Objective: Mastalgia is the most frequent symptom seen in patients who undergo breast imaging. There are various medical treatment methods in the literature. However, malignancy should be excluded before starting treatment. This is a prospective study, evaluating the necessity of imaging in patients who have applied for cyclic or non-cyclic breast pain, with normal physical examination, and without a family history. Material and Methods:Two hundred women, younger than 30 years of age, who applied to Iğdır State Hospital general surgery department with complaint of cyclic or non-cyclic breast pain, were prospectively studied. Patients with nipple discharge, complaint of lump in their breast, who were pregnant or lactating, who had breast cancer history in their family and those who were found to have lumps on examination were excluded from the study. All patients underwent ultrasound imaging and the same radiologist evaluated them. Results:The breast examination was normal in all patients. Ultrasound imaging results were completely normal in 98 (48%) patients. 47 (23.5%) patients were found to have fibroadenoma, with a mean diameter of 9.6 mm (5 mm-14 mm). 45 (22.5%) patients had simple cysts with a mean diameter of 7.8 mm (3 mm-11 mm). 6 (3%) patients were found to have intraductal papillomas and 4 (2%) to have lipomas. All patients were classified as either BI-RADS 1 or BI-RADS 2. Conclusion:It is recommended that malignancy should be eliminated before starting treatment in patients with breast pain. In this study, the necessity of imaging in patients younger than 30 years and who applied to the general surgery department for only breast pain, was investigated. None of the patients with a normal breast examination were found to have any lesions considered suspicious for malignancy. We believe that if breast examination is normal, the patient is equal to or younger than 30 years of age and there is no family history, imaging is not necessary and that medical therapy can be started directly after the patient is informed.
FS has no negative effect on ilioinguinal nerve. FS application may protect the nerve from the harmful effects of polypropylene mesh in inguinal hernia repair.
A AB BS S T TR RA AC CT T O Ob b j je ec c t ti i v ve e: : The sur gi cal in fec ti on ra te is not low in so me se ri es of elec ti ve pi lo ni dal sinus sur gery des pi te sing le do se an ti bi o tic proph yla xis. This study was de sig ned to com pa re wo und in fec ti on ra te after a sing le do se and a 5-day in tra ve no us course of cefazolin plus met ra ni da zo le admi nis tra ti on in patients who were operated employing Kary da kis flap for pi lo ni dal si nus. M Ma a t te e r ri i a al l a an nd d M Me et t h ho od ds s: : A to tal of 50 pa ti ents were in vol ved in this pros pec ti ve ran do mi sed cli ni cal study. Kary da kis flap pro ce du re was used and a va cu um dra in was left in si tu in all ca ses. The pa ti ents were di vi ded in to two gro ups: Gro up 1 had eit her a sing le do se of 500 mg met ra ni da zo le plus 500 mg ce fa zo lin so di um IV for proph yla xis and Gro up 2 were sub jec ted to sa me pre o pe ra ti ve drugs IV follo wed by the ir oral ad mi nis tra ti on for fi ve days (Se fa zol 500 mg tab let plus Flagyl 500 mg tab let, twice a day). The sur gi cal si te in fec ti on ra te, to tal dra i na ge vo lu me and dra in re mo val ti me we re re cor ded. R Re e s su ul lt ts s: : The study was trun ca ted be ca u se of oc cu ren ce of an unac cep tab le in fec ti on rate, thus, 30 pa ti ents we re ab le to con ti nu e on the study. Fi ve sur gi cal si te in fec ti ons we re ob ser ved in 14 pa ti ents in Gro up 1 (35.71%) whe re as only one in fec ti on was re cor ded in 16 pa ti ents in Group 2 (6.25%). Alt ho ugh the tar get pa ti ent num ber was not re ac hed, the sta tis ti cal dif fe ren ce was alre ady ac hi e ved (p= 0.04). The me an to tal dra i na ge vo lu me was gre a ter in Gro up 1 than in Gro up 2 (91.42 v.s. 72.12 ml; p= 0.073). Ho we ver, the me an dra in re mo val ti mes we re si mi lar. C Co on nc c l lu u s si i o on n: : The wo und in fec ti on ra te is high in elec ti ve pi lo ni dal si nus sur gery. Sing le do se proph ylac tic an tibi o tic com bi na ti on may not be suf fi ci ent to avo id wo und in fec ti on in pi lo ni dal si nus sur gery in which Kary da kis flap tech ni qu e is used. K Ke ey y W Wo or rd ds s: : Pi lo ni dal si nus; sur gi cal wo und infec ti on; an ti bi o tic proph yla xis; ce fa zo lin Ö ÖZ ZE ET T A Am ma aç ç: : Pi lo ni dal si nüs ne de niy le elek tif cer ra hi uy gu la nan ve tek doz an ti bi yo tik prof lak sisi ya pı lan ba zı se ri ler de cer ra hi alan en fek si yo nu ris ki dü şük de ğil dir. Bu ça lış ma da pi lo ni dal si nüs ta nı sıy la Kary da kis tek ni ğiy le ame li yat edi len has ta lar da tek doz se fa zo lin-met ra ni da zol prof lak sisi ile ay nı kom bi nas yo nun beş gün lük uy gu la ma sı nın ya ra en fek si yo nu ora nı na et ki si araş tı rıl dı. G Ge e r re eç ç v ve e Y Yö ön n t te em m l le er r: : Bu pros pek tif ran do mi ze ça lış ma ya top lam 50 has ta da hil edil me si plan lan dı. Tüm has ta la ra Kary da kis flep ame li ya tı ya pıl dı ve va kum lu dren kul la nıl dı. Has ta lar ay nı an t...
Pseudomyxoma peritonei is a rare but challenging neoplastic disease which is characterized with intraperitoneal mucinous-gelatinous fluid accumulation. It rarely presents as a mass mimicking abdominal wall hernias A recurrent incisional hernia due to pseudomyxoma peritonei is presented here. A 60-year-old female patient had been operated on for a left mucinous ovarian cyst 20 cm in diameter in 1998. Mucinous material had disseminated into interloop spaces through the right subdiaphragmatic region. Total abdominal hysterectomy + bilateral salpingooophorectomy and peritoneal toilet had been performed. She was rehospitalized for abdominal distention and a 4 cm defect over the incision and underwent a hernia repair using polypropylene mesh in 2001. Abdominal distention recurred to give a rise to an incisional hernia in 2006. She was reoperated for decompression and repair, but nothing could be done because of sticky adhesions and the incision were simply closed. The patient was referred to our department for operation. A prosthetic hernia repair with 30 × 30 cm polypropylene mesh was performed. The patient was discharged on the postoperative 5th day following an uneventful recovery. However, she died of disseminated disease after 18 months.
148 The effect of using methylene blue in surgical treatments of pilonidal disease: a prospective randomized study 1 3 SummaryObjectives The aim of this study was to examine the effect of using intraoperative methylene blue (MB) in the treatment of pilonidal disease in the Karydakis flap practice on wound infection and recurrence and also by investigating other factors that affect wound infection and recurrence.Patients and methods In our research, the data of 231 patients, 129 of whom were in the MB [+] group and 102 of whom were in the MB [−] group, were obtained. Each patient's age, gender, body mass index, whether they underwent pilonidal sinus surgery previously, the number of primary orifices, the number of secondary orifices, any preoperative infection, abscess drainage, and the use of antibiotic, if any, were recorded.Results The rate of postoperative wound infection in the entire group was found to be 25.1 %. While 19.4 % of the patients in MB [+] group had a wound infection, 32.4 % of the patients in the MB [−] group had a wound infection. The usage of MB was found to be a preventing factor in the occurrence of wound infection (p = 0.024).Conclusion MB is beneficial owing to its reducing effect on wound infections, which in turn is associated with a lower recurrence rate and a fast postoperative recovery. We suggest the use of MB at the beginning of acute or chronic pilonidal sinus surgeries, as MB is nontoxic and is of very low cost.
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