Contribution of Endorectal Ultrasound, Magnetic Resonance Imaging and Positron Emission Tomography to Operation Strategy in Rectal Cancer

Objective:Colorectal cancer is the most common type of cancer in the gastrointestinal tract. Preoperative staging is important for applying appropriate treatment modalities. The role of endorectal ultrasonography (ERUS), magnetic resonance imaging (MRI) and positron emission-computed tomography (PET-CT) in rectal cancer patients was evaluated.Method:In this study, between October 2010-April 2012, 30 patients who were diagnosed as rectal cancer clinically and histopathologically were evaluated with ERUS, MRI and PET-CT preoperatively and results were compared with histopathologic findings.Results:Between October 2010-April 2012, 30 patients who were diagnosed as rectal cancer with biopsy in Bezmialem University Medical Faculty Hospital General Surgery Department were included in this study [20 male (66.6%), 10 female (33.3%) and their ages are 38-75 years old, 21 of them received neoadjuvant treatment and 9 of them did not received]. All patients were evaluated with MRI, ERUS and PETCT preoperatively. Rectal cancer patients who are primarily operated from rectal adenocarcinoma were included in this study. For T staging, preoperative MRI, ERUS and PET-CT staged 9 (31%), 12 (41%) and 12 (40%) of 30 patients accurately, respectively. For N staging, preoperative MRI, ERUS and PET-CT staged 15 (51%), 16 (55.1%) and 17 (56.6%) of 30 patients accurately, respectively. In comparison to other modalities, PET-CT did not yield a significant difference in staging and did not change operation strategy. PET-CT detected distant metastasis in 3 patients. One of them was liver and two of them were lung metastasis. Biopsies from mass predicted as lung metastasis did not result as metastasis. PET-CT has high rates of false positivity to detect distant metastasis. In statistical analysis, significant p-values for evaluation could not be obtained.Conclusion:Efficacy of routine use of PET-CT on staging, evaluation of T, N and extramesorectal spread could not be shown

Ozone therapy as a novel complementary therapeutic approach in refractory idiopathic granulomatous mastitis

Background: Autoimmunity may play a major role in the pathogenesis of idiopathic granulomatous mastitis (IGM). The therapeutic potential of ozone therapy has recently been shown in rheumatological diseases, and this study aimed to assess the clinical efficacy of ozone therapy (OT) in refractory IGM. Methods: Patients with biopsy-verified IGM and incomplete response after steroid therapy (n = 47) between 2018 and 2021 were enrolled. Of these, 23 cases in cohort A had standard treatment with further steroid therapy (ST), and 24 were treated with systemic OT via autohemotherapy (AHT) in addition to steroid therapy (cohort B). Results: The median age was 33 years (range, 24–45). Patients in cohort B had a higher complete response rate after completion of a four-month ozone therapy than those in the ST-group (OT-group, 37.5% vs. ST-group, 0%; p = 0.002). At a median follow-up of 12 months (range, 12–35), the patients treated with OT had a lower one-year recurrence in the affected breast than cases in cohort A treated with ST (OT-group, 21% vs. ST-group, 70%; p = 0.001). No significant side effects were observed in patients in cohort B related to AHT. Furthermore, OT significantly decreased the total steroid treatment duration (median week of steroid use; 26 weeks in cohort A vs. 12 weeks in cohort B; p = 0.001). Conclusion: Systemic OT increases the complete response rate and decreases the duration of steroid treatment in patients with refractory IGM. Therefore, ozone therapy is an effective, well-tolerated, and safe novel complementary therapeutic modality.Istanbul Breast Societ

NEUROENDOCRINE DIFFERENTIATED BREAST CARCINOMA: A CASE REPORT

Neuroendocrine tumors are rarely seen in the breast. They are commonly located in the gastrointestinal tract and the lungs. These tumors of the breast may be purely neuroendocrine or neuroendocrine diff erentiated. Some breast tumors may have neuroendocrine foci. The clinical significance of these tumors are unclear. However, they are thought to have no relation with the prognosis and patient outcome. This is the report of a patient with neuroendocrine diff erentiated invasive breast carcinoma treated surgically in the classical manner

A reliable pancreaticojejunal anastomosis with V-Loc 180 wound closure device for soft pancreatic stump

WOS: 000335085400046PubMed ID: 24901167Background/Aims: Although mortality rates decreased in recent years, pancreaticoduodenectomy is still associated with high morbidity rates. Pancreatic fistula is the leading cause of morbidity after pancreaticojejunal anastomosis and commonly occurs in soft pancreas. The objective of this study is to compare outcomes of conventional modified invaginated end to side pancreaticojejunostomy with a new practical method using V-Loc (TM) 180 wound closure device in soft pancreas. Methodology: Between December 2011 and August 2013, a total of 90 pancreaticoduodenectomy procedures were performed in our hospital. 28 of them were defined as soft pancreas according to attending surgeon and included in this study. Patients were divided into two groups consecutively and analysed for postoperative pancreatic fistula (POPF) rate, length of stay, operation time, cost and particular duration of anastomosis. Pancreatic fistulas were classified according to International Study Group on Pancreatic Fistula (ISGPF) definition. Results: 1 grade A and 2 grade B fistulas appeared in V-Loc group (Group 1), whereas 1 grade A, 2 grade B and 1 grade C fistulas appeared in conventional anastomosis group (Group 2). Conclusions: Pancreaticojejunostomy with V-Loc suture is a convenient method in soft pancreas and can be performed safely