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Background: The diagnosis of acute appendicitis (AA) is mainly dependent on clinical evaluation. There are several scoring systems developed for an accurate and early diagnosis of AA. Modified Alvarado score is one of the most common systems. The Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) scoring system was developed in 2010. The aim of this study is to evaluate and compare the accuracy of modified Alvarado and RIPASA scoring systems for the diagnosis of AA. Methods: A total of 100 cases with the clinical diagnosis of AA were included in the study. All the cases were treated surgically. For all cases, modified Alvarado and RIPASA scores were calculated and recorded. According to the calculated cut‐off values, sensitivity, specificity, negative and positive predictive values and total accuracy were calculated for each scoring systems. Results: According to the receiver operating characteristic curve. the optimal score of modified Alvarado score for AA was found to be 5.5 with a sensitivity of 88% and specificity of 69%. According to the receiver operating characteristic curve, the optimal score of RIPASA score for AA was found to be 8.75 with a sensitivity of 94% and specificity of 88%. With the cut‐off value of 8.75, total accuracy of RIPASA scoring was found to be 85.2%. Although there is no significant difference in negative appendicectomy rate, both sensitivity and the specificity of the RIPASA were found to be significantly higher than the modified Alvarado. Conclusion: According to the current study, RIPASA scoring system was found to be superior to modified Alvarado in the prediction of cases with AA. [ABSTRACT FROM AUTHOR]

BACKGROUND: The Lichtenstein's and Kugel's procedures for inguinal hernia repair have been compared in terms of immediate complications, including hematoma, testicular pain and wound infection, and long-term outcomes such as chronic pain. OBJECTIVE: The aim of the present study was to compare trunk muscle strength, quality of life (QoL), and neuropathic pain (NP) components using a prospective controlled study following the above two procedures. METHODS: Sixty consecutive patients underwent elective inguinal hernia repair from 2013 until 2014. Thirty patients were operated using standard Lichtenstein, while 30 were treated with a Kugel patch. Six months after initial surgery, trunk muscle strength and patient QoL were evaluated. Additionally, 40 healthy volunteers, matched for age and sex, were recruited for comparison. Trunk muscle strength was measured isokinetically, whereas QoL and pain level were assessed using the Short Form 36 (SF-36) and the PainDETECT questionnaire (PD-Q), respectively. RESULTS: Mean peak moment of trunk flexion and trunk flexor-extensor (agonist/antagonist) ratio were significantly lower in patients than in controls, while no differences were observed between the two surgery groups. In addition, trunk extension strength was mearly identical in all there (2 experimental, 1 control) groups. Only two patients in the Lichtenstein group and one patient in the Kugel group showed a PD-Q score over 19 and NP component. There was no difference in the PD-Q scores and SF-36 domains between the different surgery groups. CONCLUSIONS: Based on the outcome parameters evaluated in this study, none of the two surgical interventions is superior to the other. Therefore, the particular choice of surgical procedure should rely on other factors. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Surgery / Bilimsel Tip Yayinevi is the property of Bilimsel Tip Yayinevi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background/aim: Inguinal hernia repair is one of the most common surgical procedures worldwide. There is still controversy over which method has the best postoperative results. The aim of this study was to compare early and late postoperative results of laparoscopic totally extraperitoneal herniorrhaphy (TEP) and open Lichtenstein herniorrhaphy (OLR). Materials and methods: The study was conducted in a randomized prospective manner and it was concluded with 302 patients (147 cases in TEP group and 155 cases in OLR group). All procedures were performed by two experienced surgeons in both open and laparoscopic inguinal hernia repair. Results: The groups were similar in terms of age, sex, and types of inguinal hernia according to Nyhuss classification. The mean operation time was shorter in TEP group with 49.2 ± 15.5 min vs 54.3 ± 14.6 min in OLR group (P = 0.004). The mean length of hospital stay was significantly shorter in TEP group (P = 0.001). The mean postoperative visual analogue scale score was significantly lower in TEP group. With a mean follow-up of 40.95 months, the recurrence rates were similar in both groups with a rate of 4.3%. In terms of chronic pain, TEP group has better results than OLR with 3.4% vs 25.2%, respectively (P = 0.001). Conclusion: In experienced hands, TEP procedure has better early and late postoperative results than OLR, whereas recurrence rates are similar. [ABSTRACT FROM AUTHOR]

Objective: Incisional hernia is a significant problem after laparotomy, and there is still no consensus on an ideal treatment method. The aim of this study was to compare the results of onlay and sublay mesh repair techniques. Material and Methods: In this randomized prospective trial, 100 patients were divided into two groups: onlay and sublay groups. Recurrences were evaluated by performing a physical examination. Results: The median follow-up was 37.1 (26.6 to 46.5) months. In the onlay group, the mean operation time was significantly shorter. However, in terms of postoperative pain and wound complications, the sublay group had significantly better results. The recurrence rates were found to be similar in both groups (6% in the onlay group and 2% in the sublay group). Conclusions: In the treatment of incisional hernia, sublay mesh repair is superior to onlay mesh repair in terms of postoperative pain and wound complications. Both techniques have similar recurrence rates. [ABSTRACT FROM AUTHOR]

Copyright of Southern Clinics of Istanbul Eurasia is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Radioactive iodine (RAI) treatment is recommended as the first choice for toxic thyroid nodules by American Thyroid Association (ATA). Here, we present our second case of papillary thyroid carcinoma after RAI therapy. A fifty fiveyear- old woman received RAI therapy for toxic thyroid nodule in the right lobe in 2005. Pre-treatment fine needle aspiration biopsy (FNAB) revealed benign cytology. She was euthyroid after the therapy. However, 8 years after the treatment she had 15 mm thyroid nodule in the same location. This time, FNAB result was suspected for papillary thyroid carcinoma. The patient underwent bilateral total thyroidectomy and the histopathological evaluation revealed papillary thyroid carcinoma in the nodule. This is the second case with papillary carcinoma after RAI therapy. Papillary carcinoma developed after the RAI therapy. In conclusion, all cases should be closely followed up after RAI therapy for carcinoma development. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Higher Education & Science / Yüksekögretim ve Bilim Dergisi is the property of Zonguldak Bulent Ecevit Universitesi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkish Journal of Surgery / Ulusal Cerrahi Dergisi is the property of Turkish Surgery Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Non-operative management of abdominal injuries has recently become more common. Especially nonoperative treatment of blunt abdominal trauma is gaining wide acceptance. In this study, the efficacy of non-operative treatment in abdominal trauma (blunt-penetrating) is discussed. Material and Methods: All patients who received treatment due to abdominal trauma from November 2008 to January 2013 were retrospectively analyzed. The demographic characteristics, type of injury, injured organ, type of treatment (operative vs. nonoperative) and mortality data were evaluated. Results: The study includes 115 patients treated for abdominal trauma at our clinics. The mechanism of trauma was; 60% stab wounds, 23.5% blunt abdominal trauma and 16.5% gunshot wounds. Forty-two patients (36.5%) were operated for hemodynamic instability and / or peritonitis on admission. The remaining 63.5% of patients (n=73) were treated nonoperatively, 10 of whom required laparotomy during follow-up. The remaining 63 patients were treated with non-operative management. The success rate for non-operative treatment was 86.3% and there was no difference in terms of the types of injuries. The mortality rate was 4.3% (n= 5) in the whole series, but there were no deaths among the patients who had received non-operative treatment. In the whole patient group 54.2% (n=63) were treated nonoperatively. Conclusion: Nonoperative treatment in abdominal trauma is safe and effective. Patients with clinical stability and normal physical examination findings can be treated nonoperatively with close monitoring. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Higher Education / Yüksekögretim Dergisi is the property of Deomed Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: This study is done to evaluate the accuracy of indications according to malignancy in two hospitals, Konya. Methods: In our study, the patients undergo thyroidectomy operation in two hospitals in years 2007 and 2008 are retrospectively examined. We examined the patients' age, gender, thyroid hormone levels, ultrasonographic findings, if they have, fine needle aspiration biopsy (FNAB) results, the criteria for surgical indication and histopathologic tests. Results: There were 60 patients in group A and 223 patients in group B. The cases in two groups were similar for age, gender and the diameter of the dominant nodule. In group A main indication was potential for malignancy that had been determined by US or FNAB. In group B main indication was potential for malignancy that had been determined by USG. In group A, fine needle aspiration biopsy was performed in 19 of 53 patients with simple noduler goiter. In group B in none of the patients' file there was a record for FNAB. The rate of malignancy was 25% in group A and 13% in group B (p=0.028). Conclusion: This study shows that, in patients with simple goiter, potential for malignancy should be carefully evaluated with clinical findings, USG and FNAB. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the effects of information acquired by KETEM's staff on the diagnosis and treatment of breast cancer. Patients and Methods: Between 2007-2010, BSE was first taught and performed in all women. USG was performed for those ≤40, and MG for those ≥40; also, USG and MRI were ordered, if necessary. For patients with BIRADS 4-5 lesions via USG, MG and MRI and those whose lesions were diagnosed with USG, tru-cut biopsy and USG were performed. While different treatments were administered for those diagnosed with cancer within first 2-year period, their treatments were planned and performed in second 2-year period under decisions by breast council. Information for patients was obtained from the data in hospital, and that concerning staff's training from personal files. Results: Between 2007-2010, 17768 women applied to Konya KETEM [mean age rate 51 (18-19)]. Of these, 10595(60%), 10492(59%) and 119(0.6%) were administered with MG, USG, respectively. Performing biopsy from suspected malignant 378(2%) breast lesions, 104(0.6%) were diagnosed with cancer. Meetings of Breast Council started on 3rd February, 2009. A surgeon was sent to Breast Unit of Istanbul Medical School, Istanbul University for 3 months. All staff in Konya KETEM were trained. While excisional biopsy was performed for 52% of patients with suspected cancers, and modified radical mastectomy was done before 2007-2008, diagnoses were conducted via tru-cut biopsy between(2009-2010), and rate of breast conserving surgery was 24%. Conclusion: In-service training for all staff in KETEMs contributes to modern and accurate procedures in diagnostic and therapeutic stages of breast cancer. [ABSTRACT FROM AUTHOR]

Aim: Diagnosis of intrathoracic goiter is easy by recent modalities. However, unless suggested, it can be overlooked even in patients who have undergone multiple goiter surgery. We would like to emphasize the important points that require attention in diagnosis and treatment, by presenting two cases of failed intrathoracic goiter diagnosis although both patients had undergone thyroidectomy, one twice and the other once, along with a third intrathoracic goiter case diagnosed at first consultation, where an intrathoracic nodule was found separate from the main gland. Results: 1- K.£-, 60-year-old female patient, twice undergone thyroidectomy, 20 and 9 years ago. Finally, the patient was admitted to the clinic of chest diseases due to a complaint of chest pain, and was referred to the clinic of chest surgery with a diagnosis of intrathoracic mass. The examinations resulted in a diagnosis of recurrent goiter with an intrathoracic component. We performed total thyrodectomy by cervical and thoracic incisions. When we investigated her old files, we determined an undetected goiter with an intrathoracic component in her chest X-ray taken 9 years ago. 2- §.A., 38-year-old female patient, undergone total thyroidectomy upon diagnosis of retrosternal goiter. Following the completion of total thyroidectomy, we detected a second thyroid nodule in the mediastinal space, with a diameter of 3 cm, and completely free of main thyroid tissue. 3- FA., 65-year-old male patient, undergone thyroidectomy 20 years ago. We were unable to access his old files. He was admitted to our hospital with a complaint of dispnea. A large portion of his recurrent goiter on the left side was intrathoracic, and his chest X-ray showed a trachea with an advanced deviation to the right. We performed total thyroidectomy. Conclusion: In goiter patients, the intrathoracic component may be overlooked even during surgery. In order to avoid overlooking such a condition, chest X-rays should also be examined for intrathoracic component. Furthermore, the possibility of presence of an intrathoracic thyroid tissue, separate from the main thyroid tissue, should be kept in mind. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study is to determine the factors affecting the development of parathyroid surgery in our hospital. Material and Method: We investigated the age, sex, laboratory, imaging and histopathologic data about the patients who had undergone parathyroid surgery between 2000 and 2010. We evaluated the methods used in diagnosis, determination of surgical indications, surgical and anesthesia techniques and the follow up period. We determined the data that can play a role in the process of diagnosis and treatment of this disease. Results: Until 2005 there were important deficiencies about laboratory investigations and specialists for parathyroid surgery. These were resolved in 2006, except an experienced surgeon. There had been only 2 parathyroid operations until February 2010 (one in 2002 and the other in 2007). In 2008 there was a case with incidental parathyroid adenoma excision during a thyroidectomy. In 2009, with the inauguration of an experienced surgeon, the parathyroid surgeries gained momentum. After this date, there were 28 parathyroid surgeries in 22 months. Twenty two of the cases had primary hiperparathyroidism and 6 had secondary hiperparathyroidism. Twenty one (95,5%) of the 22 parathyroid adenomas underwent MIP Six patients with secondary hyperparathyroidism underwent total parathyroidectomy and parathyroid autotranspiantation. The success rate of the treatment was 100%. Conclusion: Parathyroid surgery is a team work. With an appropriate team, more than 90% of parathyroid adenomas can be treated by MIP. [ABSTRACT FROM AUTHOR]

Purpose: We have noticed the increase in pilonidal sinus operations (PSO) and performed this study to determine the extent of this change and if there is a difference between the number of pilonidal sinus surgery and outpatient and inpatient numbers. Material and Method: We scanned PSO, which was performed in three hospitals [medical faculty hospital (MFH), education and research hospital (ERH) and state hospital (SH)] in the same city, in the last 10 years between 1999 and 2008. We have determined the yearly distribution of cases, total number of operations performed, number of general surgery operations (GSO) at the same period and changes in staff of general surgery clinics. We reviewed the number of outpatients, inpatients and the middle group surgical procedures containing PSO as well, performed at the whole city and the country in the last 10 years. Results: The number of PSO was 234 and the number of GSO was 7.728 at MFHs in the first 5 years. These numbers were 259 and 10.384 in the second period, respectively. The increase was 11% for PSO and 72% for GSO. The increase in PSO was lower than GSO. In ERH there were 506 PSOs in the first 5 years and 760 PSOs in the second 5 years. The number of GSO had increased from 11.563 to 11.452 in the second 5 years. There was a 1% decrease in the number of GSOs, whereas the number of PSOs increased by 50% (p<0.001). The number of PSOs performed in SHs increased from 353 to 1.224, by 247%. Also, the number of GSO increased from 10.215 to 15.595, by 53%. The increase in the number of PSOs in two hospitals (ERH and SH) was statistically significant (p<0.001). The number of PSOs was 246 in 2005 and it became 1.341 in 2008, with an increase of 439% at the whole city. Considering Turkey, the number of PSOs performed was 12.415 in 2005 and it increased to 54.633 (340%) in 2008. Conclusion: There is a rapid increase in the number of PSOs performed at the state hospitals in Konya and all around Turkey. Absolute reasons for this increase should be investigated and preventive measures should be taken. [ABSTRACT FROM AUTHOR]

Objective: To determine changes in surgical treatment of pilonidal sinus disease (PSD) in Konya in last 11 years. Methods: We analyzed patients operated in Konya State Hospital (SH), Education and Research Hospital (ERH) and Medical Faculty Hospital (MFH) between the years 1999 and 2010. There were 4009 patients. We evaluated patients in terms of age, gender and surgical procedures. Results: Of the 4009 cases with PSD, 3591 (89.6%) were male and 418 (10.4%) were female. Procedures using flep (PUF) were a rare option in SH and ERH in the first period. Number of patient treated by surgical procedures using flep was 14 in SH in the first period. In SH, the rate of PUF was 43.8% in 2004, 61.8% in 2005 and after that year it was all above 50%. It reached 82.4% in 2009 in SH. In ERH there were only 15 (2.1%) patients treated by PUF in the first 7 years and it reached a rate of 44.4% in 2007 and 92.8% in 2009. In MFH, the rate of PUF was below 50% (48.3%) only in 2000. Increase in the rate of PUF from 1999 to 2010 was significant in all three hospitals. Conclusion: In MFH, PUF has been the method preferred in treatment of PSD. These methods had began to be used in hospitals of Ministry of Health 5-8 years later. Recently in all three hospitals PUF is used more than 80% of patients with PSD. [ABSTRACT FROM AUTHOR]

Objective: To present our early results with endoscopic transanal electrovaporization of rectal tumours. Design: Retrospective study. Setting: Department of Surgery, Faculty of Medicine, University of Selçuk. Subjects: 10 patients, 4 with malignant and 6 with benign lesions. Interventions: Vaporization of the tumour using a new ridged roller electrode, the VaporTrode, and a standard 24F urological resectoscope. Main outcome measures: Morbidity and recurrence. Results: There were no complications and all adenomas were vaporized completely. 2 patients with obstruction required a further treatment 3 and 5 months later because of recurrence. Median duration of operation was 22.5 minutes (range 10-38) and median duration of hospital stay was 3 days (range 1-4). Conclusion: The VaporTrode is a safe and potentially useful tool for transanal excision of rectal tumours, the long term efficacy of which should be tested in larger series of patients. [ABSTRACT FROM AUTHOR]

Spindle cell lipoma is a rare lipoma, originates from subcutaneous tissue and mostly seen at back region. In this case report we represent a case with inguinal mass misdiagnosed as inguinal hernia and then diagnosed as spindle cell lipoma. There are two cases in literature with spindle cell lipoma originating from spermatic cord. This case is unique as having both pheochromacytoma and inguinal spindle cell lipoma mistaken as inguinal hernia. [ABSTRACT FROM AUTHOR]

Introduction: Adrenal hemorrhage is a rare but life-threatening condition. Spontaneous hemorrhage occurs without any trauma. Focal bleeding may cause even a subclinical condition or cardiovascular collapse with massive bleeding. Non-proper diagnosis may cause even death. In literature most of the cases are treated conservatively. Conservative treatment necessitates close follow up and if fails, surgery becomes challenging. Case: Here, we present a case with spontaneous adrenal hemorrhage that was first taken to conservative treatment and undergone emergency surgery. Conclusion: Conservative treatment of adrenal hemorrhage necessitates close follow up and if fails, surgery becomes challenging. [ABSTRACT FROM AUTHOR]

Fibromatosis, also known as desmoid tumor, is a rare disease. Breast fibromatosis is extremely rare. Herein, we present a case of breast and abdominal aggressive fibromatosis in a woman to discuss optimal treatment management. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to investigate the effectiveness of the use of ligasure in bowel closure operation in rats. Methods: Twenty Wistar-albino rats were divided into two groups with 10 in each. In Group 1, sigmoid colon was incised from the middle and its distal was closed on it with 4/0 silk. In Group 2, sigmoid colon was divided from the middle with ligasure LS1200 probe and its distal was left in the closed form ligasure. In both of the groups, proximal sigmoid colon ans was entered in the form of colostomy with 4/0 silk to the left part of the abdomen. Tissue samples were taken for determination of tissue hydroxyproline level. The measurements of the amount of collagen tissue are determined by an amino acid, hydroxyproline. Results: While the average duration of the operation was 25,7 minutes in Group 1, it was 18,8 minutes in Group 2 and the difference between them was significant in favour of Ligasure (p<0.001). Tissue hydroxyproline level was 123,6 mg/L/gr doku (13-232) in Group 1, and 123.3 mg/L/gr doku (32-216) in Group 2 and no significant difference was determined between the groups. Adhesion level between the groups was also similar. Conclusions: This study experimentally shows that the stump can be effectively closed within a shorter time with ligasure in Hartman colostomy. LigaSure and standard methods were similar for adhesion and hydroxyproline levels. This use of Ligasure in terms of anastomotic healing shows equal success with the standard methods of colostomy. [ABSTRACT FROM AUTHOR]

Amaç: Bu çalışmada, ratlarda bağırsak kapatılması sırasında kullanım kolaylığı sağlayan ligasure kullanımının, doku kollajen miktarı üzerindeki etkisini araştırmak amaçlanmıştır. Yöntem: Yirmi Wistar-albino rat 10'arlı iki gruba ayrıldı. 1. Grupta sigmoid kolon ortasında kesildi ve distal 4/0 ipek ile kapatıldı. 2. grup sigmoid kolon distali ligasure LS1200 prob ile kapatıldı. Her iki grupta, proksimal sigmoid kolon, karnın sol kısmına 4/0 ipek ile kolostomi yapıldı. Bu işlem sırasındaki cerrahi süreleri ile postoperatif 7. günde intraabdominal adezyon düzeyleri değerlendirildi ve doku hidroksiprolin düzeylerinin ölçümü için doku örnekleri alındı. Anastomoz iyileşmesinin biyokimyasal parametresi kollajen miktarı tayini olduğundan, doku örneklerinde hidroksiprolin düzeyinin ölçümü yapıldı. Sonuçlar: Operasyonun ortalama süresi Grup 1'de 25,7 dakika iken, Grup 2'de 18.8 dakika idi ve aralarındaki fark Ligasure lehine anlamlıydı (p <0.001). Doku hidroksiprolin düzeyi Grup 1'de 123,6 mg/L/gr doku (13-232) ve Grup 2'de 123.3 mg/L/gr doku (32-216) idi ve gruplar arasında anlamlı bir fark bulunamadı. Gruplar arasında adezyon düzeyi de benzerdi. Tartışma: Bu çalışmayla kolostomi işleminin ligasure ile daha kısa bir sürede yapılabildiği gösterilmiştir. Ligasure kullanımında, standart yöntemlere kıyasla gruplar arasında doku hidroksiprolin düzeylerinde farklılık tespit edilmemiştir. Bu da anastomoz iyileşmesi açısından Ligasure kullanımının, standart kolostomi yöntemleriyle aynı düzeyde başarılı olduğunu gös [ABSTRACT FROM AUTHOR]

BACKGROUND: The Lichtenstein's and Kugel's procedures for inguinal hernia repair have been compared in terms of immediate complications, including hematoma, testicular pain and wound infection, and long-term outcomes such as chronic pain. OBJECTIVE: The aim of the present study was to compare trunk muscle strength, quality of life (QoL), and neuropathic pain (NP) components using a prospective controlled study following the above two procedures. METHODS: Sixty consecutive patients underwent elective inguinal hernia repair from 2013 until 2014. Thirty patients were operated using standard Lichtenstein, while 30 were treated with a Kugel patch. Six months after initial surgery, trunk muscle strength and patient QoL were evaluated. Additionally, 40 healthy volunteers, matched for age and sex, were recruited for comparison. Trunk muscle strength was measured isokinetically, whereas QoL and pain level were assessed using the Short Form 36 (SF-36) and the PainDETECT questionnaire (PD-Q), respectively. RESULTS: Mean peak moment of trunk flexion and trunk flexor-extensor (agonist/antagonist) ratio were significantly lower in patients than in controls, while no differences were observed between the two surgery groups. In addition, trunk extension strength was mearly identical in all there (2 experimental, 1 control) groups. Only two patients in the Lichtenstein group and one patient in the Kugel group showed a PD-Q score over 19 and NP component. There was no difference in the PD-Q scores and SF-36 domains between the different surgery groups. CONCLUSIONS: Based on the outcome parameters evaluated in this study, none of the two surgical interventions is superior to the other. Therefore, the particular choice of surgical procedure should rely on other factors. [ABSTRACT FROM AUTHOR]

Objective: In this study we evaluated the usefullness of Tc99msestamibi, a tumor agent, to detect malignancy for nodules reported as "SFM" and "ITFL". Methods: Thirteen of 24 cases, reported as "SFM" or "ITFL" by FNAB, underwent bilateral total thyroidectomy after imaging by Tc99msestamibi. Then, Tc99msestamibi imaging, FNAB and hystopathologic results were compared. Results: There were only one male and the mean age was 44,9±12,6 (29-77). We detected "SFM" in 10 (76,9%) cases, and "TFL" in 3 (23,1%) cases. By hystopathologic investigation 6 papillary, 1 follicular, 1 medullary, 4 benign cystic goiter and 1 lymhocytic thyroiditis detected. There was MIBI uptake in all cases with malignancy, except one with medullary thyroid cancer (6 papillary and one follicular cancer). MIBI uptake was detected also in one of four cases with benign cystic gioter and one case with lynphocytic goiter. The mean nodule diameter was 26,9±20,1 mm (23,6±6.87 mm in benign cases, 29,28±26,45 mm in malignant cases, p>0.05). Conclusion: The sensitivity, specifity, pozitive and negative predictive value of of Tc99msestamibi were 75% and 60%, 0,75 ve 0,60, respectively. As conclusion, to determine the usefulness of Tc99msestamibi for detecting malignancy in nodules reported as "SFM" or "ITFL" by FNAB, more studies with larger populations should be performed. [ABSTRACT FROM AUTHOR]

Objective: Total thyroidectomy (TT), as well as thyroid cancer, is commonly performed in the treatment of benign thyroid diseases. This procedure provides satisfactory treatment for accidental thyroid, along with terminating symptoms and risks of recurrences. In this study, the necessity and significance of TT were aimed to be emphasized by determining the risk of accidental thyroid cancer in the cases surgically treated due to thyroid disease. Methods: TT was performed in 505 cases. Among these were the cases of benign multinodular goiter (BMNG), toxic adenoma or toxic multinodular goiter. Postoperative histopathological findings of the cases were evaluated by doing the diagnosis via physical and routine examinations and imaging methods. Results: Mean age rates of the cases were 48 (18-82), and 88.5% were composed of women (n=447). The most frequent clinical diagnosis prior to the surgery was BMNG (n=467, 92.5%).While BMNG was determined as the most common histopathologic diagnosis after TT at the rate of 67.5% (n=341), thyroid cancer was found to be10.9% (n=55). Although papillary cancer was found to be 92.7% (n=51), medullary, follicular and anaplastic types of cancer were found as 0.4% (n=2), 0.2% (n=1) and 0.2% (n=1), respectively. Papillary cancer was also determined to be the highest type in the distribution of thyroid cancers as to sex. Compared to sex, age rates exhibited no statistically significant difference in the distribution of general, benign and malign types of cancers (P>0.05). Conclusion: Because high rates of thyroid cancer were determined after thyroidectomy in benign thyroid diseases, it is appropriate that TT should be preferred for satisfactory treatment in these cases. Now, the morbidity and mortality rates of TT are equal to subtotal thyroidectomy. [ABSTRACT FROM AUTHOR]

Colonoscopy is the gold standard in diagnosis of colorectal diseases. It is generally a safe procedure with low complication rate. Splenic rupture is a very rare complication of colonoscopy. The case presented here, is a 57 years old male patient with complaint of hematochesia. He had colonoscopy and diagnosed as sigmoid colon tumor. After colonoscopy he had the findings of acute abdomen. At the operation splenic rupture was detected and he had undergone splenectomy with subtotal colectomy for the sigmoidal tumor. Splenic rupture is very rare but fatal complication of colonoscopy. In the management of patients with post-colonoscopy abdominal pain splenic injury should be kept in mind. [ABSTRACT FROM AUTHOR]

Background: Acute appendicitis (AA) is the most common reason for abdominal surgery in the world. The aim of this study was to evaluate the effect of medical treatment on histological findings in rabbits with AA., Methods: Twenty-one male New Zealand rabbits were divided into 3 groups: appendix ligation and medical treatment, appendix ligation and no treatment, and control group, which underwent only laparotomy., Results: In appendix ligation without treatment group, AA findings were much more severe., Conclusion: Medical treatment reduced inflammation of AA.

Objective: Surgery and percutaneous aspiration-injection-re-aspiration (PAIR) are widely accepted treatment modalities for hepatic hydatid cysts. Endoscopic retrograde cholangiopancreaticography (ERCP) acts as a minimally invasive rescue method for the biliary complications of both the hydatid cysts and treatment modalities. The aim of this study was to identify the role of different treatment modalities in the obliteration of hydatid cysts., Methods: Patients treated for hydatid cysts between January 2009 and December 2013 were evaluated in the study. Data were collected from hospital records. All cyst cavities were evaluated by ultrasonography or computed tomography., Results: Ninety-five (40.4%) males and 140 (59.5%) females were included in the study. Before the procedures, the mean cyst diameter was 89.7±33.5 mm. At follow-up, the mean cyst diameter decreased to 53.2±30.1 mm. In the ERCP group, the mean diameter of the residual hydatid cyst cavity was significantly lower than that of the other groups (p=0.003)., Conclusion: ERCP provides faster cyst shrinkage and even disappearance of the residual cavity in 50% of cases. Moreover, in hydatid cysts with biliary communication, ERCP+ES can be safely used for primary treatment.

Objective: Hydatid cyst disease (HCD) is a zoonotic infestation of Echinococcus granulosus, which is frequently seen in some regions of the world. Unusual localization of Echinococcus granulosus is very rare. Hence, we would like to present our experience of identifying an extra-hepatopulmonary location of hydatid cysts., Methods: A total of 157 patients with an unusual location of hydatid cysts treated between 2000 and 2012 were retrospectively evaluated according to their age, sex, symptoms, diagnosis, stage, location of the cyst, and treatment modality., Results: Out of 157 patients, 68 were male and 89 were female. The mean age was 43.65 (4-85) years. The most involved organ was the spleen. The cysts were classified in 96, 57, and 4 patients as type I-II, III, and IV-V, respectively., Conclusion: The Puncture, Aspiration, Injection, and Reaspiration regimen should be the primary treatment option for hydatid cysts with unusual locations. As much as possible, organ-preserving surgery should be a treatment of choice in extra-hepatopulmonary hydatid cysts.

Objective: Non-operative management of abdominal injuries has recently become more common. Especially non-operative treatment of blunt abdominal trauma is gaining wide acceptance. In this study, the efficacy of non-operative treatment in abdominal trauma (blunt penetrating) is discussed., Material and Methods: All patients who received treatment due to abdominal trauma from November 2008 to January 2013 were retrospectively analyzed. The demographic characteristics, type of injury, injured organ, type of treatment (operative vs. nonoperative) and mortality data were evaluated., Results: The study includes 115 patients treated for abdominal trauma in our department. The mechanism of trauma was stab wounds in 60%, blunt abdominal trauma in 23.5% and gunshot wounds in 16.5%. Forty-two patients (36.5%) were operated for hemodynamic instability and/or peritonitis on admission. The remaining 63.5% of patients (n=73) were treated nonoperatively, 10 of whom required laparotomy during follow-up. The remaining 63 patients were treated with non-operative management. The success rate for non-operative treatment was 86.3% and there was no difference in terms of the types of injuries. The mortality rate was 4.3% (n= 5) in the whole series, but there were no deaths among the patients who had received non-operative treatment. In the whole patient group 54.2% (n=63) were treated nonoperatively., Conclusion: Nonoperative treatment in abdominal trauma is safe and effective. Patients with clinical stability and normal physical examination findings can be treated nonoperatively with close monitoring.

Objective: Hydatic cyst is a parasitic disease caused by the larvae of Echinococcus granulosus. In the study, the aim is to evaluate the relation between serology and grow-up time in atypically localized cysts., Methods: Retrospectively, all the patients with hydatic disease between December 2004 and May 2012 were screened from the hospital database. Hydatic cyst localization other than the liver and lungs were accepted as atypical localization., Results: There were 325 patients with a diagnosis of hydatic disease. Most common localizations of the cysts were the liver (72.8%) and lungs (21%). Atypically localized cyst rate was 6.4% (n: 21). The most common atypical localization was the spleen (2.4%). 80.9% of atypically localized cysts were primary cases. In 3 cases with primary intramuscular hydatic cyst and 2 cases with primary subcutaneous hydatic cysts, serology was negative., Conclusion: The relation between the hydatid cyst and the host is the main factor in serological tests and grow-up time. In tissues with a weaker cellular immunity like muscle and subcutaneous tissue, serology tends to be negative and grow-up time to be faster. In atypically localized cysts,hematogenous dissemination cannot explain the pathogenesis fully. Therefore, lymphatic dissemination should be kept in mind.