No abstract

Both procedures can be safely performed in pilonidal disease with a standard length of stay in hospital and a similar loss of productive power. However, the Karydakis flap seems to have a significant higher infection rate and this probably increases the cost.

OBJECTIVE:This prospective randomized clinical study was conducted to evaluate the safety and tolerability of early oral feeding after colorectal operations.METHODS:A total of 199 patients underwent colorectal surgery and were randomly assigned to early feeding (n = 99) or a regular diet (n = 100). Patients' characteristics, diagnoses, surgical procedures, comorbidity, bowel movements, defecation, nasogastric tube reinsertion, time of tolerance of solid diet, complications, and length of hospitalization were assessed.RESULTS:The two groups were similar in terms of gender, age, diagnosis, surgical procedures, and comorbidity. In the early feeding group, 85.9% of patients tolerated the early feeding schedule. Bowel movements (1.7±0.89 vs. 3.27±1.3), defecation (3.4±0.77 vs. 4.38±1.18) and time of tolerance of solid diet (2.48±0.85 vs. 4.77±1.81) were significantly earlier in the early feeding group. There was no change between the groups in terms of nasogastric tube reinsertion, overall complication or anastomotic leakage. Hospitalization (5.55±2.35 vs. 9.0±6.5) was shorter in the early feeding group.CONCLUSIONS:The present study indicated that early oral feeding after elective colorectal surgery was not only well tolerated by patients but also affected the postoperative outcomes positively. Early postoperative feeding is safe and leads to the early recovery of gastrointestinal functions.

Objectives:To evaluate the incidence of hypocalcemia and recurrent laryngeal nerve disfunction secondary to level VI lymph node dissection in patients with papillary thyroid carcinoma.Methods: This randomized prospective study investigated a group of 60 consecutive papillary thyroid carcinoma patients who initially underwent thyroidectomy plus level VI neck dissection (29 patients) -with or without lateral neck dissection -and thyroidectomy alone (31 patients). In order to evaluate the morbidity of central lymph node dissection, postoperative recurrent nerve dysfunction and hypocalcemia were compared between two groups.Results: Early postoperative hypocalcemia was higher in the thyroidectomy plus neck dissection group (group 1) than the thyroidectomy without neck dissection group (group 2) (18/29-62.1% vs. 6/31-19.4%; p=0.001). Permanent hypocalcemia developed in 4 patients of group 1 (4/29-13.8%) and 2 patients of group 2 (2/31-6.5%) six months after surgery (P=0.672). No permanent vocal cord paralysis was observed in both groups. Transient vocal cord paralysis occurred in a patient of group 1. Conclusions:According to the study results, central lymph node dissection can be safely applied in papillary thyroid carcinoma patients without increasing the risk of permanent morbidity in the hands of experienced surgeons.

Thyroid autografts were found to be functional and thought to have a potential preventing postoperative hypothyroidism.

Pilomatrixoma is a benign soft tissue neoplasm originated from follicular matrix of hair and is also known as Malherbe's calcified epithelioma. Some lesions are located on the skin and are usually misdiagnosed. A small number of patients had been dermoscopically examined. In this article, three patients of pilomatrixoma who had three different dermoscopic views were evaluated and discussed in concordance with the literature.

Objective: To investigate factors that may have an effect on recurrence by retrospectively analysing the data of patients who were followed up and treated for idiopathic granulomatous mastitis in this clinic.

Kolon Kanseri hastalarında Sentinel lenf nodu haritalandırması: Bir anlamı var mı? Amaç: Kolorektal kanserlerde (CC) lenf nodu tutulumu, hastalığın nüksü, sağkalım ve adjuvan tedaviye karar vermede majör prognostik faktör olarak değerlendirilir. Sentinel lenf nodu (SLN) meme ve melonomada patolojik değerlendirmeyi güçlendiren etkili bir teknik olsa da CC'de halen tartışmalıdır. Bu nedenle, bu çalışmada SLN'nin CC'de lenf nodu durumunu değerlendirmesindeki duyarlılığı, özgüllüğü ve doğruluğunu değerlendirmeyi amaçladık. Yöntem: Bu prospektif randomize çalışmaya, kolorektal kanser nedeniyle acil veya elektif ameliyata alınacak olan ardışık 84 hasta dahil edildi. Lenf nodu durumunu değerlendirmek için "in vivo" mavi boya ile haritalama yöntemi kullanıldı. Yöntemin duyarlılığı mavi boya ile ilk boyanan 3-4 lenf nodunun nihai patoloji raporuyla karşılaştırılarak değerlendirildi. Bulgular: SLN'nin metastatik lenf nodunu tahmin (%61,54) etmedeki belirleyiciliği az, yalancı-negatiflik oranı yüksek (%38,5), özgüllüğü %100, tahmin oranı %88,1 idi. Genel doğruluğu %81,08, negatifi tahmin değeri %82,76, pozitifi tahmin değeri ise %100 idi. Bizim çalışmamızda olduğundan daha ileri (upstaging) bir evreleme yapılmadı. Sonuç: Bu sonuçlar göz önünde bulundurulduğunda, SLN haritalaması, yüksek tespit oranına rağmen hastanın lenf nodu durumunu klinik olarak kabul edilebilir doğrulukla tahmin edemedi. Çalışmada bölgesel lenf nodu disseksiyonuyla birlikte yapılan "en bloc" tümör rezeksiyonunun CC'lerde halen standart tedavi yöntemi olduğunu vurgulamaktayız. SLN haritalaması düşük prediktif değerinden dolayı, operasyonun niteliğini değiştirmemelidir. Anahtar Kelimeler: Sentinel lenf nodu, kolorektal kanser, evreleme, lenf nodu metastazı Aim: Lymph node status in colon cancer (CC) is a major prognostic factor that determines the disease recurrence, survival, and the adjuvant treatment. Although sentinel lymph node (SLN) is an effective technique that improves pathologic assessment in breast cancer and melanoma, the feasibility and outcomes of SLN in CC is still controversial. Hence, we aimed to evaluate the sensitivity, specificity, and accuracy of SLN for determining lymph node status in CC. Method: A total of 84 consecutive patients undergoing urgent or elective colectomy for colon cancer were enrolled in this prospective randomized study. In vivo SLN mapping with blue dye was used to evaluate the lymph node status. The sensitivity of the method was evaluated by comparing the pathologic condition of 3-4 blue dyed lymph nodes with final conventional pathologic assessment. Results: The sensitivity of identification for SLN was low (61.54%) for predicting lymph node metastasis, false-negative rates were high (38.5%), specificity was 100%, the detection rate was 88.1%, the overall accuracy rate was 81.08% , negative predictive value 82.76%, and positive predictive value was 100%. No upstaging was determined in our study. Conclusion: Considering our results, SLN mapping could not predict the nodal status with clinically acceptable accurac...