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Objective: This study aimed to investigate the treatment options and compare patient management with the literature for patients operated on for an acute abdomen who had complications due to inflammation of the Meckel’s diverticulum at our clinics. Material and Methods: This study retrospectively evaluated 14 patients who had been operated on for acute abdomen and had been diagnosed with Meckel’s diverticulitis (MD) in Ege University Medical Faculty Department of General Surgery, between October 2007 and October 2012. Results: Fourteen patients with a diagnosis of Meckel’s diverticulitis (MD) were retrospectively analyzed. Radiologically, the abdominal computer tomography showed pathologies compatible with mechanical intestinal obstruction, Meckel’s diverticulitis and peridiverticular abscess, as well as detection of free air within the abdomen on direct abdominal X-ray. Among patients diagnosed with complicated Meckel’s diverticuli (obstruction, diverticulitis, perforation) 10 patients had partial small bowel resection and end-to-end anastomosis (71.5%), three patients underwent diverticulum excision (21.4%), and one patient underwent right hemicolectomy+ileotransversostomy (7.1%). Conclusion: Meckel’s diverticulum is a vestigial remnant of an omphalomesenteric channel in the small bowel. It is a real congenital diverticular abnormality that contains all three layers of the small bowel. Surgical excision should be performed if Meckel’s diverticulum is detected in order to avoid incidental complications such as ulceration, bleeding, bowel obstruction, diverticulitis or perforation. Meckel’s diverticulitis does not have specific clinical and radiological findings. Delayed diagnosis can lead to lethal septic complications. Complications associated with Meckel’s diverticulitis, especially if a definite diagnosis is not made during the preoperative period, should be considered in the differential diagnosis. In the presence of a complicated diverticulum the appropriate treatment should be emergent surgical intervention.

Objective: In this study, we aimed to determine the significance of the staging systems (EORTC, De Groot, MACIS, and TNM) on the prognosis of well-differentiated thyroid cancer patients who underwent surgery in our clinics. Material and Methods: This retrospective study included 181 patients who were operated between December 1995-December 2007, with a diagnosis of thyroid cancer. In order to obtain data related to cancer staging, a computer program for PDA was developed to facilitate parameter recording. Survival analysis was performed. The findings were compared to the predicted rates by the staging systems. Results: According to the De Groot staging system, stage 1 and stage 2 patients’ results were compatible, but stage 3 and 4 patients’ results were different (stage 3; 87% versus 66.6%, stage 4; 35% versus 100%, p=0.04). In the MACIS staging system, 20-year survival rates are determined and comparison should not be made due to insufficient follow-up period in this study. When compared to the EORTC staging system, stage 3 and stage 4 patients’ results were determined different (stage 3; 51% versus 100%, stage 4; 33% versus 50%, p=0.02). The most consistent results in terms of prognosis was determined in comparison with the TNM staging system (stage 1; 100% versus 97.8%, stage 4; 45.3% versus 50%). Conclusion: Many classification systems are proposed for well-differentiated thyroid cancer, to predict the behavior of the tumor. In this study, we concluded that for determination of prognosis in well-differentiated thyroid cancer, the TNM staging system could best predict prognosis consistent with clinical findings.

Tiroid kanseri, endokrin organ kaynakli kanserler arasinda en sik gorulenidir (1,2). Tiroid kanserlerinin yaklasik %85’ini papiller tiroid kanseri olusturmaktadir. Papiller kanserlerin bir alt grubu olarak siniflandirilan ve ≤10mm tumorler olan ‘papiller mikrokarsinomlar’ tum papiller kanserlerin %30’unu olusturmakta ve daha az agresif davrandiklari kabul edilmektedir (2-5). Yuksek sagkalim oranlarina ragmen bazi hastalarda lokal nuks ve metastazlar ortaya cikmakta ve bu durum daha agresif bir cerrahi tedaviyi gerektirebilmektedir. Her ne kadar literaturde tanimlamasi konusunda kargasa mevcut ise de ‘tiroid kanserinde multisentrisite’, tiroid kanserinin, ayni tiroid lobunda veya iki lob icerisinde birden fazla yerde bulunmasi olarak tanimlanir (6). Gunumuzde yaygin olarak kullanilan tani yontemleri ile papiller mikrokarsinom tanisini ve multisentrik ozelligini belirlemek kolay degildir. Mikrokarsinomlar genellikle palpe edilemez ve klinik olarak sessiz seyretmektedir. Otopsi calismalarinda papiller mikrokarsinom gorulme orani bolgesel olarak degismekle birlikte %0.01-%35 arasinda bildirilmektedir ve bu oranlar cogu papiller mikroarsinomun benign davranisli oldugunu desteklemektedir (2,3,7,8). Cogu mikrokarsinom tanisi ise ‘tesadufi’ olarak benign davranisli tiroid hastaligi nedeniyle ameliyat edilen hastanin piyesinin patolojik incelemesi sonucu ortaya cikmaktadir. Gunumuzde daha yuksek cozunurluklu ultrasonografi ve ultrasonografide kusku duyulan, capi 1 cm’den kucuk nodullere uygulaARASTIRMA YAZISI