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Objective:Postoperative pulmonary complications (PPC) are one of the most important causes of postoperative morbidity and mortality. The ARISCAT Risk Index is a seven-variable regression model that classifies patients as low, intermediate, and high risk and is used to estimate the overall incidence of postoperative pulmonary complications. In our study, we aimed to evaluate the effectiveness of ASA and ARISCAT index in predicting pulmonary complications in after laparoscopic abdominal cancer surgery. Materials and Method:After the approval of Hospital Ethics Committee, 100 patients scheduled to have major laparoscopic abdominal cancer surgery were included in the study. Preoperative ASA and ARISCAT score, comorbidities, intraoperative fluid amount, ventilation parameters, pneumoperitoneum pressure and duration of surgery were recorded. Patients were followed up for pulmonary complications until discharge from hospital. The length of hospital stay was recorded. Results:Pulmonary complications developed in 11 patients postoperatively. PPC incidence was found similiar within ASA and ARISCAT risk groups (p> 0.05). There was no significant correlation between ASA and ARISCAT risk index and PPC (p= 0.23 and p= 0.89, respectively). The number of fluids administered intraoperatively was significantly higher in patients who developed PPC (p= 0.018). There was a significant correlation between sugical site and PPC development (p= 0.012). The duration of surgery and length of hospital stay was longer in patients with PPC (pË,0.05). Conclusion:We found that both ASA score and ARISCAT risk index are not sufficient to predict postoperative pulmonary complications in laparoscopic major abdominal cancer surgery, and the surgical site, long operation time and the volume of fluid used intraoperatively are important independent risk factors for pulmonary complications. [ABSTRACT FROM AUTHOR]

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Hair is the major component of man’s esthetic.Androgenetic alopesia is the most important cause of men hairloss and it is also the main indication for hairtransplant.Hair transplantaion is done mostly by follicular unit implantation which are taken one by one with special punches in recent years. The outcome of the procedure is mainly determined by the donor density of the patient, the size of hair-less area,and the experience,knowledge and the skill of the phycisian.Hair transplantation is a very sophisticated subspeciality branch which provides a great relaxation for male patients. It is also the sole treatment model for androgenetic alopecia and other permanent hair loss diseases. With the advancement and diversification of hair transplantation technique, the improvement of the tools used in surgery and the increse in experiences which create natural results, the hair transplantation became the most demanded cosmetic surgery procedure by men. Hair transplantation results in recent years have a natural appearance and can be done with a very high level of patient satisfaction and safety. The future of hair restoration surgery focuses on cell-based treatments as well as minimal incision surgery. [ABSTRACT FROM AUTHOR]

Background: In this study, it was aimed to evaluate the correlation of ultrasonography (USG) parameters (pyloric muscle sizes) with age in term infants diagnosed with infantile hypertrophic pyloric stenosis (IHPS). Materials and Methods: Data of 49 patients diagnosed with IHPS between November 2015 and December 2019 and underwent pyloromyotomy surgery were retrospectively analyzed for this study. The demographic and laboratory data were obtained from the electronic records of the patients. USG parameters such as pyloric muscle thickness (PMT), pyloric diameter (PD), and pyloric muscle length (PML) were measured separately. Term infants were divided into two groups as neonatal (0-28 days) and postneonatal (29-364 days) in order to compare the distribution of USG parameters by age. Infants whose clinical data and USG images were not available together with preterm infants (gestational age <37 weeks) were excluded from the study. Results: Of the 32 patients included in the study, 24 (75%) were male and 8 (25%) were female, and the mean age of the infants was 57.8 days and the median (minimum-maximum) value was 57.5 (9-180) days at the time of admission. In USG examinations, the hypertrophic pyloric muscle was detected in elongated and thick appearance, narrowing the lumen in all patients. There were 15 (46.9%) infants in the neonatal period and 17 (53.1%) in the postneonatal period. In the preoperative measurements, PMT, PD, and PML were high (median value; 4.8, 11.2 and 19.5 mm, respectively). The pyloric measurements of infants in the neonatal and postneonatal period were similar between the two groups, and there was no statistically significant difference (p> 0.05). The correlation between PMT and PML (r = 0.490, p = 0.033) and the correlation between PMT and PD (r = 0.741, p < 0.001) were significant. However, no significant correlation was found between age and pyloric measurements (p> 0.05). When comparing laboratory data, hemoglobin values were significantly lower in infants in the postneonatal period compared to the neonatal group (11±1.5 and 13.7±2.7 g/dL; p < 0.001, respectively). Conclusion: Due to the advantages of USG ionizing radiation used in the diagnosis of IHPS, high sensitivity, and dynamic examination, it is an effective and reliable imaging method that should be preferred first. Although pyloric measurements are valuable for diagnosis, it has been concluded that there is no significant correlation between age and pyloric sizes. [ABSTRACT FROM AUTHOR]

Aim: Bleeding can not be absolutely terminated in spite of conventional techniques of hemostasis. In order to investigate the effect of Ankaferd Blood Stopper® (ABS) on persisting bleeding after conventional hemostasis. Patients Methods: Between 2009-2010, we applied topical ABS spray or plasebo on orthognatic surgery (n=19). Substances were applied to the surgical field after conventional methods of hemostasis. In orthognatic surgery group, the association of blood loss with the operation type, age, gender, ABS usage, duration of operation and blood pressure were analyzed. Results: The rates of Hb and Htc decline were % 25 in ABS group and % 19 (Hb), % 20 (Htc) in placebo group. The only significant association was with gender indicating a higher blood loss with being male (p=0,01). Conclusion: In conclusion, this study did not reveal any ABS effect on bleeding from the surgical site persisting after conventional hemostasis. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to evaluate the effects of lidocaine injection to scar tissues in addition to physical therapy on pain, depression and functional status in patients diagnosed with fibromyalgia syndrome (FMS) after surgery. Methods: In this retrospective study, 45 female patients who completed their treatment out of 54 patients (52 females, 2 males) who were found to have undergone surgery prior to the diagnosis of FMS out of 117 patients (108 females, 9 males) were included. Patients were divided into groups of physical therapy (PT) and lidocaine injection to scar tissues in addition to physical therapy (PT + lidocaine). All patients underwent PT (hot pack + TENS + therapeutic ultrasound) for 15 sessions to neck / back areas. Lidocaine injection was performed 6 sessions in 3 weeks, with an average of 0.7 cc of %0.5 lidocaine to 1 cm2 scar tissue. Evaluation parameters; pain and morning stiffness [visual analogue scale (VAS)], number of sensitive points, depression level [Beck Depression Inventory (BDI)], functional evaluation [Fibromyalgia Impact Questionnaire (FIQ)]. Pre- and post-treatment data and data 4-6 weeks after treatment were recorded. Results: The study was completed with 22 of PT, 23 of PT + injection, total 45 cases. All cases were women, with a mean age of 40.69 ± 5.51 years. There was no significant difference between the groups in terms of demographic and clinical parameters before the treatment (p> 0.05). Significant improvement was found in all groups for all parameters (p <0.01).When the differences between the groups were compared, pain, morning stiffness, BDI, FIQ in PT + Lidocaine group were significantly changed compared to the PT group (p <0.01). Conclusion: Both PT and PT + lidocaine treatment are effective treatments in women with fibromyalgia syndrome (FMS). In patients who underwent PT + lidocaine, the treatment modality provided more significant well-being than the PT group in terms of pain, severity of morning stiffness, depression and functional status. [ABSTRACT FROM AUTHOR]

Objective: Biochemical recurrence (BCR) does not occur in all patients with surgical margin (SM) positivity after radical prostatectomy (RP). The aim of our study is to evaluate the effect of additional features such as length, extent and Gleason grade on BCR in the positive SM determined in patients undergoing RP in our clinic. Materials and Methods: Clinicopathologic data and SM characteristics of 56 patients with pathologic stages of pT2-3aN0M0 and surgical border positivity were recorded from patients admitted to our RP database with retropublic RP between August 2001 and January 2015 and their relationship with BCR was evaluated statistically. Results: The median follow-up time of the patients was 39.4 (13-208) months. BCR was detected in 17 (30.3%) of the patients. Prostate specific antigen levels, tumor volumes and tumor percentages were found significantly higher in the patients with BCR (p<0.05). In the BCR group, focal SM positivity was found statistically less frequent compared with the disease-free follow-up group (47.1% and 94.9% respectively; p<0.001). There was no statistically significant relationship between BCR both surgical margin Gleason grade (SMGG) and SM length (p>0.05). According to the Kaplan-Meier survival analysis, the relationship between SMGG and the time of BCR was statistically significant (p=0.04). In SMGG 5 patients, the duration of BCR development was found significantly shorter. According to multivariable Cox regression analysis none of the factors were found to be effective on BCR (p>0.05). Conclusion: SM positivity is one of the important factors for BCR. However, patients with positive SMs are quite heterogeneous and it is obvious that not all patients should be treated in the same way. It is wise to assess adjunctive SM features such as SM, length, Gleason score and grade, and decide according to the patients' risk groups to decide on adjuvant treatment. [ABSTRACT FROM AUTHOR]

Background and Design: The risk factors for scar development are still being discussed by dermatologists and surgeons. The aim of this study was to analyze the independent risk factors for the development of incisional scar type which develop after an abdominal delivery. Materials and Methods: Four hundred-ninety-two women who underwent caesarean operation one year ago or earlier were included in this study. After a detailed anamnesis and physical examination, data including demographic features, type of suture materials, time of suture removal, presence of striae, family history of hypertrophic scar, history of infection and/or hematoma, and total weight gain during pregnancy were recorded from the medical reports of patients. The scars were separated into two groups as atrophic and hypertrophic. The obtained data were compared according to the type of scars. A p value of less than 0.05 was considered statistically significant. Results: Both groups were similar in terms of demographic data. Atrophic scars were found in 408 of 492 patients and hypertrophic scars in 84 patients. Presence of wound site infection or hematoma (odds ratio OR: 5.64, 95%, confidence interval CI: 3.12-10.22), presence of striae (OR: 1.80, 95% CI: 1.12-2.91) and positive family history of hypertrophic scar (OR: 4.25 95% CI: scar formation, while removal of nonabsorbable suture in less than 8 days (OR: 5.04 95% CI: 2.31-10.99) and wound closing time up to 11 days (OR: 2.80 95% CI: 1.64-4.78) were correlated with atrophic scar formation. Conclusion: Family history of hypertrophic scar, suture removal time after 7 days and complicated wound healing process seem to be risk factors for hypertrophic scar formation after surgical incision. Knowing these risk factors may contribute to the development of strategies to prevent scar formation. [ABSTRACT FROM AUTHOR]

Fibromatosis is the most common primary tumor of mesentery. Mesenteric fibromatosis is a very rare lesion which does not metastasise but can be locally aggressive. Fibromatosis may be classified as extra-abdominal, abdominal wall, or intra-abdominal. The etiology of fibromatosis has not been determined. Most of the patients with mesenteric fibromatosis are asymptomatic. Herein, we presented a case who was 45 years old, complained of left lower quadrant pain. Preoperative evaluation included abdominal ultrasound, computed tomography (CT). According to the CT report, the patient was diagnosed with gastrointestinal stromal tumor. A mobile mass was seen on the jejunal mesentery during laparoscopic exploration. The tumor was removed by wide excision with safe margins. Patients was discharged on the fifth day of the operation. The histological diagnosis was of jejunal agressive fibromatosis. Even though there are different types of treatment protocols, surgery with negative surgical margin is preferred to prevent local recurrence. In these type of cases safe margins can be achieved with wide laparoscopic excision. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to determine the risk factors and the effect of prophylactic antibiotic use on surgical site infection after elective operations in neurosurgery and orthopedic departments. Methods: Prospectively 154 patient evaluated in neurosurgery and orthopedic departments at the Medical Faculty of Marmara University Hospital. All data collected by the method of face to face interview according to "Patient Follow-up Form". The patients observed fort the sing and symptoms of infection and prophylactic antibiotic use, from the beginning to the end of hospitalization. After discharge the patients were asked about the sing and symptoms of infection by telephone interview. Results: At the end of the study surgical site infection identified in thirteen patients: Pseudomonas aeruginosa and Enterococcus fecalis were responsible for surgical site infections in two patients. Multivariate Logistic Regression Analysis of surgical site infection risk factors showed that urinary catheter use increase infection risk 5.8 times (Odds ratio;5.80, P value=0.031, %95 Confidence intervals; 1.17-28.61). Other risk factors (duration of hospitalization, prosthesis implantation, duration of operation, body mass index) were not statistically related with surgical site infection. Conclusion: In order to prevent the development of surgical site infection it is important to determine the risk factors and not to apply invasive procedures. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the outcomes of phacoemulsification with anterior chamber maintainer in vitrectomized eyes with complicated cataract. Material and Method: Twenty eyes of 20 patients who developed complicated cataract after pars plana vitrectomy (PPV) were included in the study. Phacoemulsification with clear corneal incision and foldable intraocular lens implantation was performed. In group 1, anterior chamber maintainer (ACM) was used during phacoemusification and in group 2, ACM was not used. Pre- and postoperative visual acuities as well as per- and postoperative complications were reviewed retrospectively. Re sults: Anterior chamber maintainer was used during the surgery in 12 (60%) cases and was not used in 8 (40%) cases. Phacoemulsification was performed 16.5±9.2 (4-40) months after PPV. Best-corrected visual acuities were between hand motions and 0.4 preoperatively and between counting fingers from 1 meter and 1.0 postoperatively in group 1. Best-corrected visual acuities were between hand motions and 0.1 preoperatively and between counting fingers from 1 meter and 0.8 postoperatively in group 2. Posterior capsule was ruptured in 1 eye peroperatively in group 1. In group 2, phacoemulsification was more difficult due to deep anterior chamber in 8 eyes and intraoperative complications were iris sphincter rupture in 1 eye and posterior capsule rupture in 1 eye. Mild corneal edema in 7 (58.3%) eyes, fibrin reaction in 2 (16.6%), intraocular lens decentralization in 1 (8.3%) and posterior capsule opacification in 4 (33.3%) eyes were the postoperative complications in group 1. Mild corneal edema in 5 (62.5%) eyes, fibrin reaction in 1 (12.5%) and posterior capsule opacification in 2 (25%) eyes were the postoperative complications in group 2. Discussion: Complicated cataracts which may develop after PPV can be treated safely with phacoemulsification. Continuous irrigation during the surgery may provide a stable anterior chamber and prevents surgical complications. [ABSTRACT FROM AUTHOR]

Aim: Eccrine spiradenoma is a rare soft tissue tumor that originates from the eccrine sweat glands. We aimed to evaluate the outcomes of our patients who underwent surgery for eccrine spiradenoma. Material-Methods: Nine patients who underwent surgery for eccrine spiradenoma between January 2006 and July 2011 were reviewed in detail to obtain information regarding clinical and histopathological features retrospectively. All patients' age, gender, symptomts and duration, mass localization, surgical findings, pathology reports, postoperative complications and follow-up data were recorded. Results: There were 3(33.3%) male! 6 (66.7%) female patients with a median age 37,7 ± 14,8 (24-75) years in the study group. The pathology report of 8 patients was benign, while one was malignant. The patient with malign eccrine spiradenoma was a 75 year-old female. All patients presented with a palpable mass (100%) and 5 of them (55%) had also pain and tenderness. The average duration of complaints was 8.6 years (3-15 years). The masses were localized in back in the thoracic spine in 3 patients, on the scapula in 2, on an arm in 2 and on the right lateral neck in I case. The malign mass was located in the haired skin of the patient. All masses were excised with a clean surgical margin. No recurrence was detected at a median follow-up period of 31.8 months. Conclusion: Eccrine spiradenoma should be taken into consideration in the differential diagnosis of the soft tissue masses of the skin. Radical surgical excision should be planned due to the risk of malignancy and recurrence. [ABSTRACT FROM AUTHOR]

Aims: In this study we investigated that surgical site infections established in Kocatepe University Medical Faculty Hospital betvveen January 2007- December 2008. Material methods: In our hospital, hospital infection surveillance are carried out by maintaince prospective surveillance method and the data are recorded regulary. In this study we were obtained the data among surveillance recods. Results: At the end of the study we found that 134 surgical site infection attacks in 113 patients. In our hospital surgical site infection rate was found 15.5%. 61.9 % of these attacks were superficial-incisional, 26.9 % of them vvere deep-incisional and 11.2 % of them were organ/space infections. When infection agents were evaluated we found that Gram positive agents rate vvere similar to Gram negative agents. Conclusion: Surgical site infection surveyans are important like hospital infection surveillance in all hospital because surveillance data can reveal some defects in hospital. [ABSTRACT FROM AUTHOR]

Objective: Evaluation of a patient with cervical lymphadenopathy (TbLa) initially with suspected malignancy was discussed. Case report: A 23-year-old patient presented with growing cervical mass, weight loss and night sweats. Under local anesthesia, the patient underwent incisional biopsy of cervical lymph node. Histopathological analysis of the tissue revealed "caseous granulomatous lymphadenitis". Ehrlich Ziehl Neelsen staining showed acid-fast bacteria (ABR). The tissue M.tuberculosis complex-polymerase chain reaction (PCR) was positive but culture for tuberculosis (Tb) was negative. For diagnosing the pulmonary tuberculosis (ATb), ABR smears and cultures of sputum were taken. Tb bacilli in sputum was identified and also the culture was positive. The patient was diagnosed as "primary active lung tuberculosis ATb and cervical TbLa" with these findings. Conclusion: The patient recovered completely by 9-month combined anti-tuberculous therapy and the treatment was well tolerated. [ABSTRACT FROM AUTHOR]

Objective: We retrospectively evaluated the relationship between preoperative prostate specific antigen (PSA), PSA density, free/total PSA ratio and unfavorable pathological features of surgical specimen and biochemical failure in patients with clinically localized prostate cancer who have undergone radical retropubic prostatectomy. Materials and methods: The study included 75 patients with clinically localized prostate cancer who have undergone radical retropubic prostatectomy and bilateral pelvic lymphadenectomy. Patients were divided into groups according to preoperative PSA densities (two groups as <15% and >15%) and free/total PSA ratios (three groups as <10%, 10-20% and >20%). Serum PSA levels of 0.2 ng/mL and higher were considered as biochemical failure after radical prostatectomy. The distribution of patients according to positive surgical margins, extracapsular extension, seminal vesicle involvement, perineural invasion, pathological stage, and postoperative biochemical failure were evaluated. Results: The mean follow-up period after radical prostatectomy was 17.1±12.2 months. Unfavorable pathological features of surgical specimen were significantly related only with preoperative serum PSA level of >10 ng/mL (p<0.05). Biochemical failure was detected in 25.7% of patients during follow-up (n=18). The only significant parameter associated with biochemical failure was preoperative serum PSA level >15 ng/mL (p<0.05). Conclusion: Preoperative PSA level is still the most important parameter in the prediction of postoperative pathological stage and biochemical recurrence. [ABSTRACT FROM AUTHOR]

Objective This systematic review was done to evaluate studies that investigate effect of unshaved skin preparation on development of surgical area infection on patients having cranial surgery. Material and Method Review of the study was done by using keywords "tirassiz kraniyal cerrahi", "unshaved neurosurgery", "without shaving cranial surgery" in search engines and reference lists of included studies. The studies that were published in English and that examine relationship between skin preparation and development of surgical area infection in patients who had cranial surgery were included. Data was analyzed by using a standard data summarizing form. Results Within potentially related review, studies that were published between 1992-2009 were included into systematic review. 5 of the studies are in form of non-randomized controlled study and 9 of them are designed as semi-experimental study. Because of nonexistence of control group in semi-experimental studies no results were reported about effect of unshaved skin preparation on development of surgical are infection. Nevertheless it was also expressed that there is no difference between groups in the studies that have a control group. Conclusion There is need for well-designed, randomized controlled studies that show the effect of unshaved skin preparation on the development of surgical area infection in patients having cranial surgery and that show contribution to adaptation of patient's routine life. It is thought that this systematic review will guide in the planning of studies that will be done on this topic. [ABSTRACT FROM AUTHOR]

Gossypiboma is a mass lesion at the site of surgery due to a forgotten surgical sponge. Forgotten foreign bodies are mostly retained in the abdominal cavity but there are some cases in the thorax, cranium, breast, and an extremity. Gossypiboma should be considered, especially by radiologists, in patients with a history of surgery, who present with non-specifc symptoms and abdominal mass. In this report, we describe the case of a female patient who presented with non-specifc abdominal discomfort and fever about six months after open cholecystectomy. (The Medical Bulletin of Haseki 2014; 52: 47-9) [ABSTRACT FROM AUTHOR]

Objectives: To ensure reconstruction of contracted eye socket with the use of simple incision and appropriate conformer. Materials and Methods: A total 54 cases who applied between 1991-2006 years, due to the complaint of not fitting the prosthesis were enrolled. Results: The mean follow up time was 72.8 (6-119) months. After simple incision 28 patients was able to fit their prosthesis after first operation. This incision was repeated two times in 7 patients and three times in 2 patients. We were unable to follow 7 patients with simple incision. In 37 out of 47 patients the results were found to be successful, in 12 patients other methods were used. Conclusion: In anophthalmic socket and postenucleation socket syndrome, simple incision can be taken into consideration before deciding for an enhancement operation. [ABSTRACT FROM AUTHOR]