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Aim: The transient receptor potential melastatin (TRPM) channel is subfamilies of the transient receptor potential (TRP) channels, cation permeable channels. Ischemia and reperfusion (I / R) injury is a phenomenon highlighting cellular damage of the liver caused by oxygen. Lidocaine is a local anesthetic that blocks sodium channels and suppresses mitochondrial functions of neutrophils. In this study, we purpose to investigate the effects of TRPM2/8 and TRPM6/7 expressions after lidocaine treatment in liver ischemia/reperfusion rat model. Materials and Methods: The study was carried out on 32 male Wistar rats. The animals were randomly divided into 4 groups including sham, lidocaine, I/R group and I/R- lidocaine group. The portal vein and the hepatic artery branches were clamped for 60 minutes for complete ischemia. TRPM2/8 and TRPM6/7 gene expression levels were assessed by RT-qPCR. Results: The expression levels of TRPM2 were significantly higher in liver-I/R group compared to sham and lidocaine groups (p

To present the early metabolic effects of sleeve gastrectomy with transit bipartition (SG + TB) procedure in female obese patients with type 2 diabetes mellitus (T2DM). This prospective clinical study was carried out between January 2016 and June 2017. Inclusion criteria were female participants under 60 years old with T2DM, body mass index ≥ 40 kg/m2 and HbA1c level ≥ 8%. All patients underwent to SG + TB procedure. Primary outcomes were the glycemic control variables, and the secondary outcomes were weight loss and dyslipidemia levels up to the last follow-up point. A total of 35 female participants with an average age of 48.8 ± 6.0 years old and a mean preoperative BMI of 42.0 ± 1.3 kg/m2 were included during the study period. Diabetic remission was achieved in 88.6% of patients (n = 31) on the third month without any antidiabetic medications. The mean postoperative BMI of patients was 24.8 ± 1.6 kg/m2, and dyslipidemia levels were significiantly lower at the last follow-up point of all patients. SG + TB procedure may be a potent therapeutic option for the treatment of obese patients with T2DM.

OBJECTIVE A dissertation is a scientific document. However, if it is not published in a scientific journal, it will gain access to only a limited audience and thus will be unable to achieve its objective. Nevertheless, the rate of publishing in journals is not high among dissertations. In this study, we aimed to investigate the publishing rates of general surgery dissertations in journals and the total number of citations. MATERIAL AND METHODS All medical dissertations that have been prepared at general surgery departments of university hospitals and presented between the years 2006 and 2008 were analyzed. The authors checked whether the dissertations were published in a journal or not, by searching the dissertation in 4 different resources with the name of their authors. RESULTS Two hundred and thirty-two dissertations were included. Half of those dissertations were experimental animal studies. Seventy dissertations were published in various journals. Fifty one (22%) of these were published in Science Citation Index Expanded journals, while 19 (8.1%) of them were published in Turkish non-Science Citation Index Expanded journals. There was no significant difference in terms of publishing rates between study types. The number of annual citations per article was 1.1. The writer of the dissertation was the first author in 35 (68,6%) articles. CONCLUSION The publishing rates of dissertations in general surgery is low, with only 22% being published in Science Citation Index Expanded journals. The citation rate was also detected to be low in our study. Consequently, a dissertation should be considered as a scientific research study and planned as such, not as obligatory assignments. The publishing rates of dissertations should be increased, and authors should be led and encouraged to publish their dissertations.

Objective Although all animal studies are conducted in line with a specific purpose, we think that not all animal studies are performed for a scientific purpose but for personal curiosity or to fulfill a requirement. The aim of the present study is to reveal the purposes of experimental studies conducted on animals. Matherial and methods We searched for experimental studies performed on rats in general surgery clinics via PubMed, and obtained the e-mail addresses of the corresponding authors for each study. Afterwards, we sent a 7-item questionnaire to the authors and awaited their responses. Results Seventy-three (22.2%) of 329 authors responded to the questionnaire. Within these studies, 31 (42.5%) were conducted as part of a dissertation, while the remaining 19 (26.0%) were conducted to meet the academic promotion criteria. Only 23 (31.5%) were conducted for scientific purposes. The cost of 41% of those studies was higher than 2500 $. Conclusion As shown in this study, the main objective of carrying out animal studies in Turkey is usually to prepare a dissertation or to be entitled to academic promotion. Animal experiments must be planned and performed as scientific studies to support related clinical studies. Additionally, animal studies must have well-defined objectives and be carried out in line with scientific purposes that may lead to useful developments in medicine, rather than personal interests.

Staple-line bleeding and leakage is a life-threatening complication in obese patients following laparoscopic sleeve gastrectomy. The aim of this study was to examine the potential effects of Ankaferd blood stopper (ABS) and Fibrin Sealant (FS; Tisseel (R)) on sleeve gastrectomy staple-line healing in an experimental animal model. A total of 30 Wistar albino female rats were divided into three groups and were subjected to sleeve gastrectomy with linear stapling. Group A (control group) had nothing administered, Group B was administered FS on the staple-line, and Group C was administered ABS on the staple-line following sleeve gastrectomy. After sacrifice on postoperative day 5, anastomotic burst pressure, tissue hydroxyproline levels and histopathological parameters were measured. The results revealed that group C had the highest mean bursting pressure level. However, the values of this parameter were not found to differ significantly between the groups (P>0.05). Group B and C had a similar hydroxyproline levels but increased compared with group A (P

Thank you for the opportunity to comment on the letter to the editor entitled BOur Experience regarding the association between Gastrointestinal Stromal Tumor and Bariatric Surgery. A response to a letter BGastrointestinal Stromal Tumor After Laparoscopic Sleeve Gastrectomy: Be Awake Before, During, and After a Bariatric Procedure.^ We read this letter with great interest and we are grateful to the authors for their interest and thoughtful comments regarding our former letter [1]. In their letter, the authors shared their experience regarding the gastrointestinal stromal tumor (GIST) as a bariatric surgery incidental finding [2]. The authors presented 12 cases which were retrospectively analyzed from a group of 50 European laparoscopic surgeons. In their case series, the demographics of the patients and anatomic tumoral localization and pathological characteristics (size, margins, CD117 marker, and mitotic index) were similar with other studies in the literature [1, 3–5]. WOS: 000458263000043 30547279 Q1

The citation number of an article gives us information about its quality and contribution to science. In this article, we aimed to find the most frequently cited article in general surgery from Turkey, and evaluate how these articles in general surgery contributed to the world literature.We used the science citation index expanded database to find the most frequently cited articles in general surgery from Turkey.Among the 52 articles found, the most common subjects were as follows: hydatid cyst (21.1%), pilonidal disease (15.4%), laparoscopic operations (15.4%), breast diseases (11.5%), and inguinal hernia (7.7%). Two articles were cited in more than 100 articles. Furthermore, 48.8% of the articles were published from three major cities. Most articles were published between 2000 and 2004, and 65.4% of articles were case series.Most of the cited articles were about hydatid cyst and pilonidal disease, which are more common in the Turkish population compared with other countries. Evaluation of most cited articles is important to identify the fields in which Turkey contributes to the world literature.

The predisposing factors for the development of sacrococcygeal pilonidal disease (SPD) still remain undetermined. Here, we investigate the sacrococcygeal angle as a possible predisposing factor for the development of disease. Consecutive male patients admitted to our clinic with the diagnosis of SPD were included. Sex, age and BMI matched healthy controls without SPD were enrolled to the study. The predefined sacrococcygeal angles of patients and controls were measured on lateral pelvic radiographs by a single experienced radiologist. Thirty patients were included in each group. Sacrococcygeal angles of patients and control group were measured as 37.3 ± 14.5 and 36.81 ± 10.23 in patients and controls, respectively. The difference with respect to sacrococcygeal angle was not statistically significant between two groups. Sacrococcygeal angle which is the main skeletal determinant of intergluteal sulcus is not a predisposing factor for the development of sacrococcygeal pilonidal disease.

Objective: Vascular sealing devices (VSD) can be safely used in thyroid surgery. The purpose of this survey was to investigate general surgeons’ approach to the use of VSD in thyroid surgery in Turkey. Material and Methods: A questionnaire containing 10 items was prepared and announced via the Dialogue in Endocrinology Society website. The results were then analyzed. Results: Fifty surgeons (65.8%) stated that they always use VSD, 20 (26.3%) stated that they sometimes use these devices and six (7.9%) declared that they never use VSD. Thirty-six surgeons (47.4%) reported that they use ligation all the time, and 42 (55.3%) stated that upper pole vessels should be ligated at least once. Twenty two point four percent of the responders stated that they faced a complication, which they thought was related to VSD. Conclusion: The vast majority of surgeons routinely uses VSD and accepts it as a safe tool. However, the observed complication rate was very high.

Introduction: Acute appendicitis is the most common abdominal pathology requiring emergent surgical proce- dure. For treatment, laparoscopic surgery is commonly performed. For appendix stump closure different procedures are used. Aim: Evaluation of the results of patients in whom the stump of the appendix was closed with a hand-made loop during laparoscopic appendectomy (LA). Material and methods: Patients in whom the stump of the appendix was closed with a hand-made loop during LA were included in the study. Reports of patients were collected from patient files retrospectively. Laparoscopic appen- dectomy was applied through 3 ports. Two loops were placed in the stump of the appendix. Loop was a modification of the Roeder loop that has been described in the literature and has been shown to be safe. Results: Sixty-one patients were included in the study. Twenty-four of them (39%) were female, 37 of them (61%) were male. The age range is from 13 to 60 (average age is 30) years. During the postoperative period, one surgical wound infection and two intraabdominal abscesses were detected. There was no leakage from the stump of the appendix in any patients. Conclusions: One of the most important components of cost of LA is the technique of closure of the stump. Stapler, endoloop, various clips or a hand-made loop could be used for closure. We recommend using a hand-made loop for closure as an easy, safe and cheap method.

This study aimed to determine early postoperative changes of LDL/HDL subfraction profile and HDL-associated enzymes following laparoscopic sleeve gastrectomy (LSG). Thirteen obese patients (mean body mass index (BMI) 52.74 ± 10.97 kg/m(2)) underwent LSG and normal weight control patients (mean BMI 23.56 ± 1.92 kg/m(2)) underwent laparoscopic abdominal surgery. Fasting blood samples were collected prior to surgery, at day 1 after surgery, and after postoperation oral feeding. LDL and HDL subfraction analysis was done by continuous disk polyacrylamide gel electrophoresis. Plasma levels of cholesteryl ester transfer protein (CETP), lecithin-cholesterol acyltransferase (LCAT), and apolipoprotein A-1 (apoA-I) were determined by enzyme-linked immunosorbent assay. Measurement of CETP and LCAT activity was performed via fluorometric analysis. LDL subfraction profile showed no change in both LSG and control group patients. No significant difference was observed in HDL cholesterol, HDL-subfraction distribution, and apoA-I levels in the control group. LSG patients showed a significant increase in HDL-large and a significant decrease in HDL-small fractions at postoperation day 1 compared to preoperation. HDL cholesterol significantly decreased and apoA-I significantly increased in LSG patients after postoperation oral feeding compared to both preoperation and postoperation day 1. Changes in HDL subfraction profile at postoperation day 1 after LSG were accompanied by a significant decrease in CETP protein, LCAT protein, and LCAT activity as compared to preoperation levels. Early changes in HDL subfraction profile and HDL-associated enzymes following LSG suggest that the surgical procedure, irrespective of changes in body weight, affects reverse cholesterol transport.

Aim: The aim of this study was to evaluate the early results of stapled hemorrhoidopexy in patients with grade 3 and 4 hemorrhoidal disease. Material and Method: 30 patients who have grade 3 and 4 hemorrhoidal disease and applied stapled hemorrhoidopexy was included to study. Demographic data of patients, postoperative analgesic requirements, lenght of hospital stay, operation time, complication and recurrences were recorded. Results: 19 patients were female and 11 patients were men. Average age of patients were 32 (27-52). The most common symptom in admission was rectal bleeding. 18 patients have grade 3 hemorrhoid disease and 12 patients have grade 4 hemorrhoid diesease. Average lenght of hospital stay was 1.5 days (1-10). 5 patients needed narcotic analgesic at postoperative period. One patient had hemorrhage after 8 hours of operation. One patient had rectum perforation. 2 recurrences detected in the early postoperative period. Discussion: Although stapled hemorrhoidectomy is less painful than conventional techniques, long-term results are still controversial.

Carcinosarcoma of the breast represents less than 1% of primary breast mailgnancies. Both malign epithelial and malign mesenchymal elements exist together in the breast. A 59 year old postmenopausal women presents with a bloody nipple discharge and mass in breast. In left breast 2×1 cm mss detected and excisied. At pathological examination breast carcinosarcoma was detected. Then modified radical mastectomy was performed. Tumor measured 4×4×3.5 cm. Tumor cells were negative for estrogen, progesteron. C-erb-B2 was negative. There was no metastasis in axillary lymph node metastasis. Carcinosarcoma of breast is rare tumor. It mass be consider in diagnosis of patients with large breast mass.

The most frequent abdominal pathology requiring emergent surgery is acute appendicitis. Laparoscopic appendectomy has been performed for the treatment of acute appendicitis since 1983. Closure of the appendix stump is vital to prevent severe postoperative complications. Different methods are described for closure such as stapler, endoloop, titanium clips, non-absorbable polymer clips (hem-o-lok clip), handmade loops, transsection by Ligasure or with bipolar cautery. The ideal method should be safe, applicable and cheap. The most appropriate method remains to be controversial. All methods are reported as safe, but some have higher costs, and some prolong the operation. In this article, we reviewed clinical and experimental studies on different methods of stump closure, and we tried to compare the benefit of these methods over others.

Background This study aimed to determine early postoperative changes of plasma polyunsaturated fatty acids (PUFAs) following laparoscopic sleeve gastrectomy (LSG). Methods Ten obese patients (mean BMI: 51.10 ± 11.59 kg/m2) underwent LSG and eleven normal weight control patients (mean BMI: 24.37 ± 2.33 kg/m2) underwent laparoscopic abdominal surgery. Fasting blood samples were collected prior to surgery, at day 1 after surgery and after postoperation oral feeding. Plasma levels of arachidonic acid (AA, C20:4n6), dihomo-gamma-linolenic acid (DGLA, C20:3n6), eicosapentaenoic acid (EPA, C20:5n3) and docosahexaenoic acid (DHA, C22:6n3) were determined by an optimized multiple reaction monitoring (MRM) method using ultra fast-liquid chromatography (UFLC) coupled with tandem mass spectrometry (MS/MS). Prostaglandin E2 (PGE2) was measured in serum samples by enzyme immunoassay. Results A significant decrease was observed in insulin and HOMA IR levels in sleeve gastrectomy patients after postoperation oral feeding compared to preoperation. Plasma AA levels and AA/EPA ratio were significantly increased in sleeve gastrectomy patients after postoperation oral feeding compared to postoperation day 1. Serum PGE2 levels and AA/DHA ratio was significantly higher in sleeve gastrectomy patients at preoperation, postoperation day 1 and after postoperation oral feeding when compared to control group patients. Conclusion Increased peripheral insulin sensitivity associated with LSG may play a role in the significant increase of plasma AA levels in sleeve gastrectomy patients following postoperation oral feeding. The significant increase in PGE2 levels and AA/DHA ratio in sleeve gastrectomy group patients also confirms the presence of a proinflammatory state in obesity.

Introduction Acute appendicitis is the most common abdominal pathology requiring emergent surgical procedure. For treatment, laparoscopic surgery is commonly performed. For appendix stump closure different procedures are used. Aim Evaluation of the results of patients in whom the stump of the appendix was closed with a hand-made loop during laparoscopic appendectomy (LA). Material and methods Patients in whom the stump of the appendix was closed with a hand-made loop during LA were included in the study. Reports of patients were collected from patient files retrospectively. Laparoscopic appendectomy was applied through 3 ports. Two loops were placed in the stump of the appendix. Loop was a modification of the Roeder loop that has been described in the literature and has been shown to be safe. Results Sixty-one patients were included in the study. Twenty-four of them (39%) were female, 37 of them (61%) were male. The age range is from 13 to 60 (average age is 30) years. During the postoperative period, one surgical wound infection and two intraabdominal abscesses were detected. There was no leakage from the stump of the appendix in any patients. Conclusions One of the most important components of cost of LA is the technique of closure of the stump. Stapler, endoloop, various clips or a hand-made loop could be used for closure. We recommend using a hand-made loop for closure as an easy, safe and cheap method.

Rectalleiomyosarcoma(LMS)isararediseaseoccupyinglessthan 0.1 % of colorectal tumors [1]. Even if we know therelation between radiation and colorectal carcinomas, the re-lation between radiation and LMS is not certain because ofuncommon existence. Up to date, rectal LMS after pelvicradiotherapy was detected in four patients. Our case is thefifth patient in literature.A75-year-oldfemalepatientwasadmittedtoourclinicwithacomplaint of change in bowel habits. In history, she has aunilateral oophorectomy with diagnosis of ovarian maligncystic lesion 35 years ago, and afterwards, she has undergoneradiotherapy of 15 days duration. Her physical examinationwas normal. In laboratory assessments, anemia and occultblood in her stool were detected. Her CA-125 level waselevated; other tumor marker (CEA, CA19-9, AFP, CA15-3)levelswereallnormal.Therewerenotanypathologicfindingsin transabdominal ultrasound examination, but a mass lesionin the rectum with a diameter of 7 cm was detected withabdominal computerized tomography. During endoscopy, at9 to 10 cm proximal to the anus, a tumoral lesion obliteratingintestinal lumen was seen and biopsy was taken. The histo-pathologicalexaminationofthebiopsyspecimenrevealedthatit is a LMS. Tumor cells stained positively for vimentin andactin but negatively for PanCK. Metastasis examination wasdone and no metastasis was detected.After informing the patient and completing preoperativepreparations, low anterior resection was performed. Therewere not any complications in the postoperative period.Patient was discharged at the sixth day of operation. In histo-pathologicalexamination,thetumorsizewasreported8cmindiameter. Fourteen lymph nodes were removed at the opera-tionandmetastasiswasnotdetected.Tumorcellswerestainedpositively for vimentin, but negatively for pancytokeratin,S100,beta-catenin,CD3,CD117,anddesmin.Fifteenmitoseswere recognized at ten times magnification.Ten percent of smooth muscle tumors are LMS.Leiomyosarcoma of the gastrointestinal tract is generally lo-cated at the stomach or small bowel, rarely at the colon orrectalregion.Itoriginatesfromthemuscularmucosaorproprialayer of the gastrointestinal tract. Whereas radiotherapy is awell-known risk factor for colon carcinoma, for colorectalLMS, its role is not well defined. Because of small numberof patients, it is difficult to show the correlation in between.Sarcomas after radiotherapy account for 0.5–5.5 % of allsarcomas. Most of them are osteosarcoma and fibrosarcoma.Differentiation of sarcoma as primary tumor or secondary toradiotherapy is important for clinical and academical ap-proaches. But there is not any strict criterion for differentia-tion. Cahan introduced some criteria for this reason whichwere revised by Huvos afterwards [2]. With regard to theserevised criteria, if patient has history of radiotherapy, if diag-nosed sarcoma is at the same region of radiotherapy, if sarco-ma is diagnosed long after radiotherapy, and if sarcoma isdiagnosedhistologically,onecansaythatsarcomaisrelatedtoradiotherapy. Paulino et al. investigated secondary cancerdevelopment after exposure to radiotherapy due to malignantdiseases. They reported malignant tumor development afterradiotherapyat5.4%ofpatients,andat71%ofthesepatients,tumor development is at the same side of radiotherapy.Secondary sarcomas were detected 4.6–33.6 years (averageof 10.1) after the first tumor [3]. In another study, secondarycancer development period after exposure to radiotherapy atadult agehood is found to be 5–40 years interval.