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Objective: Idiopathic granulomatous mastitis (IGM) is a benign inflammatory breast disease of unknown etiology that affects women in their reproductive period. The most commonly preferred option as first-line treatment is steroids, but the lack of a standard treatment protocol and high recurrence rate after treatment constitutes a recurring challenge during its management. The aim of this study was to investigate whether the decision to end the treatment should be made radiologically or clinically. Materials and Methods: This retrospective cohort study included IGM patients who had complete clinical recovery with steroids and were followed for a minimum of 30 months. Patient demographics, disease severity and findings, treatment regimens and duration, and magnetic resonance imaging (MRI) findings at clinical recovery were assessed for their relation to recurrence. Results: Eighty-nine patients who were clinically completely healed after steroid treatment for IGM were included in the study. At the time of clinical healing, 51 (57.3%) patients had a complete radiological response and 38 (42.7%) had a partial radiological response (PRR) on MRI. Overall, recurrence developed in 22 (24.7%) patients after a median 38.6-month follow-up. Patients who experienced recurrence were significantly older and had PRR when their treatment was stopped upon clinical healing. Conclusion: During the process of clinical healing, the imaging findings revealed that the remaining disease seems to be a significant predictor for recurrence in IGM patients. In patients with PRR, extending the treatment with either prolonged steroid therapy or by surgical excision of the occult residual disease may prevent recurrences in IGM patients.

INTRODUCTION[|]The relationship between the surgeon's experience/volume of performed operations and postoperative results of thyroid surgery is a pressing issue that has been widely discussed in recent publications. This study aimed to compare the complication rates in thyroidectomy operations performed before and after specialization and evaluate the effect of specialization on the outcomes of thyroid surgeries.[¤]METHODS[|]The study included patients who had undergone thyroidectomy with or withoutneck dissection due to benign or malign thyroid diseases in a single tertiary reference hospital between April 2013 and March 2017. The patients were divided into two groups: those who were operated on before specialization (BS) and after specialization (AS). Age, gender, operation type, postoperative hypocalcemia, incidental parathyroidectomy, recurrent laryngeal nerve (RLN) injury, and postoperative bleeding or hematoma were compared between the groups.[¤]RESULTS[|]Of the thyroid patients, 776 were operated on (367 (47%) and 409 (53%) of the BS and AS groups, respectively). No significant difference was found between the two groups regarding the postoperative Ca2+ level, while the parathormone was significantly lower in the BS group (p=0.2 and p=0.02, respectively). In addition, postoperative transient hypocalcemia was significantly less common in the AS group (p

INTRODUCTION[|]Various surgical techniques were used to treat advanced sacrococcygeal pilonidal disease. Long learning curve, prolonged surgery and length of hospital stay were observed in most of these methods. In this study, we aimed to present our experience with random pattern rotation flaps in the treatment of sacrococcygeal pilonidal disease with damaged skin structure.[¤]METHODS[|]From January 2012 to January 2014, 33 patients were treated with random pattern rotation flaps. Demographic data, body mass index, volume of extracted tissue, width/height ratio of flap, operation time, wound complications and recurrences were evaluated.[¤]RESULTS[|]Patients were 29 (87.8%) male and 4 (12.1%) female with a mean age of 27.8. The mean operative time was 50.1 minutes and length of hospital stay was 1.3 days. The mean width/height ratio was 0.51 and most of the patients (20/60.1%) had a width/height ratio below 0.5. The mean follow-up period was 54.1 months. Two (6.1%) patients had a recurrence and wound complications occurred in three (9.1%) patients. Most of the patients considered the operation as 'good' for both health status and aesthetic satisfaction. Although most of the patients' satisfaction of health status was changed as 'excellent' on follow-up after one year, there was no statistically significant difference (p=0.37).[¤]DISCUSSION AND CONCLUSION[|]Random pattern rotation flap is a simple solution in the treatment of pilonidal sinus with damaged skin structure. The short learning curve, short operation time, short length of hospital stay and earlier return to work are seen as the advantages.. Further comparative studies are needed to compare health status and aesthetic outcome.[¤]

INTRODUCTION[|]The aim of this study was to compare the effects of breast-conserving surgery (BCS) and subcutaneous mastectomy with implant reconstruction (SMIR) in terms of postoperative psychosocial effects, sexuality, and quality of life.[¤]METHODS[|]Demographic data and clinical breast cancer parameters of patients who underwent BCS (n=48) or SMIR (n=27) between January 2012 and December 2016 were reviewed retrospectively. The data were collected via face-to-face interview using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and the breast cancer-specific submodule, EORTC QLQ-BR23.[¤]RESULTS[|]In this study group, 23 (48%) patients who underwent BCS and 25 (92.6%) patients who underwent SMIR were premenopausal (p0.05). Fatigue scores on the QLQ-C30 were greater for SMIR patients, as well as arm symptoms in the QLQ-BR23 side effects scale (p

INTRODUCTION[|]The aim of this study was to examine and describe the efficiency of endoscopic balloon and bougie dilatation techniques applied to anastomotic strictures developed in patients who underwent a low anterior resection (LAR) and ileostomy.[¤]METHODS[|]A total of 167 patients underwent an LAR with an ileostomy due to rectal cancer between July 2014 and December 2017. Nineteen (%11.4) cases with anastomosis stricture were retrospectively evaluated and included in the study. Patients were classified according to the dilation time. Group 1 patients received dilatation within the first 3 months postoperatively, and Group 2 patients received dilatation after 3 months. Demographic data, the dilatation technique, the number of dilatation applications, the level of the stricture, the success rate, and the stoma closure time were evaluated.[¤]RESULTS[|]In Group 1, the mean number of dilatation procedures was 1.8 (range: 1–3), whereas in Group 2, the mean was 3.8 (range: 2–5). The success rate was 100% in Group 1 and 66.6% in Group 2. There was a statistically significant difference between the groups in the requirement for dilatation and the success rate (p=0.022, p=0.028, respectively).[¤]DISCUSSION AND CONCLUSION[|]It was concluded that dilatation techniques are most successful when applied within 3 months after surgery in cases with stenotic anastomoses. The risk of strictures and the number of repeated dilatations was lower and the success rate was significantly higher in these cases.[¤]

INTRODUCTION[|]The present study is a comparison of results in patients with pathological nipple discharge (PND) who underwent microductectomy and those who underwent major duct excision (MDE).[¤]METHODS[|]This study included patients who underwent surgery in the clinic due to PND between October 2015 and October 2011. Data were collected via retrospective chart review. The patients were divided into 2 groups according to the type of surgery (Group Micro and Group Major). The demographic characteristics of the patients, the character of the discharge, preoperative imaging findings, preoperative cytological findings, postoperative pathological findings, and follow-up results were analyzed.[¤]RESULTS[|]The records of a total of 78 patients were examined. Group Micro comprised 57 patients, and 21 were included in Group Major. The most frequently observed lesion in both groups was papillomatous lesion without atypia (Group Major: n=8, 38.1% and Group Micro: n=26, 45.6%). Premalignant lesion was detected in 17 patients (atypical ductal hyperplasia, papillomatous lesion with atypia, ductal carcinoma in situ, intraductal papillary carcinoma). Although the number of patients with a premalignant lesion in Group Major was greater than that seen in Group Minor, the difference was not significant (n=11, 19.3% and n=6, 28.6%, respectively; p=0.3).[¤]DISCUSSION AND CONCLUSION[|]Conventional imaging and cytology techniques are usually insufficient in the diagnosis of PND. Therefore, surgery is frequently required in these patients. Microductectomy or MDE may be selected as the preferred surgical procedure. In this study, the results of the 2 procedures were found to be similar.[¤]

AIM: Sentinel lymph node biopsy is a minimal invasive technique, which is an alternative for axillary dissection. In this prospective study we tried to evaluate accuracy of sentinel lymph node biopsy in early stage breast cancer, using only isosulphane blue solution.MATERIAL and METHOD: 40 patients without axillary metastasis were included in our study. Age, diagnostic biopsies, preoperative stage, time and number of sentinel lymph node biopsies, histopathological evaluations, postoperative stage, early postoperative complications were evaluated.RESULTS: Mean detection time for sentinel lymph nodes was 15 (5-25) minutes by 38 patients. Mean number for detected nodes was 1 (1-4). We found mean 16 (9-30) nodes with axillary dissections. 19 patients had axillary metastasis. Only a single patient showed negative sentinel lymph node result. By 37 patients we have shown that sentinel lymph node biopsy is a reliable method. We could not detect any recurrences or metastasis.CONCLUSION: Sentinel lymph node biopsy is a reliable method in evaluation of axillary node status. Axillary dissections can be avoided through sentinel lymph nodes without metastasis.