Background: Red cell distribution width (RDW) is one of the standard parameters with blood cell counts. Much previous research has indicated that it increases in cases of systemic inflammation or cardiametabolic incident. However, information on the relation of RDW with solid tumors causing systemic inflammation is limited. In the present research, we examined the relation of RDW with malignant and benign lesions of the colon. Materials and Methods: 115 patients with colon polyps (group 1), and 30 with colon cancer (group 2) who were diagnosed histopathologically in our clinic between January 2010-January 2013 were scanned retrospectively. Patients with anemia, hematologic diseases and active inflammation were excluded. RDW, mean corpuscular volume (MCV), hemoglobin (Hgb) and platelet (Plt) measurements were recorded and their relations with the malignant and benign lesions of the colon were examined. Results: Both groups were similar in age and gender distribution. RDW values of patients with colon cancer were significantly higher than the patients with colon polyp (p=0,01). No significant differences were detected between the two groups in terms of MCV and Plt values (p>0,05). Conclusions: RDW can be used as an early warning biomarker for solid colon tumors. Further prospective research is required on the relations of cheap and easily measured RDW parameters with colon malignancies.
The lower rates of wound infection and recurrence associated with the Limberg flap reported elsewhere may be associated with healing of the tension-free procedure. In this study, tension-free primary closure was found to be as effective as the Limberg flap reconstruction.
Objective: Incisional hernia is a significant problem after laparotomy, and there is still no consensus on an ideal treatment method. The aim of this study was to compare the results of onlay and sublay mesh repair techniques. Material and Methods:In this randomized prospective trial, 100 patients were divided into two groups: onlay and sublay groups. Recurrences were evaluated by performing a physical examination. Results:The median follow-up was 37.1 (26.6 to 46.5) months. In the onlay group, the mean operation time was significantly shorter. However, in terms of postoperative pain and wound complications, the sublay group had significantly better results. The recurrence rates were found to be similar in both groups (6% in the onlay group and 2% in the sublay group). Conclusion:In the treatment of incisional hernia, sublay mesh repair is superior to onlay mesh repair in terms of postoperative pain and wound complications. Both techniques have similar recurrence rates. Keywords:Incisional hernia, mesh repair, onlay, sublay INTRODUCTIONIncisional hernia is a significant complication after laparotomy; its incidence ranges between 10% and 20% (1-4). This common problem can result in bowel strangulation, pain, and enterocutaneous fistula, and it affects the quality of life. The results of repair techniques vary widely. High recurrence rates have been reported for suture techniques, whereas mesh placement can reduce recurrence (5-10). In mesh repair, one of the most important problems is the placement of the mesh. Some techniques are reported to be associated with particularly high rates of some complications, such as recurrence, wound infection, and fistula (11,12). In the literature, several studies compare mesh and suture repair techniques, open and laparoscopic repair techniques, and mesh type as well as the plane in which the mesh should be placed. Currently, there is no consensus regarding the abdominal plane in which the mesh should be placed (13).The aim of this study was to compare the early and late results of onlay and sublay mesh repair techniques. , an American Society of Anesthesiologists score (ASA) of 4, or severe pulmonary or cardiac disease were not included. The remaining patients who agreed to be involved and signed the informed consent form were randomized into two groups: onlay group and sublay group. After the initial evaluation, 100 patients were included and were randomized to each group by the closed envelope method. The patients' demographic data, BMI, diameter of fascial defects, operation time (from first incision to dressing), visual analog scale (VAS) scores at the second and 24 th hours, length of hospital stay, drain takeoff time, postoperative complications, and recurrences were recorded. The fascial defect diameter was measured intraoperatively and is presented in cm 2 . All operations were performed according to the elective standard. There were no emergency operations. MATERIAL AND METHODS Operative TechniqueAll operations were performed under general anesthesia, and no antibioti...
MATERIAL AND METHODSAll patients who underwent LSG or LGP due to morbid obesity at Beyhekim Konya Hospital General Surgery Clinics by a single surgeon between the years 2009-2012 were retrospectively analyzed. Age, sex, and BMI on admission were evaluated. Preoperative levels of fasting blood glucose, aspartate aminotransferase (AST), alanine aminotransferase (ALT), triglycerides, cholesterol, and blood pressure were determined to investigate the presence of metabolic problems. The length of hospital stay was determined for both groups. All patients who underwent surgery were included. Objective: Various different surgical methods are used for obesity surgery. Among them, laparoscopic sleeve gastrectomy (LSG) and laparoscopic gastric plication (LGP) have been both successfully performed in recent years. In this study, we compared the treatment results of patients who underwent LGP, a method that was introduced later consisting of plication of gastric greater curvature to achieve volume reduction, with results of patients who underwent LSG. Material and Methods:We analyzed data on morbid obese patients who underwent bariatric surgery with either LSG or LPG in Konya Beyhekim Hospital between 2009 and 2012. Demographic features including age and sex, preoperative blood biochemistry, body mass index (BMI) before and after operation, duration of hospital stay, morbidity, mortality and complications were analyzed. Results:Fifty-five patients who were operated for obesity between 2009 and 2012 were included in the study. 29 patients underwent LGP, and 26 patients LSG. The BMI in the LGP and LSG groups was 41.4±3 kg/m 2 and 42.0±3.1 kg/m 2 , respectively. There was no significant difference between two groups in terms of BMI. Two groups were also similar in terms of age and gender. In the LGP group, one patient had postoperative necrosis of the suture line. One patient in the LSG group was re-operated due to bleeding. Another patient in this group had leakage at the suture line. Postoperative BMI assessment of groups revealed significantly lower BMI levels in the LSG group. Length of hospital stay was significantly shorter in the LGP group. There was no significant difference in complication rates between two groups. Conclusion:In this study, we obtained similar results in patients who were treated with LGP or LSG. Moreover, LSG was more efficient in decreasing BMI in morbid obesity surgery when compared to LGP. However, duration of hospital stay was significantly shorter in LGP group. We concluded that both methods could be effectively and safely used in the surgical management of morbid obesity.
Objective: Non-operative management of abdominal injuries has recently become more common. Especially nonoperative treatment of blunt abdominal trauma is gaining wide acceptance. In this study, the efficacy of nonoperative treatment in abdominal trauma (blunt penetrating) is discussed. Material and Methods:All patients who received treatment due to abdominal trauma from November 2008 to January 2013 were retrospectively analyzed. The demographic characteristics, type of injury, injured organ, type of treatment (operative vs. nonoperative) and mortality data were evaluated. Results:The study includes 115 patients treated for abdominal trauma in our department. The mechanism of trauma was stab wounds in 60%, blunt abdominal trauma in 23.5% and gunshot wounds in 16.5%. Forty-two patients (36.5%) were operated for hemodynamic instability and/or peritonitis on admission. The remaining 63.5% of patients (n=73) were treated nonoperatively, 10 of whom required laparotomy during follow-up. The remaining 63 patients were treated with non-operative management. The success rate for non-operative treatment was 86.3% and there was no difference in terms of the types of injuries. The mortality rate was 4.3% (n= 5) in the whole series, but there were no deaths among the patients who had received non-operative treatment. In the whole patient group 54.2% (n=63) were treated nonoperatively. Conclusion:Nonoperative treatment in abdominal trauma is safe and effective. Patients with clinical stability and normal physical examination findings can be treated nonoperatively with close monitoring.
The success rate for treating acute appendicitis medically is high, with antibiotic treatment being effective as the firstline therapy for many unselected patients. An increase in CRP levels to 80.8 mg/L and above seems to be a meaningful parameter for determining a lack of response to medical treatment.
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