PurposeWe aimed to compare skin closure techniques, standard (intermittent mattress) and continuous subcuticular sutures, following Limberg flap procedure.MethodsFrom July 2013 to July 2015, 92 patients with sacrococcygeal pilonidal disease were prospectively randomized into 2 groups consisting of 46 patients for both. Patients underwent sinus excision and closure with Limberg flap; continuous subcuticular suture was used in subcuticular group (SG) and intermittent mattress sutures were used in mattress group (MG) for skin closure. Characteristics of patients, features of pilonidal disease, macerations, infections, wound dehiscence, flap necrosis, operation time, time of drain removal, wound complications, early recurrences, and time till return to work were compared between the 2 groups.ResultsThere was no statistical difference between groups per sex, age, body mass index, smoking, number of sinuses, depth of intergluteal sulcus, distance of incision to anus, volume of extracted tissue, number of hair follicles per cm2, recurrence, operation, and mean follow-up time. Two patients showed signs of wound complications (4.4%) in SG, whereas 8 cases (17.4%) showed signs in MG (P < 0.05). One patient in SG had surgical site infection and required antibiotics (2.2%), where as there were 6 cases treated in MG (13.0%) (P < 0.05). Removal of drain tube, and time till return to work rates are lower for SG than MG (P < 0.05).ConclusionIn conclusion, surgical procedures which include Limberg flap method and subcuticular closure may reduce infection and maceration rates. Future studies are needed to achieve greater detailed evaluation.
The aim of the present study was to evaluate the treatment modalities and recurrence status of patients diagnosed with phyllodes tumor in light of a literature search. Methods: All female patients who received treatment for phyllodes tumor between January 2015 and January 2017 were included in our study. All data were collected through retrospective analysis. Histopathological results, type of surgery, application of chemoradiotherapy, tumor size, recurrence rate, and demographic data were analyzed. Results: Twenty-five cases were evaluated. Of the 25 cases, 8 were diagnosed as malignant. The rest were 3 borderline and 14 benign and fibroadenomas. Three of 8 malignancies were treated with mastectomy, and the other 5 were treated with wide local excision. Recurrence occurred in two cases; one of them received chemotherapy, and the other had chemoradiotherapy. All 17 remaining patients underwent wide local excision. A single case was treated with mastectomy due to large tumor size. Conclusion: There is still an ongoing debate for the treatment of phyllodes tumors. Negative margins for malignant cases play a major role for successful treatment. There is no consensus for the application of chemo-and radiotherapy.
Introduction: Laparoscopic cholecystectomy (LC) remains the gold standard surgical method for cholelithiasis. The objective of this study was to evaluate risk factors for the development of a trocar site hernia following an LC. Materials and Methods:All of the patients who underwent an LC between 2014 and 2017 at the Kartal Research and Education Hospital were included in the study. Clinical data were collected retrospectively and possible causes of a trocar site hernia were analyzed. Age, gender, the method of suturing trocar sites, open or closed trocar insertion technique, body mass index (BMI), surgical site infection occurrence, associated diseases, and follow-up times were recorded.Results: A total of 340 patients were included in this study. In the group, 254 were female (74%). The mean age was 48.4±14 years (range: 19-90 years). The mean follow-up time was 31.9±12.7 days. A trocar site hernia developed in 20 (5.9%) patients, and the mean age was 62.5±12.8 years (p=0.0001). Six (35.2%) of 17 patients with a postoperative surgical site infection developed a hernia (p=0.0001). In all, 35 patients had diabetes and 6 diabetic patients (17.1%) developed a hernia (p=0.003). The mean BMI was 31.2±6.1 kg/m2 in the presence of a hernia and 27.9±4 kg/m 2 in the absence of a hernia (p=0.001). Conclusion:This study examined age, BMI, diabetes, surgical site infection, trocar insertion method, and the technique used for the closure of fascia as possible risk factors in the development of trocar site hernia. Multivariate analysis revealed that only age, diabetes, BMI, and wound site infection were significant.
In this study, we tried to evaluate retrospectively high levels of parathyroid hormone in patients who received parathyroidectomy due to primary hyperparathyroidism in the light of the literature search. Methods: In this study, 121 patients who underwent surgery for primary hyperparathyroidism between September 2015 and December 2017 were retrospectively evaluated, according to gender, preoperative calcium and PTH levels, postoperative calcium and PTH levels, diagnosis, histopathological results, type of surgery, follow-up time and recurrence. We excluded patients who were unreachable. Results: Mean age was 54.83±12.56 (26-82). One hundred three patients were female (85.1%). One hundred nineteen patients were diagnosed (98.4%) as adenoma, whereas two patients were diagnosed as (1.6%) hyperplasia. According to histopathological results, 103 (85.1%) adenoma, four (3.3%) carcinoma, four (3.3%) hyperplasia and 10 (8.2%) adenoma and papillary carcinoma of the thyroid were found. Preoperative mean PTH value was 301.9±470 pg/ml (79-3674 pg/ml). Preoperative mean calcium level was 10.
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