Objective: Completion thyroidectomy is recommended in patients who have been diagnosed with differentiated thyroid cancer on histopathological evaluation, if their first operation was a conservative approach. The critical issue is when to do the second operation. Material and Methods:The medical records of 66 patients who underwent completion thyroidectomy for the treatment of differentiated thyroid cancer in our clinic between 2006-2013 were retrospectively analyzed. All data were compared after patients were divided into two groups according to the interval between the first surgery and completion thyroidectomy.Results: Fifty-two patients (78.8%) were women and 14 patients (21.2%) were male. Completion thyroidectomy was performed 10-90 days after the initial surgery (group 1) in 26 patients, whereas it was performed later than 90 days in 40 patients (group 2). Temporary hypoparathyroidism occurred in two patients (7.7%) in group 1, and in 3 patients (7.5%) in group 2. Transient recurrent laryngeal nerve palsy was observed in 1 patient (3.9%) in group 1, and in 1 patient (2.5%) in group 2. There were no permanent morbidities in both groups. Residual tumor rate after completion thyroidectomy was 45.5%. There was no statistically significant difference between the two groups in terms of complications after completion thyroidectomy. Conclusion:Although in some studies it is recommended that completion thyroidectomy should be performed either before scar tissue development or after clinical remission of scar tissue, edema and inflammation, we believe that timing of surgery has no effect on morbidity.Key Words: Thyroid cancer, thyroidectomy, intraoperative complication, repeat surgery INTRODUCTIONAlthough the type of surgery in the treatment of differentiated thyroid cancer (DTC) is still being debated, in recent years many authors recommend total thyroidectomy in these patients with good prognosis due to the metastasis potential, even though it is rare (1, 2). Udelsman and Shaha (3) advocate total thyroidectomy stating that with limited surgery the risk of recurrence, reoperation and morbidity increase and that radioactive iodine (RAI) ablation occurs at lower doses. In contrast, some authors suggest conservative approaches based on the findings that risk of anaplastic transformation is below 1%, multicentric tumors do not significantly affect the clinical course, and in limited surgery; RAI therapy is possible with lower morbidity, the prognosis does not change and the complication rate is lower (4, 5). Similarly, although what needs to be done in patients pathologically diagnosed with DTC and in whom a conservative approach had been preferred during the first surgery is still controversial, a completion thyroidectomy is often suggested in high-risk patients in order not to leave any thyroid tissue behind (6, 7). The critical point is the timing of the second operation.In our study, we retrospectively evaluated patients who underwent completion thyroidectomy for DTC with emphasis on the importance of timing of the...

Introduction and Aim: The purpose of this study was to determine the value, in terms of diagnosis, resectability and prognosis of pentraxin-3 (PTX3), interleukin-8 (IL-8) and vascular endothelial growth factor (VEGF) in cases of gastric adenocarcinoma, an important condition both worldwide and in Turkey, and to determine their levels in order to contribute to elucidating the pathogenesis of the disease. Materials and Methods: Serum was separated from blood specimens collected from 45 patients diagnosed with gastric adenocarcinoma and from a 30-member healthy control group. Serum PTX3, IL-8 and VEGF levels were studied by ELISA method. Results: Serum PTX3 values differed significantly between the patient group and the control group (p<0.05). Serum IL-8 values also differed significantly between the patient group and the control group (p<0.05). A significant difference was also observed between serum VEGF values in the patient group and the control group (p<0.05). Significant correlation was determined between serum PTX3 and VEGF (p<0.01; r=0.833), between serum PTX3 and IL-8 (p<0.01; r=0.818), and between serum VEGF and IL-8 (p<0.01; r=0.803), measurements when the entire study population was evaluated irrespectively of groups. Conclusion: Serum PTX3, IL-8 and VEGF levels decreased in cases of gastric adenocarcinoma compared to the control group, and their levels affected one another.

Background: Sigmoid volvulus may recur following endoscopic decompression. Flatus tubes are traditionally used to prevent an early recurrence. This study aims to evaluate the recurrence–preventive role of the flatus tubes in sigmoid volvulus. Methods: Sigmoid volvulus recurrence was retrospectively analyzed in prospectively collected clinical data of endoscopically decompressed 60 patients, in whom no tube, rectal tube, or sigmoidal tube was used. Results: Mean pain/discomfort scores were higher in rectal and sigmoidal tube groups than that of no tube group (1.2 ± 0.4, 4.2 ± 0.9, and 3.5 ± 0.9, respectively, P < .001). The early recurrence was seen in 3 patients in the no tube group, while no early recurrence was determined during tube placement in the rectal and sigmoidal tube groups (15.0%, 0.0%, and 0.0%, respectively, P < .05, P < .05, and P > .05). The tubes were removed or spontaneously discharged in 13 (65.0%) and 12 patients (60.0%) in the rectal and sigmoidal tube groups, respectively, and sigmoid volvulus recurred in 2 patients in each group following the removal or spontaneous discharge. There was no statistically significant difference between the early recurrence rates of the no tube, rectal tube, and sigmoidal tube groups following the removal or spontaneous discharge of the tubes (15.0%, 15.4%, 16.7%, respectively, P > .05) and in total (15.0%, 10.0%, and 10.0%, respectively, P > .05). Conclusion: Flatus tubes may prevent the early volvulus recurrence during their placement in sigmoid volvulus. Nevertheless, they generally cause pain and discomfort, and they are frequently removed or spontaneously discharged, which suppresses their recurrence–preventive effects.

Background Acute appendicitis (AA) is the most frequently seen surgical emergency in pregnant women and the most frequently encountered cause of non‐obstetric acute abdomen. Due to the physiological and anatomical changes that occur during pregnancy and the limited use of radiological methods, it is difficult to diagnose AA during pregnancy. These conditions increase the risk of morbidity and mortality; therefore, it is crucial to identify ideal laboratory markers that can be utilized to diagnose disease. Methods One hundred and ten pregnancies that fulfilled the inclusion criteria for AA diagnosis were retrospectively analysed between 2010 and 2021. Markers with high diagnostic values were discussed. Results The patients were divided into three groups as follows; Group I: negative appendectomy (n = 19); Group IIa: uncomplicated appendicitis (n = 59); Group IIb: complicated appendicitis (n = 32). There was no statistically significant difference in mean age or gestational week (P > 0.05). Group IIb had a higher rate of complications and a longer length of hospital stay (P < 0.05). There were significant differences between the groups in terms of white blood cell (WBC), neutrophil, neutrophil‐to‐lymphocyte ratio (NLR), platelet‐to‐lymphocyte ratio (PLR), C‐reactive protein, lymphocyte‐to‐ C‐reactive protein ratio, total, direct, and indirect bilirubin values (P < 0.05). While platelet and lactate dehydrogenase (LDH) values did not differ substantially between groups, both were found to have a high diagnostic value. Conclusion It was concluded that WBC, neutrophil, NLR, PLR, total, direct and indirect bilirubin levels could be utilized to diagnose AA. Moreover, levels of WBC, neutrophil, NLR, platelet, PLR, LDH, total, direct and indirect bilirubin can be utilized to diagnose complicated appendicitis.

Colonoscopy, which is routinely performed in diagnosis and treatment of colorectal disorders, is a reliable procedure. Its most frequent complications are bleeding and perforation. Splenic rupture is a very rarely met complication of colonoscopy, and delay in its diagnosis leads to increased morbidity and mortality. We presented a 69 years old female patient, who was diagnosed by computerized abdominal tomography, performed for her abdominal pain, which started following the colonoscopy. After 15 days of medical treatment and follow-up, laparoscopic splenectomy was performed one month after her colonoscopy. The patient was discharged on her 4 th postoperative day, with uneventful recovery. In patients who have complaint of abdominal pain following colonoscopy, an intraabdominal pathological condition should be considered and computerized abdominal tomography should be performed. If there is no detected intraperitoneal bleeding, in other words, if there is a sub-capsular hematoma of the spleen, medical management by monitoring the vital signs may be preferred. Then, splenectomy should be performed at an appropriate time. Keywords: Laparoscopy, splenectomy, colonoscopy ÖzKolonoskopi kolorektal hastalıkların tanı ve tedavisinde rutin olarak yapılan güvenilir bir işlemdir. En sık görülen komplikasyonlar kanama ve perforasyondur. Dalak rüptürü ise oldukça nadir görülen bir durumdur. Tanıda gecikme morbidite ve mortalitiye artırır. Biz 69 yaşında bir bayan hastayı sunduk. Kolonoskopi sonrası başlayan karın ağrısı şikayeti olan hastaya çekilen batın tomografisi ile tanı konuldu. On beş gün süreyle medikal tedavi uygulanan ve takip edilen hastaya kolonoskopiden 1 ay sonra laparaskopik splenektomi yapıldı. Ameliyat sonrası bir patoloji olmayan hasta 4. gün taburcu edildi. Kolonoskopi sonrası karın ağrısı oluşan hastalarda batın içi bir patoloji olabileceği düşü-nülerek batın tomografisi yapılmalı. Eğer periton içi bir kanama yoksa yani dalakta subkapsüler bir hematom var ise vital bulgu takibi ile medikal tedavi yapılabilir. Daha sonra hastaya uygun zamanda splenektomi yapılmalıdır.