FNA-Tg measurement can be performed safely for the detection of lymph node metastasis in patients with differentiated thyroid carcinomas.

The peritoneal cytokine levels can be an additional diagnostic tool that can support the early prediction of AL in colorectal surgery.

When creating cutaneous flaps during thyroidectomy, the use of electrocautery is as safe as the use of scissors. Such electrocautery does not increase the risk of wound complications in thyroid surgery.

Gastric cancer is the third most common cause of death in men and the fifth common cause of death in women worldwide. Currently, available advanced imaging modalities can predict R0 resection in most patients in the perioperative period. The aim of this study is to determine the role of serum CK18, MMP-9, and TIMP1 levels in predicting R0 resection in patients with gastric cancer. Fifty consecutive patients scheduled for curative surgery with gastric adenocancer diagnosis between 2013 and 2015 were included in the study. One milliliter of blood was taken from the patients included in the study to examine CK18, MMP-9, and TIMP1. CK18, MMP-9, and TIMP1 levels were positively correlated with pathological N and the stage (P < 0.05). The CK18, MMP-9, and TIMP1 averages of those with positive clinical lymph nodes and those in clinical stage 3 were found to be higher than the averages of those with negative clinical lymph nodes and those in clinical stage 2 (P < 0.05). Although serum CK18, MMP-9, and TIMP1 preop measurements in patients scheduled for curative surgery due to gastric adenocarcinoma did not help to gain any idea of tumor resectability, we concluded that our study had valuable results in significantly predicting N3 stage.

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Background: Gastric cancer is the 3rd most common cause of death in men and the 5th common in women worldwide. Today, surgery is the only curative therapy. Currently available advanced imaging modalities can predict R0 resection in most patients, but it can only be detected with certainty in the perioperative period. Aim: To determine the role of serum CK18, MMP9, TIMP1 levels in predicting R0 resection in patients with gastric cancer. Methods:Fifty consecutive patients scheduled for curative surgery with gastric adenocarcinoma diagnosed between 2013-2015 were included. One ml of blood was taken from the patients to analyze CK18, MMP9 and TIMP1. Results: CK18, MMP9 and TIMP1 levels were positively correlated with pathological N and the stage (p<0,05). CK-18, MMP-9 and TIMP-1 averages in positive clinical lymph nodes and in clinical stage 3, were found to be higher than the averages of those with negative clinical lymph nodes and in clinical stage 2 (p<0,05). Conclusion: Although serum CK-18, MMP-9 and TIMP-1 preoperatively measured in patients scheduled for curative surgery did not help to evaluate gastric tumor resectability, they were usefull in predicting N3-stage.

Objective: We aimed to evaluate the predictive value of elastography in determining malignancy during preoperative investigation of thyroid nodules and to compare its results with preoperative fine-needle aspiration biopsy (FNA) and postoperative histopathology results. Material and Methods:Among the group of patients who had indications for thyroidectomy between January 2013 -September 2013 in the department of general surgery 86 euthyroid patients were prospectively included in the study. Informed consent was obtained from all patients. All patients received simultaneous thyroid ultrasonography and elastography by an experienced radiologist. The patients were classified into five scores according to Tsukuba scoring. Score 1 and 2 were evaluated as soft nodules (benign), score 3 as medium consistency (usually benign), and scores 4 and 5 as hard nodules (malignant). For statistical purposes, the FNA results were classified as benign, probably benign or malignant. The histopathological results were classified as benign or malignant. The results were compared with FNA and elastography findings. Results:The fine-needle aspiration biopsy of the nodules revealed 60.5% benign, 17.4% high probability of benign, and 22.1% malignant cases; and the elastography diagnosed 38.4% benign, 23.3% high probability of benign, and 38.4% malignant nodules. The postoperative pathology evaluation diagnosed 67.4% of patients as benign, and 32.6% as malignant. The rate of detection of thyroid cancer cases (sensitivity) by elastography was 67.9%, the ability to distinguish healthy individuals (specificity) was 75.9%, and the overall adequacy of the method (accuracy) was determined as 73.3%. Conclusion:Elastography overlaps with especially benign cytology-pathology at a high rate, and provides definite diagnosis in 58% of malignant cases. In our study, elastography provided more reliable results than FNA, in terms of diagnosing malignancy.

ÖzAmaç: Primer olarak yapılan total tiroidektomi ile tamamlayıcı tiroidektomiyi ameliyat sonrası morbidite açısından karşılaştırmayı amaçladık. Yöntemler: Haseki Eğitim ve Araştırma Hastanesi Genel CerrahiKliniği'nde yapılan tamamlayıcı tiroidektomi ameliyatları ile primer total tiroidektomi ameliyatlarındaki morbidite retrospektif olarak incelendi. Cerrah tercihine göre nöromonitorizasyonun kullanılmadığı, ardışık olarak ameliyat edilen hastalar değerlendirilmiştir. Bulgular:İncelenen parametrelerden hiçbirinde yaş (p=0.207), cinsiyet (p=0.998), hormon durumu (p=0.287), nodül mevcudiyeti (p=0.287), çıkarılan lob sayısı (p=0.695), multisentrisite (p=0.081) komplikasyon oluşumu ile çalışıldığında hiçbirinde istatistiksel anlam farkı saptanmadı. Göreli orantı yönünden (odds ratio) 11.9 kat daha fazla komplikasyon riskinin ikinci ameliyat için uygun sürenin dikkate alınmadığı hastalarda oluştuğu görüldü.Tüm hastalar ele alındığında komplikasyon varlığının dağılımı tamamlayıcı tiroidektomi yapılan grupta (grup 2), ilk baştan total tiroidektomi yapılan gruptan (grup 1) anlamlı derecede yüksek bulunmuştur (p=0.003). Grup 2'de komplikasyon gelişme olasılığı Grup 1'den 10.6 kat (odds ratio) fazla gözlenmiştir. Sinir ve paratiroid hasarlarının hiçbiri kalıcı olmamıştır. Sonuç:Günümüzde teknolojik gelişmeler ve ameliyat öncesi tanı yöntemleri tamamlayıcı tiroidektomi gereksinimini azaltsa da, yapıldığında komplikasyon olasılığı baştan total tiroidektomi yapılan hastalardan daha fazladır. Ancak deneyimli ellerde kalıcı komplikasyon oranı değişmemektedir.Anahtar Sözcükler: Total tiroidektomi, tamamlayıcı tiroidektomi, diferansiye tiroid kanseri Aim: We aimed to compare primary total thyroidectomy and completion thyroidectomy in terms of postoperative morbidity. Methods:The morbidity of primary thyroidectomy operations and completion thyroidectomy operations performed at Haseki Training and Research Hospital General Surgery Clinic were evaluated retrospectively. Consecutive patients, in whom neuromonitorization was not used according to the surgeon's choice, were enrolled for study and control groups.Results: There were no statistically significant difference in age, sex (p=0.998),hormonal status (p=0.287),presence of nodule (p=0.287),number of lobes removed (p=0.695), multicentricity (p=0.081)in regard to complications.It was seen that the risk ratio (the odds ratio) was 11.9 times higher in patients in whom appropriate time was not waited for the second operation.When all patients were evaluated, the distribution of complication was found to be significantly higher in the group with completion thyroidectomy (group 2) than in the group with total thyroidectomy (group 1) (p=0.003).The probability of developing complications in Group 2 was 10.6 fold (odds ratio) higher than Group 1.Neither nerve nor parathyroid damage was permanent. Conclusion:Although technological developments and preoperative diagnostic methods reduce the need for completion thyroidectomy nowadays,the probability of complication is higher than that of pati...