Meme Hastalıkları Polikliniğine Mastalji Nedeni İle Başvuran Hastalara Klinik Yaklaşım Clinical Approach to Patients with Mastalgia in Breast Disease Outpatient Clinic

Objective: The aim of this study was to report our ap­proach and outcomes of patients applied to our breast disease policlinic with mastalgia. Methods: The records of 877 patients presented with mastalgia to breast disease policlinic between April 2014 and January 2016 were examined retrospectively. Age, sex, body mass index (BMI), mammography breast im­aging-reporting and data system score (BIRADS), ultra­sonography evaluation, biopsy status, pathology results and operation procedures were investigated. Correlation between BIRADS score, age and BMI were analyzed. Results: All of the patients were female and median age was 49,0 years. Ultrasound showed breast mass in 283 (32.3%) patients and 165 (18.8%) of these underwent fine needle aspiration or true cut biopsy. Only 14 (8.5%) patients were diagnosed as malignant. Eight of the ma­lignant cases had breast conserving surgery. Ages of the patients showed significant positive correlation with BIRADS classification values of the patients (r = 0.069, p = 0.04). However, BMI values did not correlate with BI­RADS classification values of the patients. Conclusion: Mastalgia is a common symptom in women. In high risk patients for breast carcinoma, it should be investigated seriously. Both mammography and ultraso­nography can be used at the same time for diagnoses. Especially in patients having dense breasts including young’s, mammography alone cannot be satisfying for the evaluation. J Clin Exp Invest 2016; 7 (1): 23-2

Malignant Peritoneal Mesothelioma Clinicopathological Characteristics of Two Cases

Introduction. Peritoneal mesothelioma is a rare tumor, presenting difficulties in diagnosis and treatment. Peritoneum is the second most common area of the mesothelioma after pleura, and even synchronous pleural and peritoneal mesotheliomas are observed in 30–45% of all cases. The diagnosis may be difficult due to lack of specific symptoms and clinical findings. In addition, a delay in the diagnosis is not rare especially in the absence of previous asbestos exposure. Here we report two cases of malignant peritoneal mesotheliomas. The diagnostic and therapeutic approaches for these rare neoplasms are discussed. Case Presentation. The cases were two men (one aged 54 years old and the other 40 years old). Prolonged abdominal pain and swelling were the primary presentation symptoms and findings. The mesotheliomas were developed in the right upper quadrant of abdomen in both of the cases. Both cases were treated with surgical resection. Final diagnosis were possible with histological and immunohistochemical documentation of tumor characteristics, which were consistent with dictating a mesothelial origin. No history of asbestos exposure was reported. Conclusion. Peritoneal mesotheliomas are rare clinical entities. However, patients with prolonged abdominal pain and abdominal masses should be considered to have atypical pathologies such as peritoneal mesotheliomas

Cerrahi Sonrası Nüks Pilonidal Sinüs Hastalığında Kristalize Fenol Tedavisi Crystallized Phenol Treatment in Postoperative Recurrent Pilonidal Disease

Objective: A variety of surgical and minimally invasive treatment options are available to treat pilonidal sinus disease. Recurrence after surgery is a major problem. In addition to the surgical treatment of post-surgical recur­rences, minimally invasive treatment methods are also available. In our study, we aimed to investigate the results of crystallized phenol application on patients who were admitted to our clinic with post-surgical pilonidal sinus re­currence. Methods: The data of 26 patients who were admitted to our clinic with postoperative pilonidal sinus recurrence and who were treated by crystallized phenol treatment were analyzed. Patients were evaluated in terms of age, gender, previous surgery, crystallized phenol application count, follow –up period and wound infection. Results: Data of 26 patients were analyzed.3 patients (11.5%) were admitted with recurrence after Modified Limberg surgery. 11 patients (42.3%) were admitted with recurrence after Limberg flap surgery and12 patients (46.15%) were admitted with recurrence after primary re­pair. 19 patients (73.02%) were treated by one time crys­tallized phenol application. 5 (19. 23%) patients under­went a second time application and provided treatment after the second application. The cure was achieved in 24 (92.3%) patients after repeated applications. Conclusion: Crystallized phenol application is a minimal­ly invasive treatment method that can be applied easily under local anesthesia. The method has a high success rate after repeated applications in patients with recur­rence after surgery and is a very good alternative to sur­gical therapy. J Clin Exp Invest 2016; 7 (1): 19-2

Ambulatory laparoscopic cholecystectomy: A single center experience

Aim: To evaluate the demographic and clinical parameters affecting the outcomes of ambulatory laparoscopic cholecystectomy (ALC) in terms of pain, nausea, anxiety level, and satisfaction of patients in a tertiary health center. Materials and Methods: ALC was offered to 60 patients who met the inclusion criteria. Follow-up (questioning for postoperative pain or discomfort, nausea or vomiting, overall satisfaction) was done by telephone contact on the same day at 22:00 p.m. and the first day after surgery at 8: 00 a.m. and by clinical examination one week after operation. STAI I and II data were used for proceeding to the level of anxiety of patients before and/or after the operation. Results: Sixty consecutive patients, with a mean age of 40.6 ± 8.1 years underwent ALC. Fifty-five (92%) patients could be sent to their homes on the same day but five patients could not be sent due to anxiety, pain, or social indications. Nausea was reported in four (6.7%) cases and not associated with any demographic or clinical features of patients. On the other hand, pain has been reported in 28 (46.7%) cases, and obesity and shorter duration of gallbladder disease were associated with the increased pain perception (P = 0.009 and 0.004, respectively). Preopereative anxiety level was significantly higher among patients who could not complete the ALC procedure (P = 0.018). Conclusion: Correct management of these possible adverse effects results in the increased satisfaction of patients and may encourage this more cost-effective and safe method of laparoscopic cholecystectomy