Amyand's hernia is a very rare condition with a presence of a vermiform appendix in an inguinal hernia sac. It is estimated to be found in approximately 1% of adult inguinal hernia. In this study, we report a retrospective analysis of 30 patients aged between 19 days and 8 years with an Amyand's hernia operated in our institution from 1998 to 2009, and we reviewed the literature on the topic. Hernia repair without an appendectomy was performed in patients with normal appendix. Emergency appendectomy through herniotomy was performed in cases of inflamed and perforated appendices.
ÖZET Amaç: Apendiks, eskiden karsinoid tümör olarak adlandırılan nöroendokrin tümörlerin (NET) en sık görüldüğü yerlerden biridir. Çoğunlukla semptomsuz olup apendektomi veya diğer abdominal ameliyatlar sonrasında insidental olarak saptanır. Bu çalışmada akut apandisit ön tanısı ile apendektomi uygulanan hastaların patoloji sonuçları incelenerek NET saptanan hastalar değerlendirildi. Yöntem: Ocak 2015 -Aralık 2016 tarihleri arasında hastanemizde akut apandisit ön tanısı ile opere edilen 586 hastanın dosyası ve apendektomi piyeslerine ait patoloji sonuçları retrospektif olarak incelendi. Hastaların yaş, cinsiyet ve histopatolojik tanıları ile apendiks NET olarak rapor edilen olguların makroskopik tümör bulgu durumu, tümör yeri, tümör boyutu, cerrahi sınır, Ki 67 indeksi, mitotik indeks ve sonraki tedavileri değerlendirildi. Bulgular: Hastaların 365' i erkek 228' i kadın olup, yaş ortalaması 28.2 (1-88) idi. Üç hastada (% 0.5) iyi diferansiye NET saptandı. Bu üç hastaya ait spesmenlerde akut apandisit tespit edilmedi. Hastaların yaşları 15, 35 ve 48 idi. Tümör boyutları 0.4, 0.6 ve 1.2 cm idi. Tüm olgularda tümör distal yerleşimli idi. Cerrahi sınır iki hastada negatif bir hastada pozitif idi. Her üç hastada Ki 67 proliferasyon indeksi % 2' den az ve mitotik indeks <2/10 Hpf idi. Cerrahi sınır pozitif olan hastaya ameliyat sonrası 1. ay sağ hemikolektomi yapıldı. Diğer iki hasta takip önerilerek taburcu edildi. Tartışma ve sonuç: Apendiks NET' lere histopatoloji öncesinde tanı koymak oldukca zordur. Yaşam beklentisi iyi olmakla birlikte senkron veya metakron kolorektal malignite gelişme olasılığı unutulmamalıdır. Anahtar Kelimeler: Apendiks nöroendokrin tümörü, apendektomi, insidental. ABSTRACT Introduction:The appendix is one of the common sites of neuroendocrine tumor (NET) which was formerly called as carcinoid tumor. It is mostly asymptomatic and incidentally detected after appendectomy or other abdominal operations. In this study, pathology results of patients which underwent operation for acute appendicitis and diagnosed as NET were evaluated. Methods: The files and pathology results of 586 patients which were operated for acute apandicitis in Recep Tayyip Erdoğan University Educational and Research Hospital between January 2015 and December 2016 were evalıuated retrospectively. The age, gender, histopathological diagnosis of the patients and the macroscopic tumor findings, tumor site, tumor size, surgical margin, Ki 67 index, mitotic index and subsequent treatments of the cases that was reported as appendicitis were evaluated. Results: 365 of the patients were male and 228 female. The mean age was 28.2 (1-88). Well differentiated NET was detected in three patients (0.5%). Acute appendicitis was not detected in the specimens of these three patients. The ages of the patients were 15, 35 and 48 years. Tumor sizes were 0.4, 0.6 and 1.2 cm. In all cases, the tumor was on distal site. The surgical margin was negative in two patients and positive in one patient. Ki 67 proliferation index was < 2% and mitotic index...
Amaç: Apendiksin neoplastik lezyonları oldukça nadir görülen ve çoğunluğu apendektomi esnasında insidental olarak saptanan lezyonlardır. Bu çalışmada kliniğimizde opere edilen ve apendiks musinöz tümör (ApMT) tanısı konulan olguların klinikopatolojik olarak incelenerek uygulanan tedavilerin literatür eşliğinde değerlendirilmesi amaçlandı. Yöntem: Ocak 2011-Aralık 2016 tarihleri arasında kliniğimizde opere edilen ve ApMT tanısı konulan hasta dosyası ve apendektomi piyeslerine ait sonuçlar retrospektif olarak incelendi. Hastaların yaş, cinsiyet, klinik bulgular, tanı yöntemleri, histopatolojik tanı ve sonraki tedavileri değerlendirildi. Bulgular: Hastaların 6'sı erkek, 4'ü kadın olup yaş ortalaması 48,6 (28-85 aralığında) idi. Dokuz hasta akut batın bulguları ile ve 1 hasta elektif olarak opere edilmiş idi. Tanısal yöntem olarak 4 hastada ultrasonografi ve 6 hastada bilgisayarlı tomografi uygulanmış idi. Patolojik değerlendirmede 8 hastada basit mukosel, 1 hastada musinöz adenom ve 1 hastada musinöz kistadenom mevcut idi. İki hastada akut apandisite eşlik eden apandiks divertikülü ve iki hastada divertikülit; iki hastada apendiks perforasyonu; üç hastada ise periapendiküler apse mevcut idi. Tüm hastalarda ApMT için apendektomi işlemi uygulanmış idi. Sonuç: ApMT apendiksin benign veya malign olabilen nadir bir tümörüdür. Hastalar akut apandisit bulguları yanı sıra belirgin olmayan semptomlar ile başvurabilir. Preoperatif tanı zor olmasına rağmen komplikasyonları en aza indirmede yardımcıdır. Cerrahi esnasında apendiks rüptürünü ve peritoneal mukus kontaminasyonunu önlemek için dikkatli olunmalıdır. Anahtar Kelimeler: Mukosel, apandisit, apendektomi, psödomiksoma peritonei Aim: Neoplastic lesions of the appendix are very rare and most of them are incidentally detected during appendectomy. In this study, we aimed to evaluate the clinicopathological features and applied treatments of the patients who were operated in our clinic and diagnosed as appendiceal mucinous tumor (ApMT) in the light of the literature. Method: The data and appendectomy specimens of the patients who were operated in our clinic between January 2011 and December 2016 and who were diagnosed as ApMT were retrospectively evaluated. Age, gender, clinical findings, diagnostic methods, histopathological diagnosis and subsequent treatments were evaluated. Results: Six of the patients were male and four were female. The mean age was 48.6 years (range, 28-85). Nine patients were operated for acute abdomen and one patient was operated electively. Ultrasonography was performed in four patients and computed tomography was performed in six patients preoperatively. Pathological examination revealed simple mucocele in eight patients, mucinous adenoma in one patient and mucinous cystadenoma in one patient. Two patients had appendiceal diverticulum and two patients had diverticulitis associated with acute appendicitis, two patients had appendix perforation and three patients had periapendicular abscess. All patients underwent appendectomy for ApMT. Conclusion: ApMT...
Introduction: We aimed to evaluate the effect of gestational weight gain (GWG) according to Institute of Medicine (IOM) recommendation after laparoscopic sleeve gastrectomy (LSG) on maternal and fetal outcomes.Materials and methods: A retrospective, observational study on the medical charts of pregnant women who had previously undergone LSG between 2012 and 2020. According to IOM, GWG was grouped as insufficient, appropriate, and excessive.Results: 82 pregnancies were included in this study. GWG was appropriate in 19 of the pregnancies (23%) and was insufficient in 18 (22%) and excessive in 45 (55%) of the cases. The time from operation till conception of excessive group is significantly longer than insufficient and appropriate group (p1:0.000; p2:0.029; p<0.05). There was no statistically significant difference between the groups regarding birthweight, gestational age, cesarean deliveries (CD), preterm birth, whether their child was small or large for their gestational age. There was no difference between mean hemoglobin, anemia, low ferritin level and ferritin level at early pregnancy and predelivery between groups (p<0.05). There was no significant correlation between the time from operation till conception, birthweight and gestational age. There was no significant correlation between body mass index (BMI) at conception, birthweight and gestational age. There was no significant correlation between early and predelivery ferritin and hemoglobin and birthweight and gestational age. There was no correlation between mean GWG and mean BMI at conception between birthweight in either study group. Conclusion: The gestational weight gain (GWG) did not impact maternal and neonatal outcomes.
IntroductionNowadays one of the most popular surgical method for treatment of obesity is laparoscopic sleeve gastrectomy (LSG). Data regarding long-term nutritional deficiencies following LSG are scare. We aim to assess the prevalence of nutritional deficiencies 5 years post-LSG.MethodsWe retrospectively reviewed the files of 338 patients who had LSG surgery between June 2012 and June 2019 and had preoperative data and had at least 1 year of surgery. Serum iron, ferritin, folic acid, hemoglobin and vitamin B12 levels during annual visits for six years after LSG were compared with preoperative data. Patients with missing data during follow-up were evaluated as dropout and assessments were made on patients with available data.ResultsA total of 338 patients (83% women), with a baseline BMI 46,87±6,17 kg/m2 were included. In baseline, hypoferritinemia was detected in 19.16% for <15 ng/mL cutoff and in 43.11% for <30 ng/ml cutoff value. Serum iron, vitamin B12 and folate deficiencies were exist in 37.62%, 18.64% and 4.14% of the patients, respectively. We compared this prevalances with postoperative datas and found that ferritin deficiency in follow-up visits was significantly more frequent than the baseline (p<0.001), conversely vitamin B12 deficiency was significantly less common (p<0,05).ConclusionDespite the supplement, our results show that the prevalence of patients with hypoferritinemia after LSG is higher than before surgery. This high prevalence may be associated with factors such as insufficient supplementation, insufficient absorption of oral preparations, and insufficient compliance to treatment.
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