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In this study, we aimed to investigate the clinical features of Papillary thyroid carcinoma(PTC) Tall cell variant(TCV), long-term outcomes and surgical experience in papillary thyroid carcinoma.33 patients who were operated in our clinic between August 2012 and March 2018 and diagnosed as TCV in their pathology evaluation were included in the study. The demographic and clinical features of the patients, pathological features of the tumor and long-term results were examined.A total of 33 patients were included in our study. The mean age was 55.2(18-85) years. The female sex was more dominant (75.8%). The most common presenting complaint was swelling in the neck (75.7%).Total thyroidectomy was performed in 84.8% and completion thyroidectomy after lobectomy was performed in 15.2%. Neck dissection was performed in 33% of the patients. The mean tumor diameter was 3.6 (1-10) cm. The tumor was multifocal in 36.3% of the patients. The capsule invasion rate of the tumors was present in 69.7% of the patients, extrathyroidal rate was 39.4%, Metastatic lymph nodes were detected in 30.3% of the cases. The mean follow-up duration was 39.3+22.4(5.25-78.63) months. 39.4% of patients had distant metastasis during follow-up. Disease free survival rate was 57.6%, total survival was 42.4 + 3.8 (34.7-50.0) months.TCV is closely associated with larger tumor diameter, multifocal location, extrathyroidal spread and lymph node involvement, We believe that more aggressive surgery should be performed in the treatment of TCV cases and it is important to follow up the patients more closely.Esophagus cancer, Neutrophil/lymphocyte ratio, Preoperative lymphocyte /neutrophil ratio, Prognosis.Questo studio è finalizzato ad analizzare le caratteristiche cliniche del carcinoma papillare della tiroide (PTC), variante a cellule alte (TCV), gli esiti a lungo termine e l’esperienza chirurgica nell’ambito del carcinoma papillare della tiroide. Nella nostra clinica tra agosto 2012 e marzo 2018 sono stati operati 33 pazienti, e diagnosticati come TCV dall’anatomo- patologo, e su questi si è rivolto in nostro studio retrospettivo, esaminando le caratteristiche demografiche e cliniche, le caratteristiche patologiche del tumore e i risultati a lungo termine. L’età media dei 33 pazienti era di 55,2 (18-85) anni. Il genere femminile era più dominante (75,8%). Il sintomo più frequente è stato il gonfiore del collo (75,7%), la tiroidectomia totale è stata eseguita nell’84,8% e la tiroidectomia di completamento dopo la lobectomia è stata eseguita nel 15,2%. La dissezione del collo è stata eseguita nel 33% dei pazienti. Il diametro medio del tumore era 3,6 (1-10) cm. Il tumore era multifocale nel 36,3% dei pazienti. Il tasso di invasione della capsula dei tumori era presente nel 69,7% dei pazienti, il tasso di sviluppo extratiroideo era del 39,4%, i linfonodi metastatici sono stati rilevati nel 30,3% dei casi. La durata media del follow-up è stata di 39,3 + 22,4 (5,25-78,63) mesi, ed il 39,4% dei pazienti ho presentato metastasi a distanza nel corso del follow-up. Il tasso di sopravvivenza libera da malattia è del 57,6%, la sopravvivenza totale è di 42,4 + 3,8 (34,7-50,0) mesi. In conclusione il TCV è strettamente associato a dimensioni maggiori del tumore maggiore, sviluppo multifocale, diffusione extratiroidea e coinvolgimento dei linfonodi. Riteniamo che si debba eseguire un intervento più aggressivo nel trattamento dei casi di TCV ed è importante seguire più da vicino i pazienti.

Background Periductal mastitis (PM) is a rare disease characterized by chronic inflammation of the terminal mammary ducts. Complete removal of terminal lactiferous ducts with Hadfield procedure is a previously defined technique in treatment but carries various complications risks. This study aims to evaluate the effectiveness of modified techniques in the treatment of PM. Methods Twenty women who underwent surgery due to PM between January 2012 and December 2019 were retrospectively analyzed. Types of PM were determined. All patients were operated on with three different incisions [Hadfield’s operation with periareolar incision (n:11), periareolar combined radial incision (n:7), and round block incision (n:2)]. Results The mean age was 37.5 ± 6.5 years (range: 24–49). Sixty percent of patients had type 3 PM. In Hadfield’s procedure, NAC retraction (n:2), seroma (n:1), and hematoma (n:1) were seen. In the periareolar incision combined radial incision group only one patient had complications (seroma) and none in the round block method. Follow-up was 12 ± 1.5 months and disease relapse occurred in two patients in the Hadfield group. Patients who underwent round block were more satisfied with the appearance of the nipple. Conclusions In the treatment of PM, the main principle of surgical treatment is the excision of the affected canal with a clear margin. Apart from the classical Hadfield procedure, the round block method and periareolar combined radial incision techniques can be performed in the treatment of PM.

PURPOSE Breast cancer is the most frequent cancer in women, and there is a great variability in surgical practice for treating that cancer in different countries. The aims of this study were to analyze the effect of guidelines from the Turkish Federation of Breast Diseases Societies on academic institutions that have breast centers and to evaluate surgical practice in Turkey in 2018. PATIENTS AND METHODS Between January and March 2019, a survey was sent to breast surgeons who were working in breast centers in academic institutions. The sampling frame included 24 academic institutions with breast centers in 18 cities in Turkey to evaluate interdisciplinary differences among breast centers and seven regions in Turkey regarding patients’ choices, surgical approaches, and academic institutions. RESULTS All surgeons responded to the survey, and all 4,381 patients were included. Most of the surgeons (73.9%) were working in a breast center. Multidisciplinary tumor boards were performed in 87% of the breast centers. The average time between clinical evaluation and initiation of treatment was 29 days; the longest time was in Southeast Anatolia (66 days). Only 6% of patients had ductal carcinoma in situ. Sentinel lymph node biopsy was available in every region across the country and was performed in 64.5% of the patients. In 2018, the overall breast-conserving surgery rate was 57.3% in Turkey, and it varied from 72.2% in the Black Sea region to 33.5% in Central Anatolia ( P < .001). Oncoplastic breast surgery options were available at all breast centers. However, 25% of the breast centers from the Black Sea region and half the breast centers from Eastern Anatolia and the Mediterranean region did not perform this type of surgery. CONCLUSION Increasing rates of nonpalpable breast cancer and decreasing rates of locoregional recurrences favored breast-conserving surgery, especially in developed countries. Guidelines from the Turkish Federation of Breast Diseases Societies resulted in more comprehensive breast centers and improved breast health in Turkey.

PubMedID: 25971825 BACKGROUND AND OBJECTIVES: The incidence of primary extrahepatic cystic echinococcosis (CE) is rare. Generally, radiological and serological findings can help establish the diagnosis of hepatic and pulmonary CE, but a CE in an unusual location with atypical radiological findings may complicate the differential diagnosis. The objective of this study is to present the characteristics of cases with extrahepatic CE in respect of sites of involvement, clinical presentations, radiological findings, serological diagnostic evaluations, and outcomes of infected patients. DESIGN AND SETTINGS: A retrospective analysis of surgically treated CE was conducted between January 1993 and January 2014 in the General Surgery, Pediatric Surgery, Urology, Cardiovascular Surgery, Neurosurgery, and Orthopedics departments of University of Cukurova, Faculty of Medicine, Balcali Hospital. PATIENTS AND METHODS: Among the 661 patients managed for CE, 134 had unusual sites of involvement. Radiological and serological examinations were used to differentiate CE from alveolar echinococcosis. RESULTS: Of 134 cases with unusual sites of involvement, 32 cases had liver CE (23.9%), 7 cases had lung CE (5.2%), and 2 cases had concomitant liver and lung CE (1.5%). In 93 (69.4%) cases, unusual organ involvement was isolated without any liver or lung involvement. The mean age was 45 years. Abdominal pain was the main symptom and was found in 104 patients. Thirty-one (23.1%) of 134 extrahepatic CE cases were evaluated as negative with indirect hemagglutination (IHA). However, positive results were obtained in 54 cases evaluated with Echinococcus granulosus IgG Western blot (WB), including 10 IHA-negative cases. CONCLUSION: CE with unusual localizations may cause serious problems of diagnostic confusion. The combination of clinical history, radiological findings, and serological test results (especially the WB) are valuable in diagnosing extrahepatic CE.

PubMedID: 26093739 Objectives This study presents the overall long-term hepatitis B virus (HBV) recurrence rate with possible associated factors after hepatitis B immunoglobulin (HBIG) was given in combination with 4 different antiviral (lamivudine, adefovir, entecavir, and tenofovir) drugs. Patients and Methods Between September 2000 and October 2013, the medical records of 42 adult patients who underwent liver transplantation at the Cukurova University Medical Hospital for chronic liver failure or hepatocellular carcinoma (HCC) secondary to chronic HBV were reviewed retrospectively. The analyses of risk factors for recurrence were performed based on the efficacy of hepatitis B envelope antigen (HBeAg), hepatitis B core antibody (anti-HBc), HBV DNA, preoperative prophylaxis, and the presence of HCC. Posttransplantation HBV recurrence was defined as persistence of hepatitis B surface antigen (HBsAg) positivity after orthotopic liver transplantation, or the reappearance of HBsAg and HBV DNA after initial HBsAg undetectability despite prophylaxis. Results The mean follow-up of 28 patients having HBIG and lamivudine prophylaxis was 73.25 ± 37.5 months with a recurrence rate of 3.5%. The mean follow-up of 2 patients having HBIG and adefovir prophylaxis was 90 ± 46.6 months with a 50% recurrence rate. The mean follow-up of each 6 patients who received prophylaxis with entecavir and tenofovir groups were 27.5 ± 16.1 and 16.17 ± 5.3 respectively, with no posttransplantation recurrence for both groups. On univariate analysis, preoperative factors such as anti-HBc, HBV DNA, preoperative prophylaxis, and the presence of HCC did not show any correlation with recurrence. However, HBeAg showed statistical significance for recurrence. Conclusions Low-dose HBIG in combination with antiviral agents (lamivudine, entecavir, and tenofovir) is efficacious in preventing recurrence of HBV in posttransplantation patients. © 2015 Elsevier Inc. All rights reserved.

AMAÇ: Abdominal kompartman sendromu (AKS), sınırlı bir anatomik alana sahip karında basıncın akut ve patolojik artışı ile karakterize olup, tedavi edilmediği takdirde yüksek oranda mortaliteyle sonuçlananan klinik bir durumdur. Karıniçi basıncın progresif yükselmesi sonucu ortaya çıkan bu sendromun etkileri sistemik olarak ortaya çıkar. Abdominal kompartman sendromunun tedavisi, artmış karıniçi basıncın düşürülmesidir. Dekompresif laparotomi kararını vermede en önemli kriter hastanın klinik tablosudur. Grade 3 ve 4 hastalarda dekompresif laparatomiyi takiben ameliyat sonrası karıniçi basıncın tekrar yükselmesini engellemek için karın kapatılmaz, açık abdomen uygulanır. Bu çalışmada, dekompresif laparotomi uygulanmış evre 3 ve 4 AKS'li hastalara geçici karın kapatılmasında kullanılan Vacuum-assisted closure (VAC) ve Bogota bag yöntemlerinin randomize ileriye yönelik değerlendirilmesi amaçlandı. GEREÇ VE YÖNTEM: Bu çalışmaya Şubat 2007 ile Eylül 2010 tarihleri arasında Çukurova Üniversitesi Tıp Fakültesi Genel Cerrahi Yoğun Bakımı'na travma, geçirilmiş cerrahi sonrası ya da medikal takiplerinin izlemi sırasında AKS gelişmiş ve tedavilerinin bir parçası olarak dekompresif laparotomi uygulanmış 40 hasta alındı. Hastalar ardışık randomizasyon yöntemi ile VAC ve Bogota bag olmak üzere iki gruba ayrıldı. Geçici karın kapama yöntemleri olan bu yöntemlerin sonuçları gruplar arasında randomize ileriye yönelik olarak klinik, laboratuvar, morbidite ve mortalite yönünden karşılaştırılarak değerlendirilldi. BULGULAR: Her iki gruptaki hastaların yaş, cinsiyet, vücut kitle indeksi ve yandaş hastalıkları gibi demografik özellikleri arasında anlamlı fark yoktu. AKS gelişen hastalarda etiyolojik faktörler arasında en sık neden 12 hastada (%30) görülen gastrointestinal sistem perforasyonu idi. İnsizyon boyutu ölçümlerinde VAC grubunda daha anlamlı bir azalma vardı. Hastanın primer fasya kapatılması için uygun hale gelmesi için geçen zaman VAC grubunda 16.9 gün iken, Bogota bag'li grupta 20.5 gün idi. Karıniçi basıncı düşürme değerlendirildiğinde; her iki grupta 1., 4. ve 7. günlerde benzer oranlarda düşme saptanırken, ameliyat sonrası 14. günde VAC grubunda anlamlı olarak daha fazla düşme saptandı. Mortalite gelişen hasta sayısı 12 (%30) iken, beş (%12.5) hasta VAC grubuna, yedi (%17.5) hasta Bogota bag grubuna aitti. TARTIŞMA: Bulgulara dayanarak geçici karın kapama yöntemi olarak VAC uygulamasının daha uygun olduğu kanaatindeyiz. BACKGROUND: Abdominal compartment syndrome (ACS) is a clinical syndrome characterized by progressive intraabdominal organ dysfunction resulting from an acute increase in intra-abdominal pressure (IAP). In the absence of prompt treatment, ACS can lead to lethal organ failure. Treatment of ACS is achieved by immediate decompression of the abdominal cavity. As to how and when decompression laparotomy should be performed depends on the clinical condition of the patients. There is limited data regarding outcomes of abdominal closure techiques. The present study aimed to investigate two different temporary closure methods, the vacuum assisted closure (VAC) and Bogota bag techniques, in 40 patients who underwent decompressive laparotomy as part of the management of ACS.METHODS: The study included 40 patients who developed ACS during follow-up or following trauma and abdominal surgery. As part of the treatment for ACS, these patients underwent decompressive laparotomy at the Cukurova University Medical Faculty, General Surgery Department and followed up in the Intensive Care Unit of the same hospital. VAC and Bogota bag procedures were performed as temporary closure methods for the treatment of ACS. Patients were randomly assigned to each of the two groups according to the temporary closure method performed. Clinical, laboratory, mortality and morbidity results of the patients in both groups were compared.RESULTS: Demographic features of the patients (age, sex, body mass index, co-morbidities) were similar between the two groups. The most common reason of ACS was gastrointestinal perforation in 12 (30%) patients. Decrease in incision width was significantly faster in the VAC group than in the Bogota group. Primary closure of fascia was considered appropriate in 16.9 days in the VAC group and 20.5 days in the Bogota bag group. The decrease in abdominal pressure was similar between the two groups on days 1, 4 and 7 but appeared to be significantly lower on day 14 in the VAC group. 12 patients (30%) died during the study. Among the deceased patients, 5 (12%) were in the VAC group, whereas, 7 (17.5%) belonged to the Bogota bag group.CONCLUSION: Based on these results, it is suggested that VAC has advantages when compared to the Bogota bag as a temporary closure method in the management of abdominal compartment syndrome

PubMedID: 22146169 BACKGROUND: There is no debate that laparoscopic fundoplication has become the standard procedure for surgical management of gastroesophageal reflux disease. However, there is still no consensus on whether to use prosthetic material routinely and on the preferred kind of prosthetic material. The aim of this study was to evaluate polyglactin mesh and polypropylene mesh use in laparoscopic antireflux surgery (LARS) with particular regard to symptomatic relief, patient satisfaction, and complications. METHODS: This prospective randomized study included 75 patients who underwent LARS with polypropylene mesh prosthesis and 75 patients who underwent LARS with polyglactin (vicryl) mesh prosthesis between January 2005 and January 2010. Preoperative and postoperative assessments of symptomatic and functional outcomes of patients were recorded. Outcome data analyzed included length of hospitalization, operative time, complications, and recurrence. RESULTS: Laparoscopic repair of hiatal crura with a polyglactin mesh resulted in good symptomatic and clinical outcomes similar to that of polypropylene mesh. The recurrence rate with the use of polyglactin mesh is comparable to that of synthetic or biological materials reported in the literature. CONCLUSIONS: Closure of hiatal crura with a prosthetic polyglactin (vicryl) mesh at LARS is an effective and safe procedure. © 2011 by Lippincott Williams & Wilkins.

Kimyasal madde içilmesi hastalarda ciddi sonuçlar oluşturabilir. Bu sonuçlardan biri olan striktür gelişimini önlemek için çeşitli tedavi prokolleri kullanılmaktadır. Biz tek başına konvansiyonel tedavi ile beraberinde oral yoğun sükralfat tedavisinin bir arada uygulanmasını karşılaştırmak amaçlı randomize prospektif bir çalışma planladık. Yöntem: 2004-2007 yılları arasında hastanemiz gastroenteroloji, genel cerrahi ve yoğun bakım ünitelerine kabul edilmiş evre 2b ve 3 koroziv özofajiti olan hastalar çalışmaya dahil edilmiştir. Hastalar iki gruba ayrılmıştır. Birinci gruptaki hastalara (n=8) konvansiyonel tedavi ile birlikte yoğun sükralfat, ikinci gruba (n=7) ise sadece konvansiyonel tedavi verilmiştir. 0, 21, 45, 90 ve 180. günlerde ortaya çıkabilecek komplikasyonları değerlendirmek için üst gastrointestinal endoskopik inceleme uygulanmıştır. Bulgular: Birinci grup hastanın sadece bir tanesinde semptom olarak disfajiye neden olmayan, 45. günde yapılan üst endoskopide saptanan ve 9,2 mm'lik endoskopun geçişine izin veren striktür oluşmuştur. Üçüncü ve altıncı ayki takiplerinde striktürde her hangi bir progresyon izlenmemiştir. İkinci grupta ise 6 hastada disfaji ve daralmaya neden olan striktür oluşumuna rastlanmıştır. Sonuç: Yoğun sükralfat tedavisi ileri evre koroziv özofajiti bulunan hastalarda striktür gelişim sıklığını azaltabilir. Daha fazla sayıda hasta içeren gruplar ile yapılacak çalışmalarla bulgularımızın destekleneceğini umuyoruz. Ingestion of a chemical agent is a serious problem, and several treatment protocols to prevent stricture formation have been proposed. We conducted a randomized prospective study to evaluate the effectiveness of oral intensive sucralfate plus conventional therapy compared to conventional therapy alone. Methods: Fifteen patients with stage 2b and 3 corrosive esophagitis admitted to our gastroenterology, general surgery and intensive care units between 2004 and 2007 were included. Patients were divided into two groups. The patients in the first group (n=8) received intensive sucralfate therapy plus conventional therapy, while the other group (n=7) received only conventional therapy. We performed upper endoscopic procedures on days: 0, 21, 45, 90 and 180 to identify the emergent complications. Results: In the first group, only one patient had stricture formation, allowing passage of a 9.2 mm endoscope and causing no dysphagia, on day 45. There was no progression in the stricture on follow-ups at the 3rd and 6th months. In the second group, 6 patients had stricture formation causing narrowing and dysphagia. Conclusions: Intensive sucralfate therapy may decrease the frequency of stricture formation in patients with advanced corrosive esophagitis. Further studies with large groups of patients are required to confirm our findings.

PubMedID: 19524183 The aim is to evaluate the antioxidant enzyme levels in tumoral tissues and accompanying normal tissues in gastrointestinal cancer; and compare the colorectal cancer (CRC) with gastric cancer (GC). Method: Antioxidant enzymes including glutathione reductase (GR), glutathione peroxidase (GPX), superoxide dismutase (SOD), malondialdehyde (MDA) and glucose 6 phosphate dehyrogenase (G6PD) which are important for anti-oxidant functions were evaluated in fresh tumor tissues and adjacent normal tissues obtained from a total of 58 patients. Results: All the enzyme levels were higher in tumoral tissues compared to normal tissue from non-cancerous disease. There was not a significant difference for enzyme levels between CRC and GC groups except GPx. GPx activity tended to be higher in cases without serosal involvement (SI), and this activity was higher in cases without lymph node (LN) involvement in normal tissue (p = 0.012). MDA activity was higher in cases without serosal involvement compared to with SI groups in tumor tissue (p = 0.050). G6PD activity in normal tissue was higher in cases with serosal involvement and LN involvement (p = 0.064, 0.046, respectively). GR activity was higher in signet ring cell cancer (SRC) than adeno cancer. In GC, G6PD activity in tumor was tended to be higher in undifferentiated cancer (p = 0.071). Conclusion: The antioxidant enzymes activities such as GPX, SOD, G6PD, MDA and GR were found to be related with malignant phenotype in gastrointestinal cancers. We need further studies to understand the biologic and clinical importance of these enzymes in GI cancers. © 2009 Elsevier B.V. All rights reserved.

To evaluate the preoperative and postoperative values of serum levels of zinc, magnesium, and copper in patients with cystic echinococcosis (CE).This study was conducted on patients with CE between 2000-2005 at the Faculty of Medicine, University of Cukurova, Adana, Turkey. Serum levels of zinc, copper, and magnesium of 85 patients with CE were measured both before and one year after the operation. Patients with liver CE (85 patients, 48 males) and healthy adults (40 adults, 17 males) as the control group were enrolled in the study.When compared with the control group, the mean serum levels of zinc and magnesium were lower and the mean serum level of copper was higher in the preoperative period. It was found that as duration of symptoms increased, serum zinc and magnesium levels decreased and copper levels increased. The serum levels of these elements in postoperative and control patients after one year compared equally with the levels in the initial control.The probability of increased consumption of zinc and magnesium and secretion of copper by the parasite may lead to evaluating the follow up of hydatid surgery in addition to radiological and serological methods.

Purpose : We report six cases of Alveolar Hydatid Disease (five in the liver and one in the gastrosplenic ligament invading the spleen) in which curative resection of the liver (five cases) and splenectomy (one case) were performed. Material and Methods: The records of the six patients with AHD were retrospectively evaluated. Demographics of the patients, symptoms, laboratory findings, including serology were recorded. Imaging studies determined the extent of the disease preoperatively. Classification of the lesions was done according to the PNM (P = parasitic mass in the liver, N = involvement of neighbouring organs, and M = metastasis) staging system designed by the World Health Organization. All the surgical procedures were performed as complete resections, where negative margins were approved by frozen sections. Chemotherapy with albendazole (10 mg/kg/day) was continued postoperatively for two years in five of the six patients who were alive. Results : All of the cases were from East Anatolia of Turkey, which is an endemic region. The mean age was 39.6 years (15-54 years). Major complications occurred post-operatively in all patients, possibly due to the extensive resection. No recurrence was seen during the 5 year follow-up of two cases and 2 year follow-up of three cases. Conclusion: The treatment of Alveolar Hydatid Disease is curative radical resection. Thus, pre-operative imaging studies to determine the extent and stage of the disease are of crucial importance.

PubMedID: 18026790 Background: Abdominal compartment syndrome (ACS) is a diffucult entity with two main problems during its course: (1) survival of the patient during the early period and (2) closure of the open wounds during the late period. In this study we evaluated the decision to decompress according to the level of intraabdominal pressure (IAP) and analysis of any recurrent or persistent increase in IAP. Methods: A prospective study was undertaken on 119 patients with increased IAP. The IAP was measured daily by obtaining the bladder pressure. Patients were monitored via a central venous line; and vital signs, arterial blood gases, the Acute Physiology, Age, and Chronic Health Evaluation II (APACHE II) score, and abbreviated mental tests were recorded. The suggestions of Meldrum et al. were taken as a guideline during the treatment. The sensitivity and specifity of IAP and APACHE II scores for different cutoff values were calculated using the receiver operating characteristic curve. Results: Hospital mortality was 33.6%, which increased with co-morbidities (p = 0.03). A cutoff value for IAP of 23 mmHg was considered an optimal point predicting mortality. The IAP within the first 3 days for patients who died was higher than the cutoff value. For patients with IAP of 15 to 25 mmHg, nonsurgical therapy increased the rate of mortality (odds ratio 5.2, 95% confidence interval 1.0-27.7; p = 0.03). Conclusions: In patients with ACS emergency, it is recommended that decompressive laparotomy to be performed even if the IAP falls below 25 mmHg. For patients with IAP levels higher than 25 mmHg, the IAP should be meticolusly brought below the cutoff level during the postoperative period. © 2007 Société Internationale de Chirurgie.

PubMedID: 17427114 Fasciola hepatica is a trematode rarely causing disease in humans. In symptomatic cases, while various pathologies such as damage to liver parenchyma, acute cholecystitis, and obstructive jaundice can be seen, the development of pancreatitis is rarely mentioned in the literature. The treatment of the disease is medical. In cases where no definite diagnosis can be made or in incidental cases where common bile duct exploration is being done, F. hepatica can be detected accidentally during operation. No consensus has yet been reached on the surgical procedure to be applied in this condition. We report on our case due to the rare occurrence of pancreatitis as a complication. In surgical cases, external drainage of the bile is both crucial in observing the response to the treatment, and also should be accepted as part of the treatment. © Karl Demeter Verlag im Georg Thieme Verlag KG Stuttgart.

WOS: 000247892800016 PubMed ID: 17685261 Chylous fistula is a complication related to thoracic duct injury, appearing in upper abdominal, thoracic and neck surgery. Occurrence of chylous fistula is very rare after modified radical mastectomy. We encountered a chylous fistula case after breast cancer surgery and successfully treated it conservatively. It is important that all surgeons dealing with breast surgery should be aware that, altough rarely, a chylous fistula can develop after axillary dissection. Experience related to the occurrence of this complication and its management when it occurs is quite restricted.

To investigate the changes of serum malondialdehyde (MDA) level for the oxidative stress hypothesis in patients with cystic echinococcosis (CE).The study was conducted on patients with CE before the surgical treatment. Anti-Echinococcus granulosus antibodies were determined by serological method. We assayed MDA activities measured of 57 subjects and matched in 45 healthy controls. This study took place in the Faculty of Medicine, University of Cukurova, Balcali Hospital in Adana, Turkey, between March 2004 and October 2005.The mean +/- SD of MDA levels of patients with CE was 6.70 +/- 1.66 and healthy controls was 2.53 +/- 0.43. The difference between MDA levels of patients and controls was statistically significant (p0.001).The high infection/control ratio of MDA concentration and the significant correlation strongly indicate the occurrence of oxidative stress and lipid peroxidation as a mechanism of tissue damage in cases of CE. Our study highlights the usefulness of serum markers to investigate complex pathological situations, including distinct forms of chronic liver inflammation associated with CE.