Clinical and pathological evaluation of benign skin lesions

Skin lesions are commonly benign in nature. The present study aims to evaluate the prevalence and clinicopathological characteristics of a large series of benign skin lesions (BSLs) excised in our clinic. Patients with skin lesions who underwent total excisional biopsy at the general surgery clinic between 2012 and 2016 were reviewed. A total of 551 patients with BSLs were included in the study. Of these, 43.7% were females and 56.7% were males. The age range was between 2 and 98 years with a mean of 39.7 years. The most commonly occurring group of BSLs was of the appendageal tumors (33.3%), and this finding was statistically significant. The most common keratinocytic BSL (13.6%) was verruca vulgaris. In the present study, various types of BSLs and their occurrences were evaluated. Benign skin tumors can turn into malignant types. A biopsy should be performed to establish the exact diagnosis. We performed an excisional biopsy to confirm the diagnosis

Predictive Value of Leukocyte, Neutrophil / Lymphocyte Ratio and C Reactive Protein in the Diagnosis of Idiopathic Granulomatous Mastitis

In this retrospective study, the predictive significance of leukocyte count, C-reactive protein (CRP) and neutrophil / lymphocyte ratio (NLR) was investigated in patients followed-up and treated for idiopathic granulomatous mastitis. Thus, an ideal biomarker was tried to be identifie

The region where colonic diverticulitis is infrequent: Right colon diverticulitis

Background: Diverticular disease of colon which is rare before 40 years of age is seen at a 50% frequency over 80 years of age. Approximately 10-25% of these patients experience colonic diverticulitis during their lifetime. Right-sided diverticulosis is a rare condition in Western countries, but is common among Asian countries. The aim of this study is to evaluate the clinical and treatment outcomes of our patients with right colon diverticulitis. Methods: The demographic and clinical data of 22 patients treated with diagnosis of cecum and right-sided colon diverticulitis between 2014 and 2017 were analyzed. Hinchey staging was performed to patients according to radiological evaluation and clinical findings. Then proportions of demographic and clinical features of the patients according to Hinchey staging and its statistical significance were evaluated. Results: Our study included 22 patients who had right colon diverticulitis. Female/male ratio was 0.69. 68.1% of the patients were Hinckey stage I and 31.8% were Hinckey stage II, all of which were evaluated by tomography. Mostly Hinchey stage I diverticulitis was found in the right colon (66.7%) and Hinchey stage II diverticulitis in the cecum (57.1%). The mean age of Hinchey stage II patients was higher (63,57 years) and statistically significant (p < 0.05). Two patients had appendectomy and one had right hemicolectomy. Conservative treatment was given to other 19 patients. Mean time of hospitalization was 3,4 days. Four patients who received conservative treatment at two year follow-up had recurrence; No recurrence was seen in patients receiving surgical treatment. Conclusions: Right colon diverticulitis is usually seen in solitary men in eastern societies under the age of 50. As a treatment option, conservative methods should be preferred especially in uncomplicated cases. Surgical treatment is usually used in the treatment of recurrent and complicated cases

Comparison Of Lichtenstein Repair And Mesh Plug Repair Methods In The Treatment Of Indirect Inguinal Hernia

Aim:Inguinal hernias occur in approximately 3%–8% of the population, especially in men. Methods of hernia repair currently involve prosthetic mesh applications. The aim of this study is to compare the Lichtenstein repair and Mesh-plug repair methods in the surgical treatment of indirect inguinal hernias and to identify which of these two techniques is superior regarding its conferred advantages. Methods:In this study, a total of 102 patients who were diagnosed with indirect inguinal hernia between the years 2014 and 2015 without a previous operation were analyzed. Patients undergoing Lichtenstein repair and Mesh-plug repair were compared, especially during operation time, hospital stay, postoperative pain and other aspects. Results:The mean age of patients was 28.7 years (19 - 73). The mean duration of operations and hospitalizations was significantly shorter in patients who had undergone Mesh-plug repair. Inguinal pain in the operation area on postoperative day 1, 2 weeks and 6 months was significantly less in patients who had undergone mesh plug repair. Patients were followed-up for two years. Conclusion:We concluded that Mesh-plug repair was superior to Lichtenstein repair regarding postoperative pain, quality of life of the patient, shorter duration of operation, and duration of hospital stay although the two methods were similar regarding both recurrence and complication rates. Considering this information, we suggest that Mesh-plug repair can be used safely for the treatment of indirect inguinal hernias

S100A4 may be a good prognostic marker and a therapeutic target for colon cancer

Background: Globally, the colorectal cancers rank the third in terms of cancer incidence and rank the fourth in cancer-associated deaths. S100A4, an important member of the S100 protein family, serves to promote tumor progression and metastasis. By conducting this study, we aim to examine the role of S100A4 in the prognosis of colon cancer and to demonstrate its prognostic significance. Methods: Tissue samples of colon cancer from 148 patients who underwent colon resection due to colon cancer were analyzed by immunohistochemical staining to determine the protein expression levels of S100A4. The protein expression levels of S100A4 in tumor tissue were matched with the clinicopathologic factors including patient survival. Results: Cytoplasmic expression of S100A4 protein was demonstrated in the tumor tissue of 132 patients (89.2%) out of a total of 148 study patients. Statistically, the expression levels of the cytoplasmic S100A4 protein correlated significantly with the TNM stages and patient survival. The distribution of the S100A4 protein staining in the tumor tissue was associated with the age groups, tumor localization, TNM staging, and patient survival with statistical significance. The levels of S100A4 protein expression was found to be an independent prognostic factor for TNM staging and poor survival. Conclusion: Expression of the S100A4 protein in colon cancers may be an indicator of tumor progression and lymph node metastasis and may be useful for predicting the overall survival of the patients with colon cancer. In patients with colon cancer, it may be used as an indicator of poor prognosis

Comparison Of Lichtenstein Repair And Mesh Plug Repair Methods In The Treatment Of Indirect Inguinal Hernia

Aim:Inguinal hernias occur in approximately 3%–8% of the population, especially in men. Methods of hernia repair currently involve prosthetic mesh applications. The aim of this study is to compare the Lichtenstein repair and Mesh-plug repair methods in the surgical treatment of indirect inguinal hernias and to identify which of these two techniques is superior regarding its conferred advantages. Methods:In this study, a total of 102 patients who were diagnosed with indirect inguinal hernia between the years 2014 and 2015 without a previous operation were analyzed. Patients undergoing Lichtenstein repair and Mesh-plug repair were compared, especially during operation time, hospital stay, postoperative pain and other aspects. Results:The mean age of patients was 28.7 years (19 - 73). The mean duration of operations and hospitalizations was significantly shorter in patients who had undergone Mesh-plug repair. Inguinal pain in the operation area on postoperative day 1, 2 weeks and 6 months was significantly less in patients who had undergone mesh plug repair. Patients were followed-up for two years. Conclusion:We concluded that Mesh-plug repair was superior to Lichtenstein repair regarding postoperative pain, quality of life of the patient, shorter duration of operation, and duration of hospital stay although the two methods were similar regarding both recurrence and complication rates. Considering this information, we suggest that Mesh-plug repair can be used safely for the treatment of indirect inguinal hernias

The effect of intraabdominal pressure increase on the functions of the pancreas during laparoscopic surgery

Introduction: The purpose of this study is to investigate the possible effects of increased intraabdominal pressure during laparoscopic surgery on the endocrine/exocrine functions, oxidative stress status, and histopathological structure of the pancreas. Material and methods: Three groups were constituted with eight rats in each. Group I was the control group. After pneumoperitoneum with CO2 gas was performed for 60 min at 6 mmHg in Group II and 12 mmHg in Group III, they were left to reperfuse for 30 min. Next, amylase, insulin, and glucagon levels were studied from the blood samples. Ischemia-reperfusion injury was evaluated histopathologically in pancreatic tissue samples. The level of malondialdehyde showing tissue was measured by spectrophotometry and homogenization. Results: Compared with the other groups, the mean blood amylase, insulin, and glucagon values in Group III were higher at 18.95 U/L, 2.2 IU/mL, and 1,906.18 pg/mL, respectively, and were statistically significant (p = 0.001). In addition, more hemorrhage (37.5%), congestion (100%), and inflammation (62.5%) were detected in the pancreatic tissue of Group III compared with the other groups. The average tissue malondialdehyde levels (171.39 nM/mg) were higher in Group III than in the other control groups and were statistically significant (p = 0.04). Conclusions: Laparoscopic operations at high pneumoperitoneal pressures can cause ischemia-reperfusion injury to the pancreas because of increased intraabdominal pressure. This damage increases with longer operational time. It is evident that this situation will cause even greater problems with pancreatic diseases. Care should be taken in patient selection and management of laparoscopic surgeries

Brunner’s gland hyperplasias and hamartomas in association with Helicobacter pylori

Background: The proliferative lesions of the Brunner’s glands (BGs) are hyperplasia and hamartomas, and they are usually asymptomatic and very rarely diagnosed. The aetiology of these lesions is not yet clear. The aim of this study is to evaluate the clinical presentations of patients with BG hyperplasia and hamartomas and to assess the pathological features of these lesions in association with Helicobacter pylori (H. pylori). Methods: Our retrospective study included patients who underwent upper gastrointestinal system endoscopy in the endoscopy unit of our hospital between the years 2010 and 2015. The hospital records of 18 patients diagnosed with hyperplasia or hamartoma of BG were reviewed for their clinical and pathological findings. Results: Gender distribution in our study sample was a female/male ratio of 1. The age range was between 16 and 85 years (with a mean of 48.61). BG hyperplasia and hamartomas were found in 72.22 and 27.78% of the patients, respectively. Chronic gastritis and chronic duodenitis were found in 61.11 and 8.89% of the patients, respectively, and H. pylori was detected in the stomach mucosa of 66.67% patients. H. pylori was identified in 60% of BG hamartomas and in 69.2% of hyperplastic BGs. Conclusion: Our study demonstrated that H. pylori may play an important role in the development of BG hyperplasia and hamartomas in association with chronic gastritis and duodenitis. This is probably due to chronic irritation

Brunner’s Gland Hyperplasias and Hamartomas in Association with Helicobacter pylori

Background. The proliferative lesions of the Brunner’s glands (BGs) are hyperplasia and hamartomas, and they are usually asymptomatic and very rarely diagnosed. The aetiology of these lesions is not yet clear. The aim of this study is to evaluate the clinical presentations of patients with BG hyperplasia and hamartomas and to assess the pathological features of these lesions in association with Helicobacter pylori (H. pylori). Methods. Our retrospective study included patients who underwent upper gastrointestinal system endoscopy between 2010 and 2015. The hospital records of 18 patients diagnosed with hyperplasia or hamartoma of BG were reviewed for the clinical and pathological findings. Data from patients with BG lesion were compared with 37 patients who had nonspecific duodenitis as the control group. Results. Female/male ratio in our study sample was 1/1. The age range was between 16 and 85 years with a mean age of 48.61. BG hyperplasia and hamartomas were found in 72.22 and 27.78% of the patients, respectively. The rate of H. pylori in gastric mucosa was 43.2% in the control group and 66.7% in the BG lesion group. In the BG lesion group, the rate of H. pylori was higher. H. pylori was identified in 60% of BG hamartomas and in 69.2% of hyperplastic BGs. Conclusion. Our study demonstrated that H. pylori may play an important role in the development of BG hyperplasia and hamartomas in association with chronic gastritis and duodenitis. This is probably due to chronic irritation