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HighlightsIntestinal perforations are one of the most well-known complications of NHLs.The reasons of perforation in patients who receive chemotherapy were fast tumor necrosis, tumor lysis, and tissue impairment.Depending on the steroids given to the patient, perforation may develop, and the clinical symptoms may be masked.

Introduction: Although laparoscopic repair of inguinal hernia is associated with reduced postoperative pain, it is not entirely painless. In addition to reducing the need for analgesic medication, postoperative complications, and hospitalization, postoperative pain control enables early return to normal activity. Aim: To evaluate the efficacy of bupivacaine instilled into the pre-peritoneal space and trocar incisions of patients undergoing laparoscopic totally extraperitoneal (TEP) repair of inguinal hernia. Material and methods: Bupivacaine was instilled into the pre-peritoneal space and trocar incisions of the patients in group I (n = 23), whereas it was infiltrated only into the trocar incisions of the patients in group II (n = 21). No local anesthetic was administered to the patients in group III (n = 21). Postoperative pain was assessed using the Visual Analog Scale (VAS) at 4 and 24 h, and the dosage of analgesic medication was noted. Results: No significant difference regarding age, gender, body mass index, ASA class, history of abdominal surgery, or smoking was noted between the three groups (p > 0.05). VAS score at 4 h was significantly higher in group III than in groups I and II (p < 0.05). The dosage of analgesic medication was significantly higher in group III than in groups I and II (p < 0.05), with no significant difference between groups I and II (p > 0.05). Conclusions: Infiltration of long-acting local anesthetic into the pre-peritoneal space and trocar incisions of patients undergoing laparoscopic TEP repair of inguinal hernia reduces the need for analgesic medication by reducing early postoperative pain.

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Objective: Our aim was to determine the incidence of thyroid carcinoma in patients with hyperthyroidism and hypothyroidism and to demonstrate whether hyperthyroidism is actually a protective state against carcinoma. Background: In endemic regions for goiter such as Turkey, the rate of cancer is reported to be lower among patients with hyperthyroidism than those with hypothyroidism. However, we observed in our clinic that carcinoma incidence in patients with hyperthyroidism is at least as high as those with hypo-euthyroidism. Methods: Cases of bilateral total thyroidectomy performed in the Istanbul Training and Research Hospital General Surgery Clinic between the years 2000 and 2014 were retrospectively examined. Age, gender, hormone levels, and postoperative pathological diagnoses were independently compared. Results: Data from 1200 patients was analyzed. Mean age was 49.2. Of the patients 220 (17.5%) were male and 990 (82.5%) were female; 722 of the female patients had benign pathologies and 268 had malignant pathologies, whereas 144 of the male patients had benign and 66 had malignant pathologies. Compared by age, no significant difference was detected in pathological diagnoses and hormone levels. Comparing the pathological diagnoses according to hormone levels, rate of malignancy was significantly higher in patients with hyperthyroidism than those with hypothyroidism or euthyroidism. Conclusions: Unlike what is previously accepted, hyperthyroid patients also carry a risk for thyroid carcinoma. Thus, these patients should be followed up for cancer at least as closely as those with hypothyroidism and euthyroidism.