PurposeThe aim of this study was to compare two different treatment methods for pilonidal sinus with respect to complications, recurrence, and patient quality of life.MethodsFive hundred forty-nine patients who underwent surgery for pilonidal sinus between January 2007 and August 2012 were included in this study. The patients were classified into group I (excision and primary closure) and group II (Limberg flap).ResultsThere was no significant difference in the mean age and gender of the patients between groups I and II (P = 0.512 and P = 0.472). The duration of surgical operation was lower in group I (P < 0.001). There was no significant difference in hospitalization time after surgery, minor complications, and recurrence between the groups (P = 0.674, P = 1.000, and P = 1.000, respectively). The time required for pain-free walking, urinating, and returning to work was significantly lower in group II (P < 0.001, P < 0.001, and P < 0.001, respectively). The patients in group I stated that they were more satisfied in terms of aesthetics (P < 0.001).ConclusionAccording to the results of this study, Limberg flap method has better outcomes compared with excision and primary closure. Therefore, we recommend Limberg flap for treatment of pilonidal sinus disease.

ÖzetAmaç: Laparoskopik cerrahide sık kullanımı olan verees needle(VN) ve direct trokar(DT) insertion tekniklerini prospektif randomize bir klinik çalışma ile karşılaştırmayı planladık. Gereç ve Yöntem: Laparoskopik kolesistektomi uygulanan 400 hasta bu prospektif randomize klinik çalışmaya dahil edildi. İs-tatistiksel analiz için SPSS 17.0 (SPSS Inc., Chicago, IL). kullanıldı. İnsfluas-yon teknik komplikasyonları 2 grupta incelendi. Major komplikasyonlar olarak açık ameliyata geçilmesini gerektiren durumlar (mesenterik laserasyon, kanama, organ perforasyonu, solid organ yaralanması ve damar yaralanmaları), ve minör komplikasyonlar (subcutan amfizem, extraperitoneal insflulasyon) hastanede kalış süresini değiştirmeyen faktörler olarak belirlendi. Bulgular: Her iki grupta da mortalite gözlenmezken grupler arasında ortalama yaş, erkek-kadın oranı, BMI ve ameliyat süreleri açısından bir fark gözlenme-di. 33 adet minör komplikasyon gözlendi. Bu komplikasyonların 27 Tanesi VN grubunda gözlenirken, DT grupta 6 minör komplikasyon gözlendi. VN grupta 3 adet major komplikasyon görülürken, DT grubunda major komplikasyon 1 adet gözlendi. Tartışma: Pneumoperitoneum kapalı olarak gerçekleştirilecek ise DT sokulması ile VN sokulması arasında güvenlik açısından bir fark yoktur. Anahtar KelimelerLaparoskopi; Trokar Abstract Aim: We planned a comparison of veress needle (VN) and direct trocar (DT) insertion techniques, which have been commonly used in laparoscopic surgical procedures, via a prospective randomized clinical study. Material and Method: 400 patients who had undergone laparoscopic cholecystectomy were included to the present prospective randomized clinical study. SPSS 17.0 (SPSS Inc., Chicago, IL) was used for the statistical analysis. Insufflation-related technical complications were investigated in two groups. The cases requiring open surgery (mesenteric laceration, bleeding, organ perforation, solid organ injury and blood vessel injuries) were determined as major complications. Minor complications (subcutaneous emphysema, phison and extraperitoneal insufflation) were established as factors not changing the length of hospital stay. Results: Mortality was not observed in both groups. There was no difference between the groups with respect to mean age, male to female ratio, BMI and duration of surgery. 33 minor complications were detected. 27 of these complications were observed in the VN group, whereas the number of minor complications seen in the DT group was 6. Major complications seen in the VN and DT groups were respectively 3 and 1. Discussion: If pneumoperitoneum is established by close method, there is no safetyrelated significant difference between the insertion of DT and VN.

Anahtar KelimelerFıtık; Mesh Abstract Aim: The aim of this clinical study is to investigate the consequences of mesh use in cases of inguinal hernia with an indication of emergency operation. Material and Method: Patients who were operated on for incarcerated inguinal hernia (n=246) were included in the study. The patients were divided into the following groups according to the type of operation: Lichtenstein repair (Group 1) and primary repair (Group 2). Results: There were no significant differences in duration of operation and hospitalization, post-operative mortality and post-operative morbidity between the two groups (p>0.05). The incidence of intestinal resection was higher in women and elderly patients. Furthermore, these patients needed longer hospitalization time. In addition, the rate of complication was higher in these patients. Discussion: Polypropylene mesh can be safely and effectively used in cases of strangulated inguinal hernia.

iroid nodülleri, yetişkin nüfusunun %4-7'sinde görülen yaygın bir patolojidir. A An na ah h t ta ar r K Ke e l li i m me e l le er r: : Tiroid tümörleri; guatr, nodüler; tiroidektomi A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : The aim of the present study was to determine the prevalence of incidentally diagnosed thyroid carcinoma in patients with multinodular goiter, and analyze the types of surgery preferred for such patients. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : By retrospectively reviewing 923 patients who underwent surgery for multinodular goiter, the researchers determined the prevalence of thyroid carcinoma in those patients, and evaluated their treatment protocols within the scope of the present study. R Re es su ul lt ts s: : Of 923 patients, 817 (88%) were females and 106 (12%) were males. The average age of the patients was 48.72±11.32 years. Fine needle aspiration biopsy was performed in 514 (55.6%) patients. Of all the patients, 435 underwent bilateral total thyroidectomy or bilateral near total thyroidectomy, 298 underwent bilateral subtotal thyroidectomy, 99 underwent the Dunhill procedure, and 28 underwent unilateral lobectomy due to the presence of unilateral MNG. Postoperative pathological examination revealed incidental thyroid carcinoma (ITC) in 42 (4.55%) patients. Thirty-seven of the patients had papillary carcinoma (37/923, 4.0%), four had follicular carcinoma (4/923, 0.4%), and one had Hurtle cell carcinoma (1/923, 0.1%). C Co on nc c l lo o u u s si i o on n: : The prevalence of incidental thyroid carcinoma is non-negligibly high. Therefore, in order to avoid complications of complementary thyroidectomy, bilateral total thyroidectomy should be preferred as the first operation. Ahmet Serdar KARACA,