Background/aim: Sphincter preserving surgery is one of the main goals in the treatment of rectal cancer because it improves the quality of life (QoL). However, some patients may experience disrupted symptoms called anterior or low anterior resection syndrome (LARS). This study designed to evaluate the frequency and influencing factors of LARS in patients who had undergone sigmoid or rectal resection. Materials and methods: In this retrospective, clinical study, patients who had undergone rectal or sigmoid resection and anastomosis due to any benign and malignant reasons were evaluated in terms of LARS between January 2010 and November 2019 at Mersin University Medical Faculty Hospital. The frequency and severity of LARS determined by using routine LARS scale and influencing factor; including lesion localization, operation, the proximity of anastomosis to the anal verge, creation of stoma, chemotherapy, radiotherapy application were also investigated. Results: A total of 276 of 550 patients included in this study. The major LARS incidence was found as 27.2%. Very low anterior resection (VLAR) , (OR=42.40 (95% CI [11.14-161.36], p<0.0001), protective ileostomy (OR=12.83 (95% CI [6.58-25.0], p<0.0001) end colostomy (OR=8.55 (95% CI [1.36-53.61], p=0.022), receiving chemotherapy (OR=3.08 (95% CI [1.71-5.53], p<0.0001) and radiotherapy (OR=2.51 (95% CI [1.38-4.57], p=0.003) and the ROC analysis showed that creating an anastomosis below 8.5 cm from anal verge were found to be major influencing factors on LARS (p <0.05). Conclusions: LARS may frequently occur in patients who had undergone rectal resection. The most important factors influencing LARS were found as proximity of anastomosis to the 2 anal canal and creating the protective stoma. Receiving chemoradiotherapy also plays an important role in LARS.

<br><b>Introduction:</b> Postoperative intra-abdominal adhesions are a clinical condition that may develop after any abdominal surgery and constitute the leading cause of mechanical small bowel obstructions.</br> <br><b>Aim:</b> This study investigates factors which influence the formation of postoperative adhesion and evaluates the efficiency of applying minimally invasive surgical techniques in reducing adhesion.</br> <br><b>Material and methods:</b> Patients who underwent surgery to diagnose obstructive ileus in our clinic between January 2015 and January 2020 were analyzed retrospectively. Demographic data of the patients, operation details time between the operations and history of hospitalizations, postoperative mortality and morbidity, as well as the severity of complications were recorded. The patients included in the study were divided into groups according to the surgical technique applied in the first operation (laparoscopy/ laparotomy), the abdominal incision line (upper/lower/total), and the etiology of the primarily operated lesion (benign/malignant).</br> <br><b>Results:</b> One hundred eighteen (118) patients were included in the study. The mean age of patients was 61.2 ± 10.8 (39–82) years. Age, ileus history, time to the onset of ileus, length of hospital stay and the number of complications were shorter in the laparoscopy group as compared to the laparotomy group and the difference was found to be statistically significant. In addition, when patients were categorized according to the abdominal incision line, fewer hospitalizations and more frequent postoperative complications due to ileus were observed in the sub-umbilical incision group (p < 0.05).</br> <br><b>Conclusions:</b> Postoperative adhesion formation is currently one of the clinical conditions which pose a challenge to both the patient and the clinician due to its incidence and recurrence. However, adhesion formation can be reduced by applying minimally invasive surgical methods, especially laparoscopic surgery and precise maneuvers during surgery.</br>

Background Preoperative sarcopenia is an essential factor that negatively affects postoperative results. The effect of preoperative sarcopenia on postoperative complications and prognosis in patients treated for Fournier’s gangrene (FG) is controversial. This retrospective cohort study analyzed the effect of FG to evaluate the effect of preoperative sarcopenia on postoperative complications and prognosis in patients who were operated on. Method The data of patients who were operated on with FG diagnosis in our clinic between 2008 and 2020 were reviewed retrospectively. Demographic data (age and gender), anthropometric measurements, preoperative laboratory values, abdominopelvic CT, location of FG, number of debridements, ostomy, microbiological culture result, wound closure method, length of hospital stay, and overall survival were recorded. In addition, the presence of sarcopenia was determined according to psoas muscular index (PMI) and Hounsfield unit average calculation (HUAC). Results Of the patients, 57 (30.8%) were female and 128 (69.2%) were male. According to the PMI, sarcopenia was detected in 67 (36.2%) patients and 70 (37.8%), according to the HUAC. At the end of one postoperative year, the mortality rate was higher in the sarcopenia group than in the non-sarcopenia group (P = .002, P = .01). According to the PMI, patients with sarcopenia have an 8.17 times greater risk of exitus than non-sarcopenic patients. According to the HUAC, patients with sarcopenia have a 4.21 times greater risk of exitus than non-sarcopenic patients. Conclusion Based on this large retrospective study, sarcopenia is a strong and independent predictor of postoperative mortality after Fournier’s treatment for gangrene.

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Background Any papillary lesion in the breast presents a diagnostic and therapeutic challenge. Encapsulated papillary carcinoma (ECP) is one of the rare types of breast cancer. Evidence-based guidelines are sparse. For this reason, there is no complete clarity in the diagnosis and treatment management, and there are not enough studies in the literature. This study aims to examine the necessity of sentinel lymph node sampling in the management of ECP in line with the patients' clinicopathological data. Methods We retrospectively screened with EPC in our clinic between January 2012 and March 2022. We recorded and statistically evaluated the patients' demographic, clinical, radiological, pathological, and treatment management. Results Sixty four EPC patients were identified. The final pathologic evaluation revealed that 19 patients (18.7%) had pure EPC, 27 patients (43.7%) had EPC with associated DCIS, and 18 patients (37.5%) had EPC associated with invasion. The mean age was 61, and 2 patients were male. Breast-conserving surgery was performed in 62 patients, and simple mastectomy was performed in 2. SLNB was found to be positive in only 1 of the patients. Sixty-three patients with EPC were hormone receptor-positive, one patient was triple negative, and they were associated with invasion. No death was in any patient; one had local recurrence, and a mastectomy was performed. Conclusions The overall prognosis and long-term survival of EPC is excellent. Our study and current literature indicate routine SLNB is overtreatment since surgical excision with negative margins is sufficient in EPC cases, and lymph node metastasis is rare, even with an invasive component.

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In the original online version of this article Oreste Claudio Buonomo's family name was misspelled.The original article was corrected.

BackgroundAlthough laparoscopic appendectomy is the criterion-standard treatment method for acute appendicitis, the decision on laparoscopic or conventional technique is usually made according to individual perspectives. The reasons affecting this individual point of view include whether the disease is complicated, the infrastructure of the hospital, the patient's comorbid factors, and previous intra-abdominal operations. This cross-sectional retrospective study aimed to evaluate the safety of laparoscopic appendectomy in patients with a possible diagnosis of “appendicitis” in patients who had undergone previous abdominal surgery.MethodsPatients who were operated on with the diagnosis of acute appendicitis in our clinic between March 2021 and March 2022 were retrospectively analyzed. Patients were grouped as those with a history of abdominal surgery (group 1) and without (group 2). In addition, demographic data of the patients (age, sex), body mass index, presence of comorbid disease, history of abdominal surgery, operation time, rate of conversion to open surgery, postoperative hospital stay, complications, and radiological and pathological appendix size were recorded.ResultsA total of 181 patients were included in the study. The mean age was 32.51 ± 15.89 years. Seventy (38.7%) of the patients were female, and 111 (61.3%) were male. Thirty-four patients (18.8%) were in group 1, and 111 patients (81.2%) were in group 2. The mean age, body mass index, and operation time in group 1 were statistically higher than in group 2 (P < 0.001). However, there was no difference between the groups regarding postoperative hospital stay, radiological and pathological appendix size, conversion to open surgery, and presence and severity of complications (P > 0.05).ConclusionIn line with the data the authors have shown in their study, a laparoscopic appendectomy can be performed safely in patients who have undergone abdominal surgery. Therefore, surgeons should not stray from a laparoscopic appendectomy when they see an abdominal incision.