PURPOSESacrococcygeal pilonidal disease is a source of one of the most common surgical problems among young adults. While male gender, obesity, occupations requiring sitting, deep natal clefts, excessive body hair, poor body hygiene and excessive sweating are described as the main risk factors for this disease, most of these need to be verified with a clinical trial. The present study aimed to evaluate the value and effect of these factors on pilonidal disease.METHODPreviously proposed main risk factors were evaluated in a prospective case control study that included 587 patients with pilonidal disease and 2,780 healthy control patients.RESULTSStiffness of body hair, number of baths and time spent seated per day were the three most predictive risk factors. Adjusted odds ratios were 9.23, 6.33 and 4.03, respectively (p<0.001). With an adjusted odds ratio of 1.3 (p<.001), body mass index was another risk factor. Family history was not statistically different between the groups and there was no specific occupation associated with the disease.CONCLUSIONSHairy people who sit down for more than six hours a day and those who take a bath two or less times per week are at a 219-fold increased risk for sacrococcygeal pilonidal disease than those without these risk factors. For people with a great deal of hair, there is a greater need for them to clean their intergluteal sulcus. People who engage in work that requires sitting in a seat for long periods of time should choose more comfortable seats and should also try to stand whenever possible.

We believe that soldiers coming from different regions of Turkey and candidates applying for auxiliary staff positions provide a small sample group resembling a representation of the whole of Turkey.

Laparoscopic cholecystectomy is a safety, efficacy,established method for the treatment of symptomatic gallstone disease. We aim to share traditional laparoscopic cholesistectomy experience and complications that treated with experienced surgeons in low-volume hospitals. This study was performed during the period of 2009-2011 in three hospital. We analyzed retrospectively 266 patients, who were operated elective by three surgeon whose experiences were closely. We compared demographic data, patients age, gender, number of ports, operation time, length of hospital stay, whether or not previous abdominal surgery, whether or not systemic disease, whether or not has been performed ERCP, reason of converted from laparoscopic to open cholecystectomy and complications. 266 [165 (%72,6) female and 101 (%27,4) male] patients evaluated retrospectively. The average age was 42,6 (range 27-42). The average duration of operation was 45 minutes (range 35-72). The operation was performed by using four ports in 195 (73,3%) patients and by using three ports in 71 (26,7%) patients. 25 (9,4%) patients had intra-abdominal drainage. ERCP was performed preoperatively in 5 (9,4%) patients. We convert open cholecystectomy in6 (2,3%) patients, due to bleeding, in 4 patients (1,5%) due to anatomical mismatch, 3 patients (1,1%) due to adhesions and difficult technical conditions. Laparoscopic cholecystectomy can be performed seamlessly with appropriate patient selection in low-volume hospitals, We believe that multidisciplinary approach was a priority in case with complications, it will be useful in terms of patient morbidity and mortality. Keywords: Cholecystectomy; laparoscopic; clinical outcome. ÖzetMorbiditesi %0,1 lere kadar indirilen, düşük volümlü hastanelerde uygulanabilen, ciddi komplikasyonları ancak tecrübeli cerrahlarca tedavi edilen geleneksel LK tecrübelerimizi, komplikasyonlarımızı, ne seviyede olduğumuzu görmeyi ve paylaşmayı amaçladık. Ocak 2008-Haziran 2011 tarihleri arasında 3 ayrı merkezde, 3 ayrı laparoskopik tecrübeleri birbirine yakın cerrah tarafından elektif şartlarda yapılan Laparoskopik Kolesistektomi olgularının pre-intra-post operatif bulgularına ulaşılarak, demografik verileri, operasyon endikasyonları, operasyon şekli (port sayısı, süresi), daha önce operasyon geçirip geçirmediği, Sistemik bir hastalığı olup olmadığı, hastanede yatma süreleri, açığa dönüş sebepleri, ERCP yapılıp yapılmadığı, görülen komplikasyonlar retrospektif olarak incelendi. 165 (%72.6)' i kadın, 101 (%27.4)' i erkek 266 hasta dosyası retrospektif olarak incelendi. Yaş ortalaması 42.6 yıl (range:24-72) idi. Ortalama operasyon süresi 45 dakika (range:30-75) bulundu. 71 (%26.7) hastada 3 port, 195 (%73,3) hasta 4 port kullanılarak operasyon gerçekleştirildi. 25 (%9.4) hastaya batın içi dren kondu. 5 (%9.4) hastaya preoperatif olarak ERCP yapılmış, 6 (%2.3) hasta daha önce üst batın, 31(%11.7) hasta da alt batın operasyonu geçirmiş olduğu bulundu. 6 (%2.3) hastada kanama, 4 hastada (%1.5) anatominin ortaya konamaması (anatomik uyums...

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PURPOSE:To evaluate the effects of platelet rich plasma (PRP) on the healing of fascia wherein peritonitis has been created. METHODS:Twenty eight Wistar Albino rats were divided into four groups. Only a primary fascial repair following laparotomy was performed on Group 1, a primary fascial repair performed and PRP treatment applied following laparotomy on Group 2, and a fecal peritonitis created following laparotomy and a primary fascial repair carried out on Group 3. A fecal peritonitis was created following laparotomy and primary fascial repair and PRP treatment on the fascia was carried out on Group 4. RESULTS:TNF-α was found to be significantly lower in the control group (Group 1). It was detected at the highest level in the group in which fecal peritonitis was created and PRP applied (Group 4). TGF-β was determined as being significantly higher only in Group 4. Histopathologically, the differences between the groups in terms of cell infiltration and collagen deposition were not found to be significant. CONCLUSION:When platelet rich plasma was given histologically and biochemicaly as wound healing parameters cellular infiltration, collagen accumulation, and tissue hydroxyiproline levels were not increased but neovascularization, fibroblast activation and TNF Alfa levels were increased and PRP accelerated wound healing.

Complex anatomical relation of the duodenum, pancreas, biliary tract, and major vessels plays to obscure pancreaticoduodenal injuries. Causes of pancreaticoduodenal injuries are blunt trauma (traffic accidents, sport injuries) in 25 % of cases and penetrating abdominal injuries (stab wounds and firearm injuries) in 75 % of cases. Duodenal injuries are reported to occur in 0.5 to 5 % of all abdominal trauma cases and are observed in 11 % of abdominal firearm wounds, 1.6 % of abdominal stab wounds, and 6 % of blunt trauma. Retroperitoneal and deep abdominal localization of duodenum as an organ contribute to the difficulty in diagnosis and treatment. There are three important major points regarding treatment of duodenal injuries: (1) operation timing and decision, (2) Intraoperative detection, and (3) post-operative care. Therefore, it is difficult to diagnose and treat duodenal trauma. We would like to present a 21-year-old male patient with pancreaticoduodenal injury who presented to our emergency service after firearm injury to his abdomen and discuss his treatment with a short review of related literature.

Hydatid cyst of the liver is zoonosis caused by the larval stages of taeniid cestodes belonging to the genus Echinococcus and is still endemic in the South European regions, Asia, South America, North Africa, Australia, New Zealand and several Asian and European countries. The diagnosis of non complicated hydatid cyst of the liver depends on clinical suspicion. They appear in two ways as general (systemic) symptoms, and local symptoms based on the site and organ on which larva settles. While cysts sometimes recover spontaneously, more severe clinical presentations are observed in immunosuppressive individuals. Ultrasonography is the gold standard diagnostic tool and E. Granulosus antigen 5 (Ag5) and antigen B (Ag B) obtained from cyst fluid are used as a serologic diagnostic method in combination with the imaging method. The current treatment of hydatid cyst of the liver varies from surgical intervention to minimally invasive treatments (percutaneous drainage) or medical therapies. Surgery is still the best treatment tool. Percutaneous drainage and treatment of the cyst is a good option to surgery in selected cases. Multiple, superficial single cysts are the most suitable ones for surgical treatment. Also for complicated infected cysts pressing biliary tree and vital organs, surgery should be the first choice of treatment coming to mind. We believe that the laparoscopic approach should be safe to uncomplicated cysts. The purpose of our article is to provide a current review of clinical, diagnostic, and therapeutic features of hydrated cyst diseases.

IntroductionLiposarcomas represent 20–30% of adult soft tissue tumors and its abdominal localization occurs only in 5% of cases. Most are asymptomatic, but few present with abdominal mass and pain, fatigue, nausea, vomiting. They infiltrate adjacent organs and cause intestinal obstruction, intestinal ischemia-perforation, hydronephrosis, ureteric fistula and even aortic rupture. Here we aimed to report a rare case of a giant liposarcoma which originated from mesentery.Presentation of caseA 45-year-old male presented with slightly abdomen distention, urinary retention, oliguria since fifteen days. There was no concomitant nausea, vomiting and lower extremity edema. We found renal function tests abnormal. Contrast-enhanced computed tomography (CT) demonstrated a 20 × 18 cm, well-circumscribed, lobulated, heterogeneous mass. Both ureters were compressed by the mass. The entire mass was totally excised. After the operation, the patient's renal function returned to normal levels dramatically. The tumor was diagnosed as dedifferentiated liposarcoma.DiscussionIn cases of intra-abdominal mass is detected, surely abdominal compartment syndrome (ACS) should be considered. If vital signs, pulmonary function tests (PFT) and value of the CVP are abnormal, intra-abdominal pressure should be measured. Our findings mentioned above were not observed.ConclusionA detailed history should be obtained other abdominal solid organs should also be considered while performing a careful physical examination, the amount of urinary output in particular should be questioned and this sytemic questioning should be supported by specific laboratory tests.