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Early prediction and diagnosis of perforation in acute appendicitis allow surgeons to choose the most appropriate treatment. The purpose of this study is to evaluate whether pre-operative routine laboratory examinations have a role in predicting complicated acute appendicitis.In the study, 783 patients operated with the diagnosis of acute appendicitis between the years 2014 and 2019 were analyzed retrospectively. Among the patients with non-perforated and perforated acute appendicitis, pre-operative laboratory tests include leukocyte (WBC), neutrophil, lymphocyte, platelet (PLT), mean platelet volume (MPV), platelet distribution width (PDW), C-reactive protein (CRP), and neutrophil-to-lymphocyte rate (NLR) parameters were compared.Appendicitis was not detected histopathologically in 81 cases. In the study, 89.9% (n=631) of the 702 patients were non-perforated and 10.1% (n=71) were perforated acute appendicitis cases. Perforation rate was higher in elderly patients (p0.01). It was seen that lymphocyte count was significantly lower in the perforated group, and CRP and NLR were significantly higher (p=0.048, p=0.001, p=0.028, respectively). In the diagnosis of perforated acute appendicitis, cutoff values were 44.0 mg/dL for CRP, 7.65 for NLR and 1.7/mm3 for lymphocytes. There was no statistical difference between the groups in terms of WBC, neutrophil, PLT, MPV, and PDW values.Low lymphocyte count, high CRP, and high NLR were found to be reliable and strong predictive parameters in the diagnosis of complicated acute appendicitis.

In the present study, we aimed to determine the risk factors for mortality in Fournier's gangrene (FG), which has a high morbidity and mortality rate and requires urgent surgical intervention.A retrospective analysis was made of 150 patients who were operated on in our clinic due to FG of anorectal origin be-tween 2010 and 2020. The cases were divided into survival and non-survival groups. Demographic, clinical, laboratory, and treatment data, FG Severity Index (FGSI), and simplified FGSI (SFGSI) scores were analyzed.Thirty-day mortality rate was 15.3%. In the non-survival group, rate of smoking, diabetes mellitus, malignancy and other chronic diseases, and mean age, duration of symptoms at admission, number of debridements, SFGSI, FGSI, white blood cells, and creatinine were significantly higher, while hematocrit, serum potassium, and albumin levels were significantly lower (p0.05). Among these factors, age (OR=1.147, CI=1.019-1.291; p=0.023), smoking (OR=0.09, CI=0.023-0.418; p=0.002), malignancy (OR=0.038, CI=0.008-0.186; p=0.001), and serum potassium level (OR=0.141, CI=0.022-0.910; p=0.04) were identified as risk factors associated with mortality in FG.FG is a fatal fasciitis still associated with high mortality. Advanced age, smoking, malignancy, and hypopotassemia are independent predictive risk factors for mortality in FG.

Gallbladder gangrene and perforation are an important complication of acute calculous cholecystitis and are dif-ficult to detect preoperatively. Therefore, in this study, we aimed to evaluate whether serum inflammatory parameters are predictive factors for complicated cholecystitis (CC).In the present study, histopathological findings of 250 patients who were operated on with the diagnosis of acute chole-cystitis (AC) in the emergency department between 2014 and 2019 were evaluated and the cases were divided into two groups as AC and CC. Parameters, including age, gender, body mass index, white blood cell (WBC) count, C-reactive protein (CRP), neutrophil-to-lym-phocyte ratio (NLR), mean platelet volume (MPV), and platelet distribution width (PDW), were examined for their ability to predict CC.The findings obtained in this study showed that WBC, CRP, and NLR were significantly higher in the CC group (p0.05). WBC9.000 cells/ml, CRP29.0, and NLR4.3 were the factors that could predict CC. There was no significant difference between the two groups concerning MPV and PDW (p0.05). CC was observed more frequently in patients over 65 years of age, but there was not a statistically significant difference (p=0468).WBC, CRP, and NLR are valuable biochemical markers in predicting complicated AC. Advanced age may be a help-ful predictive factor for CC. These factors may be helpful in making an early cholecystectomy decision.

This study aimed to determine whether the use of i-scan endoscopy provides additional benefits to conventional endoscopy in the diagnosis of gastric precancerous lesions.A total of 120 patients with histologically-verified intestinal metaplasia (IM) or atrophic gastritis (AG) were prospectively evaluated by esophagogastroduodenoscopy. Endoscopic examinations were performed using i-scan and high-definition white-light endoscopy (HD-WLE). The diagnostic yields of both techniques and the number of targeted biopsies per patient were compared.A total of 318 suspicious lesions were detected in 108 patients with i-scan (n = 186) and 81 patients with HD-WLE (n = 132). The diagnostic yields of i-scan and HD-WLE were 81.6% (98/120) versus 77.5% (93/120), respectively (p 0.05). When only targeted biopsies were taken into account, the diagnostic yields of i-scan and HD-WLE were 89.8% versus 65.4%, respectively (p 0.05). The mean number of biopsies per patient for i-scan and HD-WLE were 3.27 (393/120) and 7.3 (882/120), respectively (p 0.05). The mean endoscopic procedure times were 16 and 17 min for i-scan and HD-WLE, respectively (p 0.05).Although targeted biopsies with i-scan were not found to be significantly superior to either targeted or random biopsies with HD-WLE, the number of biopsies required to confirm these lesions was much lower.

BACKGROUND: There is still no consensus about whether laparoscopic appendectomy should be performed in selected cases or routinely in all cases for treatment of acute appendicitis. Especially for rural hospitals with laparoscopic equipment shortages, it is critical to develop surgical methods alternative to LA. This prospective study aimed to compare mini-incision open appendectomy (MOA) and laparoscopic appendectomy (LA) procedures. METHODS: A total of 102 patients who had been operated on by a single surgeon for acute appendicitis between July 2018 and February 2020 and whose body mass index (BMI) was 0.999, respectively). CONCLUSION: Mini-incision open appendectomy is a reliable method in patients with acute appendicitis who have a BMI of

turgut, basar can/0000-0001-9591-4697; Yurdacan, Muge/0000-0002-8653-1309 WOS:000528165700015 PubMed ID: 32185770 BACKGROUND: This study evaluated the outcome of the reversal of Hartmann's procedure based on preoperative and intraoperative risk factors. METHODS: We retrospectively reviewed 78 cases, whom we applied the Hartmann's procedure either electively or under emergency conditions in our clinic between the years 2010 and 2016. RESULTS: Of the cases reviewed in this study, 45 patients were males, and 33 patients were females. Of all cases included in this study, 32 cases were operated due to malignancies, 15 cases were operated due to a perforated diverticulum, and 11 cases were operated due to sigmoid volvulus. Reversal of Hartmann's was performed in 32 cases. The morbidity and mortality rates for the reversal of Hartmann's procedure were 37.5% and 0.0%, respectively. CONCLUSION: The reversal of Hartmann's procedure appears to be a safe operation with acceptable morbidity rates. If the correct patient selection, correct operation timing and meticulous surgical preparation are performed, the risk of morbidity and mortality of the reversal of Hartmann's procedure can be minimized.