SOTOS SYNDROME: A RARE CAUSE OF TALL STATURE

Sotos sendromu, endokrin bir bozukluk olmaksızın hızlı büyümeyle karakterize birhastalıktır. Ondört yaşında kız hasta boy uzunluğu şikayeti nedeniyle başvurdu. Doğumdave postnatal izlemlerinde boyunun yaşıtlarına göre üst sınırlarda olduğuöğrenilen hastanın klinik incelemelerinde mental retardasyon, makrosefali ve üstsınırda boy persentili saptandı. Bu bulgularla olguya sotos sendromu tanısı konuldu.Bu olgu sunumumuzda aşırı boy uzaması yakınması ile başvuran ve fizik muayenesindedismorfik bulgular saptanan hastaların ayırıcı tanısında sotos sendromunununda düşünülmesinin vurgulanması istenildi.Sotos syndrome is a disorder which is characterized by rapid growth without anyendocrine defect. A 14-year-old female patient was admitted with a complaint of tallstature. Her history revealed that her height was at the upper limits compared to herpeers at the time of birth and during the postnatal follow-ups. Clinical examinationsshowed mental retardation, macrocephaly, and a height percentile at the upper limit.Sotos syndrome was diagnosed with these clinic findings. In this case report, we aimedto stress the necessity of considering the rarely seen Sotos syndrome when making thedifferential diagnosis of patients who apply with the complaint of excessive growth anddemonstrate dismorphic findings at the physical examination

Robotic surgery for malignant and large adrenal masses: A doable and safe option

Background: Laparoscopic adrenalectomy is currently considered the gold standard method for adrenal surgery. Open surgery is the most frequent technique preferred amongst surgeons who are faced with tumours of larger sizes or challenging lesions. Despite the increasing interest in laparoscopy, most centres still utilise open surgery for challenging adrenal cases. Patients and Methods: We retrospectively evaluated our successive 30 robotic adrenalectomies performed in the past 10 years and assigned the patients into 'difficult' and 'easy' groups. Patients with malignant tumours or tumour size of over 8 cm were assigned to the 'difficult group' and others to the 'easy group'. Groups were evaluated according to the demographic features of the patients, side of the operation, the body mass index (BMI) and laparotomy history. The duration of anaesthesia, amount of bleeding during surgery and the hospitalisation periods were also evaluated. Results: There is no statistically significant difference between the two groups considering age, gender, BMI value, operation side, presence or absence of a laparotomy history, the amount of bleeding during the operation and hospitalisation duration (P > 0.05). The anaesthesia duration was found to be higher in the 'difficult' patient group (P < 0.05). Conclusion: Our results present robust evidence to support the idea that robotic adrenalectomy is not only a doable but also a safe option for malignant and large adrenal masses

Thoracic Duct Embolization for Postoperative Lymphatic Fistula

Lymphatic fistula as a rare entity particularly emerges after head and neck cancer surgery. It may lead to delayed wound healing, electrolyte loss, malnutrition, dehydration, and immune suppression. Therefore, rapid diagnosis and treatment are of the utmost importance. We aimed to present a lymphatic fistula case who was treated successfully by lymphangiography with percutaneous embolization of the thoracic duct. We believe that minimally invasive techniques could be an alternative to the conservative approach as the first-line choice

Fortune of temporary ileostomies in patients treated with laparoscopic low anterior resection for rectal cancer

2016 IEEE International Ultrasonics Symposium, IUS 2016 -- 18 September 2016 through 21 September 2016 -- 124585Purpose: The current study aims to analyze the risk factors for the failure of ileostomy reversal after laparoscopic low anterior resection for rectal cancer. Methods: All patients who underwent a laparoscopic low anterior resection for rectal cancer with a diverting ileostomy between 2007 and 2014 were abstracted. The patients who underwent and did not undergo a diverting ileostomy procedure were compared regarding patient, tumor, treatment related parameters, and survival. Results: Among 160 (103 males [64.4%], mean [± standard deviation] age was 58.1 ± 11.9 years) patients, stoma reversal was achieved in 136 cases (85%). Anastomotic stricture (n = 13, 52.4%) was the most common reason for stoma reversal. These were the risk factors for the failure of stoma reversal: Male sex (P = 0.035), having complications (P = 0.01), particularly an anastomotic leak (P < 0.001), or surgical site infection (P = 0.019) especially evisceration (P = 0.011), requirement for reoperation (P = 0.003) and longer hospital stay (P = 0.004). Multivariate analysis revealed that male sex (odds ratio [OR], 7.82; P = 0.022) and additional organ resection (OR, 6.71; P = 0.027) were the risk factors. Five-year survival rates were similar (P = 0.143). Conclusion: Fifteen percent of patients cannot receive a stoma reversal after laparoscopic low anterior resection for rec tal cancer. Anastomotic stricture is the most common reason for the failure of stoma takedown. Having complications, particularly an anastomotic leak and the necessity of reoperation, limits the stoma closure rate. Male sex and additional organ resection are the risk factors for the failure in multivariate analyses. These patients require a longer hospitalization period, but have similar survival rates as those who receive stoma closure procedure

Safety and feasibility of laparoscopic sigmoid colon and rectal cancer surgery in patients with previous vertical abdominal laparotomy

WOS: 000360993700019PubMed ID: 26231993Introduction: Current study aims to analyze the impact of previous vertical laparotomy on safety and feasibility of laparoscopic sigmoid colon and rectal cancer operations. Methods: All consecutive patients who underwent a laparoscopic resection for sigmoid colon or rectal cancer were included. These aspects were abstracted and compared within no laparotomy and previous vertical laparotomy groups: demographics, perioperative aspects, pathological features and survival. Results: There were 252 patients in no laparotomy group, and 25 cases with previous vertical incisions including lower (n = 12,48%), upper (n = 7, 28%), and lower&upper (n = 2, 8%) midline and paramedian (n = 4, 16%) laparotomies. Veress insufflation and open technique were used in 19 (76%) and 6 (24%) cases, respectively, during the insertion of the first trocar in previous laparotomy group. Patients in previous laparotomy group were significantly older (59.2 +/- 13.4 vs. 66.2 +/- 0.1, p = 0.01), but gender, ASA scores, tumor and technique related factors were similar within the groups, including operation time (200 [70-600] vs. 200 [130-390] min, p = 0.353), blood loss (250 [100-1500] vs. 250 [0-2200] ml, p = 0.46), additional trocar insertion (10 [4%] vs. 3 [12%], p = 0.101), conversion (20 [7.9%] vs. 4 [16%], p = 0.25), postoperative complication (59 [23.4%] vs. 4 [16%], p = 0.06) and 30-day mortality (7 [2.8%] vs. 1 [4%], p = 0.536) rates. Oncological outcomes regarding pathological features and 5-year survival rates (65% vs. 73.2%, p = 0.678) were not different. Conclusion: The presence of a previous laparotomy does not worsen the outcomes in patients undergoing laparoscopic removal of sigmoid or rectal cancer, thus laparoscopy may be considered to be safe and feasible in these cases

Safety and feasibility of laparoscopic sigmoid colon and rectal cancer surgery in patients with previous vertical abdominal laparotomy

Introduction: Current study aims to analyze the impact of previous vertical laparotomy on safety and feasibility of laparoscopic sigmoid colon and rectal cancer operations

Fortune of temporary ileostomies in patients treated with laparoscopic low anterior resection for rectal cancer

Purpose: The current study aims to analyze the risk factors for the failure of ileostomy reversal after laparoscopic low anterior resection for rectal cancer