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Background: The aim of this study was to present demographic information of patients undergoing totally implantable venous access port (TIVAP) implantation and to investigate the rates of early and late complications, assessing the benefits of performing the procedure underUS guidance., Methods: From May 2018 to December 2023, the outcomes of a total of 537 TIVAP implantation procedures were analyzed retrospectively. Data of the surgeons' experiences for both puncture methods (anatomical landmarks and ultrasound guidance) are presented in the study., Results: The average age of the patients was 53.1±11.9 years, and 261 (48.6%) were female. The right subclavian vein was the preferred insertion site. Fourteen patients developed early complications and 11 developed late complications. Arterial puncture was the most common early complication, while catheter-related infection was the most common late complication. The age, sex, and body mass index of the patients were not independent risk factors for developing complications. Early complications increased as the number of puncture attempts did (p=0.034) and developed significantly less when ultrasound guidance was used during insertion (p=0.011)., Conclusion: The risk of developing complications was not affected by patient's age or sex. In addition, body mass index was not shown to be an independent risk factor for patients developing complications. It may be concluded from the study that early complications in particular can be reduced with ultrasound-guided implantation.

Background: Ischemia/reperfusion injury of the intestines is a severe surgical condition. This study aimed to reveal ozone therapy effects with relatively increased ozone dosage in a created ischemia/reperfusion injury model., Methods: In this study, 24 albino Wistar rats were examined in three groups. Rats in the control group (CG, n=8) underwent only a laparotomy. In the sham group (SG, n=8) and ozone group (OG, n=8), the superior mesenteric artery (SMA) of the rats was occluded for 1 h. After deoccluding the SMA, the abdomen was closed, physiological saline was infused intraperitoneally in the SG, and an increased ozone/oxygen mixture dose (from 0.7 mg/kg to 1 mg/kg) was infused intraperitoneally in the OG. Small intestine samples were obtained at the 24th h for histopathological examination of intestinal mucosal injury and evaluated according to the Chiu score. In addition, Malondialdehyde and Myeloperoxidase levels were evaluated for oxidant levels, whereas, Glutathione (GSH) enzyme activity was measured to evaluate the tissue antioxidant system., Results: Histopathologically, the Chiu score was the lowest in the CG. It was lower in the OG compared to the SG showing the ameliorating effect of ozone on the intestinal mucosa. Chiu score in the OG was higher compared to that in the CG, but not statistically significant. A significantly higher GSH level was observed in the OG compared to the SG, proving antioxidant activity., Conclusion: In this experimental model of ischemia/reperfusion in rats, treatment with an increased ozone level decreased the inflammatory process through antioxidant mechanisms and reduced intestinal mucosal damage. However, the effectiveness of ozone therapy depends on its dosages.

Background: Signet-ring cell adenocarcinoma of the colon is well-recognized in adult patients who are extremely rare and not well-documented in children. Our study aims to raise awareness about this rare disease and its long-term outcomes., Methods: We retrospectively evaluated patients with signet-ring cell colon adenocarcinoma., Results: Six patients, three boys and three girls, with a mean age of 14.83 (range, 13-17 years), presented with signs of intesti-nal obstruction and were diagnosed with signet-ring cell colon adenocarcinoma. All patients had air-fluid levels on abdominal X-ray. Abdominal ultrasonography of all patients revealed subileus. Abdominal computed tomography was performed in five patients, and pre-operative colonoscopy was conducted in two patients before the emergency intervention. All of the patients underwent emergent exploratory laparotomy with the preliminary diagnosis of acute abdomen. In two patients, debulking surgery followed by a stoma was performed. The remaining four patients were treated with anastomosis following intestinal resection. All girls had metastases on the ovary. One of the patients died due to the burden of multiple metastases in the early period, and three died in the sixth post-operative year. We have been following the remaining two patients since then., Conclusion: Although signet-ring cell carcinomas (SRCCs) are rare, they should be considered in the differential diagnosis of acute abdomen and intestinal obstruction in pediatric patients. Despite early diagnosis and treatment, SRCC has a poor prognosis in the pediatric population.

Background: This study aims to compare the effects of medical ozone (MO) therapy and hyperbaric oxygen (HBO) therapy in an experimental testicular torsion model by measuring the oxidant and antioxidant markers and examining the histopathological tissue damage findings., Methods: Thirty-two Wistar rats are used and are divided into four groups; (1) sham group (SG), (2) only ischemia/reperfusion (I/R) by testicular torsion, (3) HBO administered group, and (4) MO administered group. No torsion was conducted in the SG. In all other groups, rats underwent testicular torsion followed by detorsion to create an I/R model. After I/R, HBO was injected in the HBO group, and in the MO group, intraperitoneal ozone was applied. At the end of 1 week, testicular tissues were obtained for biochemical analyzes and histopathological examinations. Biochemically, malondialdehyde (MDA) levels were measured for oxidant activity, and superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) levels were measured for antioxidant activity. Furthermore, the testicles were evaluated histopathologically., Results: Both HBO and MO have significantly decreased MDA levels, compared with sham and I/R groups, resulting in decreased oxidation effects. The antioxidant GSH-Px levels in the HBO and MO groups were significantly higher than in the sham and I/R groups. In addition, the antioxidant SOD levels in the HBO group were significantly higher than sham, I/R, and MO groups. Therefore, the antioxidant effect of HBO was observed to be superior to MO, specifically considering SOD levels. Histopathologically, there was no significant difference between the groups (p>0.05)., Conclusion: The study may extrapolate that both HBO and MO are antioxidant agents that can be used in testicular torsion. HBO treatment might improve the cellular antioxidant capacity due to increased antioxidant marker levels more than MO therapy. However, further studies are needed with a larger sample size.

Background: Soluble urokinase plasminogen activator receptor (suPAR) is a new biomarker of inflammation level. The aim of the study was to evaluate whether suPAR levels could be useful to detect acute appendicitis and to differentiate uncomplicated appendicitis (UA) from complicated appendicitis (CA)., Methods: We prospectively studied 105 patients consisting of 40 UA cases, 40 CA cases, and 25 control patients. Blood samples were collected to measure suPAR level, C-reactive protein level, leukocyte counts, neutrophil counts, and neutrophil percentages preoperatively., Results: Median values of suPAR level, C-reactive protein level, leukocyte counts, neutrophil counts, and neutrophil percentages in UA and CA were significantly higher than control patients. suPAR levels of the UA and CA groups showed a statistically significant difference (p=0.016)., Conclusion: The current study demonstrated that serum suPAR concentrations can be helpful in differentiating CA from UA and in diagnosing acute appendicitis.

Background: We aimed to evaluate the microbiological and immunological effects of tissue plasminogen activator (tPA) in a rat model of peritonitis., Methods: Twenty-four male Wistar albino rats were divided equally into three groups. Peritonitis and thereafter laparotomy and partial omentectomy were performed in all rats. The control group (C) had no further treatment. The antibiotics group (A) received metronidazole and ceftriaxone. The antibiotic and tPA group (A+T) received the same antibiotics as well as tPA. For microbiological and immunological analysis, blood samples were obtained at the 24th hour, and peritoneal fluid samples were obtained at the 24th and 72nd hours. On the fifth day after surgery, all rats were sacrificed, and the macroscopic findings of the peritoneal cavity were recorded., Results: The mean number of intraperitoneal abscesses was significantly higher in the control group and the lowest in the two treatment group (A+T). The levels of cytokines were not significantly different between groups. Giving tPA reduced the number and sizes of the abscesses with no significant difference in inflammatory response., Conclusion: In this experimental peritonitis model, it can be postulated that tPA decreased abscess formation without exaggerating the inflammatory response.

Background: The aim of this study was to investigate the potential contributory role of laparoscopic appendectomy in the occurrence of postoperative intra-abdominal infections., Methods: A prospective single-center study including 48 patients who underwent laparoscopic appendectomy was conducted between August 2010 and September 2011. Two peritoneal samples were obtained from each patient in the pre- and post-appendectomy period. Aerobic and anaerobic microbiological cultures were obtained from the samples. The data were analyzed with statistical methods., Results: The mean age of the 48 patients (29 male, 19 female) was 10.9 years. Among the pre-appendectomy aerobic cultures, microorganisms were isolated in 18 of the patients (38%), with Escherichia coli being the most common. In post-appendectomy aerobic cultures, various bacteria were isolated in 7 patients (14.6%), with the numbers of bacteria statistically significantly reduced (p<0.05). Anaerobic microorganisms were isolated in 12 patients (25%) and 4 patients (8.3%) in pre- and post-appendectomy cultures, respectively, with Bacteroides fragilis the most common organism; there was a significant reduction in the bacterial count (p<0.05). Each patient was regarded as their own control., Conclusion: Our results suggest that laparoscopic appendectomy does not cause an increase in intra-abdominal infections, and particularly not infections associated with anaerobic bacteria.