The objective of this study was to analyze the clinical benefit of histopathologic analysis of appendectomy specimens from patients with an initial diagnosis of acute appendicitis. We retrospectively analyzed the demographic and histopathologic data of 1255 patients (712 males, 543 females; age range, 17-85 years) who underwent appendectomy to treat an initial diagnosis of acute appendicitis. Patients who underwent incidental appendectomy during other surgeries were excluded from the study. Histopathologic findings of the appendectomy specimens were used to confirm the initial diagnosis. Ninety-four percent of the appendectomy specimens were positive for appendicitis. Of those, 880 were phlegmonous appendicitis, 148 were gangrenous appendicitis with perforation, and the remaining 88 showed unusual histopathologic findings. In the 88 specimens with unusual pathology, fibrous obliteration was observed in 57 specimens, carcinoid tumor in 11, Encheliophis vermicularis parasite infection in 8, granulatomous inflammation in 6, appendiceal endometriosis in 2, and 1 specimen each showed mucocele, eosinophilic infiltration, Taenia saginata parasite infection, and appendicular diverticulitis. All carcinoid tumors were located in the distal appendix. Six of the 11 carcinoid tumors were defined by histopathology as involving tubular cells, and the other 5 as involving enterochromaffin cells. Six patients had muscularis propria invasion, 2 patients had submucosa invasion, 2 patients had mesoappendix invasion, and 1 patient had serosal

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Ekici U, Tatlı F, Kanlıöz M. Preoperative and postoperative risk factors in laparoscopic cholecystectomy converted to open surgery. AbstractBackground. Laparoscopic cholecystectomy (LC) is nowadays the gold standard in the surgical treatment of cholelithiasis and gallbladder diseases. But sometimes it may be inevitable to convert it to open surgery to safely end the procedure.Objectives. In this study, we aimed to investigate the risk factors for conversion to open surgery from LC.Material and methods. The records of patients that underwent LC in Malatya State Hospital (Malatya, Turkey) between January 2013 and May 2014 were prospectively examined. One hundred and forty-five patients were involved in this study. The patients were divided into 2 groups: LC patients and patients converted to open surgery. For the patients in both groups, the preoperative age, gender, body mass index (BMI), disease history, previous abdominal operations, and preoperative laboratory findings were recorded, as well as the fact if the abdominal ultrasonography (US) and endoscopic retrograde cholangiopancreatography (ERCP) were performed. Results.Of 145 patients involved in this study, 127 (87.5%) were female and 18 (12.5%) were male; their mean age was 46.54 years. Nineteen of the patients were operated on after ERCP due to acute cholecystitis and 6 patients were operated on after ERCP due to choledocholithiasis. In 134 of the patients (92.4%), the operations were completed laparoscopically, while the process was converted to open surgery in 11 cases (7.6%). Male gender, chronic disease history, normal BMI level, increased thickness of the gallbladder wall, increased preoperative blood glucose level, leukocytosis, preoperative ERCP history, grade 3 or 4 (Blauer scoring system) adhesions determined during the operation, and multiple stone presence in the bladder were found to be statistically significant risk factors for conversion to open surgery. Conclusions.Patients in the risk group should be informed by experienced laparoscopic surgeons about the potential conversion to open surgery and decision on such conversion should be made when necessary.

Purpose: The purpose of this study was to assess the reliability, educational features, and popularity of YouTube videos on inguinal hernia operations using the laparoscopic total extraperitoneal (TEP) method on the basis of objective scoring criteria. Materials and Methods: We reviewed the first 50 videos on TEP. To assess the reliability and educational features of the videos, we used the DISCERN questionnaire score (DISCERN), Journal of the American Medical Association Benchmark criteria (JAMAS), and Global Quality Scores (GQS). We then used Video Power Index (VPI) to assess the videos’ power on YouTube, and total extraperitoneal scoring (TEPS) to assess their conformity with the medical technique and also the accuracy, quantity, and quality of the information contained therein. Results: In the analysis of the source and contents of videos, the VPI, DISCERN, JAMAS, GQS, and TEPS values of all videos were found to be low. A positive correlation—at a level of 0.988—was found to exist between their number of views and VPI values (r: 0.988, P<0.001). Furthermore, we also observed a positive correlation—at a level of 0.811—between the video’s likes and DISCERN scores (r: 0.811, P: 0.004). There was no other statistically significant relationship between other scores and the quantitative features of videos. A positive correlation—at a level of 0.709—was found between the videos’ GQS and TEPS (r: 0.709, P: 0.022). No correlation was found among other scores. Conclusion: Depending on the scoring criteria, the lower scores obtained by those videos show that they do not provide a sufficient level of reliability and quality information.