The Quality of Life Measurements Following Oncoplastic Breast-conserving Surgery

Objective:Oncoplastic breast-conserving surgery (OBCS) is a widely accepted surgical option among breast cancer patients. We aimed to evaluate the histopathological findings of breast tumors and quality of life scores.Method:The clinical and pathological data of 49 female patients who underwent OBSC in University of Health Sciences Turkey, İstanbul Bağcılar Training and Research Hospital between January 2015 and January 2019 for breast cancer were retrospectively evaluated. According to the location of the tumor, the racket method or J-mammoplasty techniques was selected. Quality of life and patient satisfaction assessment questionnaire was performed.Results:The mean age was 48.1 (26-68) years. The most common incision pattern was the racket pattern (85%). The invasive ductal carcinoma (89.8%) was seen more than ductal carcinoma in situ (6.1%) and papillary carcinoma (4.1%). The distance to the surgical margin was approximately 7.1 mm (1-20). The estrogen receptor positivity was 74.2% (5-100%) and progesterone receptor positivity was 61.8% (5-98%). 61.2% received chemotherapy (100%, radiotherapy). Based on questionnaires, the score of quality of life and satisfaction was 34 (25-47). Especially, the body image function [22 (15-29)] and health functions [10 (7-13)], such as breast & arm symptoms, were better in the patients who had higher scores (p<0.001).Conclusion:The histopathological patterns of the patients following OBSC potentially did not show any impact among the quality of life and satisfaction scores

Efficacy of laparoscopic transversus abdominis plane block for elective laparoscopic cholecystectomy in elderly patients

Transversus abdominis plane (TAP) block technique seems to offer one of the most efficient methods for a local pain control. Our aim is to demonstrate the effectiveness and safety of TAP block for post-operative pain control under laparoscopic vision in elderly patients during laparoscopic cholecystectomy. The patients aged more than 65 years old, who had cholecystectomy due to symptomatic cholelithiasis, were retrospectively evaluated. The patients that were operated under general anesthesia + laparoscopic TAP block and those who were operated only under only general anesthesia were compared according to their' age and gender, comorbidities, American Society of Anesthesiologists scores, visual analog scale (VAS) for pain and length of stay in the hospital. Median (+/- interquartile range) values of post-operative 24th-hour-VAS for pain was found consecutively 2 (+/- 1-3) in TAP block + group and 3 (+/- 2-5) in TAP block - group. The median post-operative 24th-hour-VAS value in overall patients was three. Patients' VAS values were higher in the TAP block - group with a statistically significant difference (p = 0.001). Furthermore, no statistically significant difference was found for other parameters in two groups. The laparoscopic-guided TAP block can easily be performed and has potential for lower visceral injury risk and shorter operational time. Efficacy, safety and other advantages (analgesic requirements, etc.) make it an ideal abdominal field block in elderly patients

The Performance Analysis of the Thyroid Nodule Size to Predict the Coexistence of Micropapillary Carcinoma

Objective:Incidental micropapillary carcinoma (IMC) is the most common variant of thyroid malignancies. There are unmet needs regarding the efficacy of nodule size in the prediction of the coexistence of IMC. We aimed to measure the effect of nodule size on the prediction of the coexistence of IMC.Method:The data of 194 patients who underwent biopsy for fine-needle aspiration cytology and subsequent thyroidectomy in a research and training hospital between January 2017 and February 2020 were analyzed retrospectively. The patients were divided into three groups according to the sizes of thyroid nodules as 0-10 mm, 11-20 mm, and >20 mm. Logistic regression analysis was performed.Results:The patients with nodule size between 0 mm and 10 mm mostly showed hypothyroidism (51.0% vs. 28.8% vs. 41.8%) while patients with size between 11 mm and 20 mm mostly had euthyroidism (44.2% vs. 45.1% vs. 41.8%, p=0.0175). Both malignancy (51.9% vs. 49.0% vs. 42.9%, p=0.544) and IMC (65.4% vs. 51.0% vs. 56.0%, p=0.32) were observed more likely in patients with moderate size (11-20 mm). We found the following variables to be predictors for the coexistence of IMC: absence of halo [odds ratio (OR): 4.50, 95% confidence interval (CI): 1.61-14.71, p=0.007], and interestingly decrease in vascularity [OR: 0.33, 95% CI: 0.12-0.87, p=0.030], and total thyroidectomy, [OR: 4.55, 95% CI: 2.30- 9.56, p2 cm), we reported more IMC inside the thyroid gland. However, the nodule size has the low performance to be a predictor for the coexistence of IMC in the thyroid gland