended under the age of 30 in our country. For this reason, in this study, we analyze our patients aged 25–30 years who underwent colposcopy in detail and discuss the possible benefits of HPV screen...

BACKGROUND: The CovidSurg-Cancer Consortium aimed to explore the impact of COVID-19 in surgical patients and services for solid cancers at the start of the pandemic. The CovidSurg-Gynecologic Oncology Cancer subgroup was particularly concerned about the magnitude of adverse outcomes caused by the disrupted surgical gynecologic cancer care during th...

Female genital system carcinosarcomas are rare gynecologic diseases that most commonly involve the corpus uteri. It can also be seen in the ovaries, fallopian tubes and vagina. 1 Carcinosarcomas are histologically classified according to malignant epithelial and stromal components. The mesenchymal component is called homologous or heterologous. The...

Background: Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods: This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published i...

Objective. Human papillomavirus (HPV) infection is a risk factor for cervical carcinoma. Over 100 types of HPV have been identified. The excisional procedures are recommended for women with high-grade cervical intraepithelial neoplasia. Surgical margin status is an important predictor of the risk of relapse. The aim of the current study was to eval...

Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index...

Objectives Lymph node assessment provides information that may influence decisions regarding adjuvant treatment in endometrial cancer patients. However, systematic lymphadenectomy may cause significant morbidity. In recent years, the use of sentinel lymph node (SLN) mapping with indocyanine green (ICG) has been accepted to avoid the morbidity of ly...

Background: Patients with a biopsy-confirmed cervical intraepithelial neoplasia 2 and 3 have an increased risk of disease progression to invasive cancer and should be treated with an excisional method. However, after treatment with an excisional method, a high-grade residual lesion may remain in patients with positive surgical margins. We aimed to...

Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index...

Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index...

Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index...

Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index...

Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index...

Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index...

Background: The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel inde...

Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index...

Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index...

Introduction/Background Cervical cancer is the third most common gynecologic cancer in women worldwide and human papillomavirus (HPV) infection is the primary risk factor for cervical neoplasms. The recurrence rates of cervical cancer are 11% to 22% and 28% to 64% for those with Federation of Gynecology and Obstetrics (FIGO) stage IB-IIA and IIB-IV...

Introduction/Background Endometrial cancer is one of the common malignant tumors of the female reproductive system. The recurrence and 5-year overall survival rates of patients with FIGO I-II are 2–15 and 74–91%, respectively. Secondary cytoreductive surgery is associated with improved overall survival in patients with recurrent disease. This video...

Objective: The present study aims to evaluate the oncological and obstetric outcomes after fertility-sparing treatment in patients with endomet-rial atypical hyperplasia (AH), endometrioid intraepithelial neoplasia (EIN), and endometrioid adenocarcinoma (EC). Materials and Methods: We retrospectively analyzed the records of patients with AH/EIN and...

Epithelial ovarian serous cancer arising in endometrioma is an uncommon phenomenon. Here, we present a case of postmenopausal ovarian high-grade serous carcinoma associated with ovarian endometrioma. A 64-year-old woman attended the clinic with pelvic pain and persistent vaginal discharge. Ultrasonography revealed an endometrial thickness and 37*23...

Amaç: Jinekolojik onkoloji bölümüne sevk edilen adneksiyal kitlesi olan gebeleri değerlendirmeyi amaçladık. Gereç ve Yöntemler: Jinekolojik onkoloji bölümüne Kasım 2016 ve Haziran 2019 tarihleri arasında sevk edilen şüpheli adneksial kitlesi olan gebelerin demografik özelliklerini, gebelik yaşını, ultrasonografik ve manyetik rezonans görüntüleme bu...

Background This study aimed to determine the impact of pulmonary complications on death after surgery both before and during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. Methods This was a patient-level, comparative analysis of two, international prospective cohort studies: one before the pandemic (January–October 201...

Objective: Some patients may regret after tubal sterilization. In such cases, tubal reanastomosis can be performed by surgical methods. The aim of the study is to describe a new technique in tubal reanastomosis and to report the pregnancy results after this technique. Methods: Twenty-eight patients who underwent tubal reanastomosis with a new metho...

SARS-CoV-2 has been associated with an increased rate of venous thromboembolism in critically ill patients.Since surgical patients are already at higher risk of venous thromboembolism than general populations, thisstudy aimed to determine if patients with peri-operative or prior SARS-CoV-2 were at further increased risk ofvenous thromboembolism. We...

Our goal was to address the safety of major gynaecologic cancer surgery without routine preoperative COVID-19 testing in the COVID-19 era. The databases of seven gynaecologic cancer centres were searched in order to identify all consecutive gynaecologic cancer patients undergoing major surgery between March 11, 2020 and May 15, 2020 for this retros...

Background Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction.

Background Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction.

Background: Glandular cell abnormalities may indicate the presence of pre-malignant or malignant lesions. Aim: This study aimed to investigate the relationship between atypical glandular cells (AGC) and patients' demographics, histopathological outcomes, Human Papillomavirus (HPV) test results. Material and methods: Between January 2015 and De...

Background: Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction. Methods: This internati...

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which pati...

Introduction: The new type of coronavirus could cause severe acute respiratory syndrome and injuries in other systems as well. Multiple organ damage can occur rapidly in patients infected with COVID-19. Previous studies have shown that many laboratory biomarkers were not within the normal ranges in COVID-19 patients. We aimed to summarize laborato...

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling.

Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection.

Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Su...

Background: Surgical services are preparing to scale up in areas affected by COVID-19. This study aimed to evaluate the association be- tween preoperative SARS-CoV-2 testing and postoperative pulmonary complications in patients undergoing elective cancer surgery. Methods: This international cohort study included adult patients undergoing elective s...

Background: Human papillomavirus (HPV) is a primary risk factor for cervical cancer. HPV 16 and 18 are the two most carcinogenic genotypes and have been reported in the majority of cervical cancer. High-risk HPVs (hrHPVs) other than HPV 16/18 cause approximately a quarter of cervical cancers. We aimed to present the colposcopy-guided biopsy result...

Background We aimed to assess the feasibility and short‐term clinical outcomes of surgical procedures for cancer at an institution using a coronavirus disease 2019 (COVID‐19)‐free surgical pathway during the peak phase of the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) pandemic. Materials and Methods This was a single‐center study...

Amaç: Tersiyer bir merkeze kolposkopik inceleme için refere edilen hastaların Human Papillomavirus (HPV) hakkındaki bilgilerini ve HPV aşısına yaklaşımını değerlendirmeyi amaçladık. Gereç ve yöntem: 01.12.2018 ile 01.05.2019 tarihleri arasında üçüncü basamak sağlık kuruluşunda kolposkopik inceleme yapılan 197 HPV pozitif hasta çalışmaya dahil edild...

Objective: Implantation failure is a multifactorial problem of reproductive medicine. However, the mechanism of this process is still not fully understood. There is increasing evidence that these cases of recurrent implantation failure might have an immunologic background. Uterine natural killer (NK) cells provide immune-modulation at the interfac...

Background Surgical services are preparing to scale up in areas affected by COVID-19. This study aimed to evaluate the association between preoperative SARS-CoV-2 testing and postoperative pulmonary complications in patients undergoing elective cancer surgery. Methods This international cohort study included adult patients undergoing elective surge...

Objective: We aimed to analyze the colposcopy-guided biopsy results in women aged 21-24 years with clinical suspicion for cervical lesion and/or cytological abnormality. Methods: This was a retrospective cohort study conducted on 461 patients undergoing colposcopic examination and biopsy between the ages of 21-24. The colposcopy-guided biopsy resul...

Background: We aimed to present the biopsy results of women with HPV 16/18 infection and investigate whether cytology is necessary as a part of routine cervical cancer screening in women with HPV 16/18. Methods: This is a retrospective cohort study conducted on 1647 patients between the ages of 30 and 65 years with HPV 16/18 undergoing colposcopy-...

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathw...

Introduction We aimed to analyze the preliminary experience of a mini-plus percutaneous instrument (MpPc) setting in total laparoscopic hysterectomy (TLH). Material and methods Forty-three women who underwent a mini-plus percutaneous total laparoscopic hysterectomy at a tertiary-care university-based teaching hospital and academic affiliated priva...

Abstract Objective: Hyperthermic intraperitoneal chemotherapy (HIPEC) is an emerging treatment modality for patients with epithelial ovarian cancer (EOC) following maximal cytoreductive surgery (CRS). This study aims to evaluate the development of hypomagnesemia without elevated serum creatinine levels in patients with EOC who underwent CRS-HIPEC....

Aim: To compare the plasma N-terminal pro-C-type natriuretic peptide concentrations of normotensive pregnant women, patients with mild preeclampsia, and patients with severe preeclampsia. Methods: We collected venous blood samples from 25 normotensive pregnant women, 15 patients with mild preeclampsia, and 15 patients with severe preeclampsia. T...

Purpose: We aimed to investigate whether systematic pelvic and paraaortic lymph node dissection delivers any survival advantage in a subgroup of patients with type II endometrial carcinoma and carcinosarcoma. Methods: We evaluated 135 patients with clinically early-stage (Stage I-II) type II endometrial carcinoma and carcinosarcoma who underwent...

Fertility-sparing surgery has a popularity in the last three decades for the management of cervical cancer in women under 40 years of age. Radical trachelectomy is a fertility‐sparing surgical technique for women who wish to retain their fertility. Vaginal-assisted laparoscopic radical trachelectomy is feasible in selected patients with early cervi...

Objective: To investigate whether testing positive for human papilloma virus (HPV) in cervical screening has an impact on female sexual functioning. Materials and methods: This study was designed as a single-center, prospective, descriptive-cross-sectional study and 300 women who received HPV testing in our hospital [HPV-positive (n=187) or HPV-...

Introduction/Background Ovarian cancer is the leading cause of death among gynecological malignancies. Primary cytoreduction for ovarian cancer is associated with significantly improved survival. We aimed to present a primary extended cytoreduction performed in this video. Methodology A 37 years-old woman was admitted with abdominal swelling and p...

Introduction/Background To evaluate the rate of combined Pap smear and human papillomavirus test positivity after cervical excisional procedures. Methodology This retrospective study included data of 452 patients who undergone cervical cold knife conization or loop electrosurgical excision procedure (LEEP) and post-cone follow-up co-testing. Age,...

Introduction/Background To investigate the factors related to incomplete excision procedure in abnormal cervical cytology among the different levels of surgical education. Methodology From the medical records, data were collected from patients with abnormal cervical cytology and/or positive HPV test who have underwent colposcopic biopsy and requir...

Introduction/Background Targeted to find the correlation between HPV types and surgical margin positivity in patients exposed the excisional procedure for treatment of precancerous cervical pathologies. Methodology We investigated retrospectively 453 patients who recommended Loop Electrosurgical Excision Procedure (LEEP) or Cold Knife Conization (...

Introduction/Background Ovarian cancer is the leading cause of death among gynecological malignancies. Even if a complete cytoreduction is achieved at the time of first surgery, about 60–70% of advanced stage patients develop a recurrence. Secondary cytoreductive surgery is associated with improved overall survival in patients with recurrent ovaria...

Introduction/Background To investigate CA-125 levels in uterine papillary serous carcinoma (UPSC) patients. Methodology From January 2015 to December 2018, we collected data of UPSC and preoperative CA-125 levels of patients. Subsequent parameters were evaluated; age, preoperative endometrial sampling results, tumor size, lymph node involvement, L...

Introduction/Background Drain placement remains controversial and there has been nearly no prospective studies evaluating the effectiveness on the gynecologic oncology cases. While some surgeons put on drains most of the cases after surgery, the literature search on general surgery and gynecologic cases suggest that the benefits are questionable. T...

Introduction/Background Although studies on performance in cancer patients are increasing, there has not been enough efforts to validate the Eastern Cooperative Oncology Group Performance Status (ECOG-PS). Therefore, we aimed to translate and validate the ECOG into Turkish. Methodology This was done by drawing on the original version and by employ...

Introduction/Background The aim of our study was to determine whether endocervical glandular involvement after excisional procedures is related to the depth of the removed conization material. Methodology Between April 2016 and December 2019, patients who underwent colposcopy and excisional procedures in the department of gynecologic oncology were...

We aimed to report a detection failure of sentinel lymph node (SLN) mapping via indocyanine green in a patient with endometrial cancer with a previous history of chronic lymphocytic leukemia (CLL), which is a potential risk factor to obstruct lymphatic channels. A 64‐year‐old woman with a 12‐year history of CLL presented to the clinic with grade 2...

The aim of this study was to investigate whether patients with CIN 2/3 with different amount of distance to negative cone biopsy margin differ in terms of post-conization follow-up results. Cold-knife cone specimens with a negative surgical margin with a diagnosis of CIN-2/3 were selected. The minimum distance between the margin and lesion was cate...

Objective: The aim of the study was to compare the safety of the laparoscopic and open method for endometrial cancer staging.Methods: Between January 2015 and August 2017, we reviewed 121 women with endometrial cancer treated by open (n=81) or laparoscopic (n=40) approach, retrospectively. Two groups were compared in terms of operating times, intra...

Amaç: Ultrasonografide gözlenen minör belirteçlerin artmış anöploidi riskiyle ilişkili olduğu düşünülmektedir. Çalışmamızda ikinci düzey ultrasonografi sırasında saptanan minör belirteç izlenmiş olguların prenatal ve postnatal dönemde yapılan takiplerinin sonuçlarının değerlendirilmesi amaçlanmıştır. Gereç ve yöntemler: Zeynep Kamil Kadın ve Çocuk...

Objective: The present study examined the progression of fetal pyelectasis detected in patients during antenatal period and its relationship to postnatal urinary tract pathology. Methods: Medical records of 10 patients in whom isolated fetal pyelectasis (defined as an-teroposterior [AP] diameter of renal pelvis of 5 mm or greater in the second trim...

Introduction We aimed to compare the presence and the amount of nerve fibers in endometrial, myometrial and leiomyoma tissues using protein gene product 9.5 (PGP 9.5) and neurofilament (NF) immunohistochemical staining in uterine leiomyoma patients with and without pain complaint. Methods Patients undergoing hysterectomy for uterine leiomyoma were...

Differentiated thyroid cancer is the second-most frequent tumor among those tumors diagnosed during pregnancy after breast cancer; it also is the most common endocrine malignancy. Pregnancy-associated cancer was defined as a malignancy detected during pregnancy or within 2 years of delivery, but most of the patients with pregnancy-associated cancer...

Objective: To investigate Wnt1-inducible signaling pathway protein-1 (WISP1) levels and their correlation with metabolic parameters in pregnant women with gestational diabetes mellitus (GDM) and non-GDM healthy pregnant women. Materials and methods: In this prospective cross-sectional study, the study group was composed of 62 women with GDM and...