Sa1130 the effect of phoenixin-14 on sepsis-induced hepatic injury and impaired intestinal contractility

Proof systems for the Relativized Propositional Calculus are defined and compared

Incidental Gallbladder Carcinoma Diagnosed After Laparoscopic Cholecystectomy

Introduction: Laparoscopic cholecystectomy (LC) is one of the most performed general surgeries. Incidental gallbladder carcinoma (IGBC) is diagnosed in 0.3–2.9% of all cholecystectomies and accounts for most detected gallbladder cancers (GBCs). This study aims to evaluate the incidence, clinical, and prognostic features of IGBC diagnosed after LC for benign gallbladder disease. Materials and Methods: We performed a retrospective analysis of patients who underwent cholecystectomy between January 2016 and October 2021 at the Istanbul Sultanbeyli State Hospital General Surgery Clinic. Data regarding the demographics, pathological features of the tumors, and survival times of patients were examined. Results: A total of 745 patients were analyzed. The patients’ median age was 43 (18–78), and the male-tofemale ratio was 137:608. Four patients were diagnosed with gallbladder carcinoma after LC; however, one patient had pre-operative suspicious GBC. Three patients were diagnosed with IGBC. The cancer stages and survival times of the IGBC patients were pT2, pT2, and pT1a and 8, 34, and 40 months, respectively. Conclusion: Most GBCs are detected incidentally. The most significant factor determining the prognosis is an early stage detection. To detect IGBC, cholecystectomy specimens must be carefully examined histopathologicall

A spontaneous transomental hernia: A rare cause of bowel obstruction

Internal hernias (IH) are rare situations that account for 0.5-3% of all cases of intestinal obstruction. Transomental hernia is a rare subtype, hardly diagnosed, and represents approximately only 2% of internal hernias. In 2018, a 41-year-old female patient presented to Marmara University Hospital emergency service with abdominal pain, nausea, and vomiting. Her medical history included asthma, and she had no abdominal surgery. With the preliminary diagnosis of small bowel obstruction, laparotomy was done and showed a loop of ileum was herniated through into an unusual defect of the omentum. The obstructed loop of the small intestine into the hernia site was reduced. It was seen as viable, so no resection was necessitated. We divided the greater omentum into two parts from the edge of the defect area to prevent recurrences. The patient\"s postoperative period was uneventful, and she was discharged on the second postoperative day. Small bowel strangulation is more seen in transomental hernia than in other internal hernia types. So it is related to high morbidity and mortality. Surgery should not be delayed to reduce complications

Percutaneous endoscopic gastrostomy: a secondary care hospital experience

INTRODUCTION: Percutaneous endoscopic gastrostomy (PEG) is the most common enteral feeding method in patients with swallowing disorders. PEG is a minimally invasive procedure, but acute and chronic complications may develop after the procedure. Therefore, in this article, we evaluated PEG interventions that were performed in a secondary care hospital. METHODS: We performed a retrospective observational study of patients who underwent PEG intervention from January 2019 to June 2021 at the Istanbul Sultanbeyli State Hospital Endoscopy Unit. This study was approved by the local Ethics Committee and registered with ClinicalTrials.gov (NCT05012527). A total of 45 patients’ comorbidities, indications, complications, and 30-day mortality rates were analyzed. RESULTS: The majority of our population was elderly patients, and the mean age of the patients was 74. Most patients had multiple comorbidities such as hypertension, Alzheimer’s disease, stroke, and diabetes mellitus. The minor complication rate was 24.4%, and the major complication rate was 4.4%. Thirty-day mortality was observed in 18% of this cohort. DISCUSSION AND CONCLUSION: Before the PEG procedure, the patient’s general condition, the expected time of insufficient food intake, life expectancy, and comorbidities should be carefully examined. Our study has shown that PEG is a viable and safe procedure

A Case of Peutz-Jeghers Syndrome Presenting With an Inoperable Periampullary Tumor

Peutz-Jeghers syndrome (PJS) is a syndrome characterized by multiple hamartomatous polyps in the gastrointestinal system and melanin pigments accumulating in the skin and mucous membranes. Patients with PJS have an increased risk of gastrointestinal malignancies. In this syndrome, pancreatic cancer is primarily detected in older ages. In this article, we present a case of a patient with an unresectable periampullary tumor and PJS

Recurrent Perianal Abscess in a Patient With Hermansky-Pudlak Syndrome Associated Granulomatous Colitis: A Case Report

Hermansky-Pudlak syndrome (HPS) is a rare genetic disease consisting of the triad of oculocutaneous albinism, bleeding diathesis, and pigmented reticuloendothelial cells. In HPS patients' granulomatous colitis could be an additional feature and perianal abscess could be seen in such patients. We report a patient with HPS-associated granulomatous colitis, refractory to medical treatment, and perianal involvement. Patients with HPS-associated granulomatous colitis and perianal involvement may require multiple surgical interventions and there is no consensus yet for treatment in such patients

Gender-specific prevalence of sacrococcygeal pilonidal sinus disease in Turkey: A retrospective analysis of a large cohort

Background Many studies have been carried out to find the optimal treatment for pilonidal sinus disease (PSD), but the gender-specific prevalence in Turkey has not been revealed. Therefore, this article evaluated patients diagnosed with pilonidal sinus disease in our hospital. We aimed to analyze the gender ratio in PSD. Methods We evaluated patients admitted and who underwent pilonidal sinus excision at the Istanbul Sultanbeyli State Hospital between January 2010 and January 2022. Patients with missing data, multiple admissions, and multiple surgeries of the same patient were excluded from the analyses. Patients were stratified according to age into two groups: = 18 (adult). Age and gender, diagnosis at admission, and operation status were analyzed. Results A total of 10,324 PSD patients were analyzed. 24.8% (n = 2559) of the patients were female and 75.2% (n = 7765) were male. Patients\" ages ranged from 13 to 86 years; the mean age was 26.5 years. Of all patients, 1621 (15.7%) had an abscess at the time of diagnosis. 4345 pilonidal sinus surgery cases were evaluated; 25.3% (n = 1100) of the patients were female and 74.7% (n = 3245) were male. The girl/boy ratio of PSD in teenagers was 0.86, and the female/male ratio of PSD in patients aged 18 years and older was 0.27. Conclusion The female gender prevalence of sacrococcygeal pilonidal sinus disease is 25% in Turkey. Pilonidal sinus disease surgery is mainly performed in secondary care hospitals; therefore, unpublished data from these centers may contribute more to pilonidal sinus disease research

SİLS Port Kullanılarak Yapılan Transanal Minimal İnvaziv Cerrahi (TAMIS): Tek Merkez Kısa Dönem Sonuçları

Aim: Conventional transanal excision was described decades ago for treatment of benign rectal neoplasms. However, the chalanges of this technique leads to use alternative approachs. We evaluated the results of transanal minimally invasive surgery (TAMIS) with single incision laparoscopic surgery (SILS) port in treatment of benign rectal neoplasms. Method: Data of the patients who underwent TAMIS with SILS port in one center were retrospectively analyzed. SILS port was placed through in the anal canal and ultrasonic sealing device was used for excision the tumors. Complications during or after surgery were reported. Patients were followed-up by rectal examination with rectoscopy and recurrences were evaluated. Results: Between July 2015 and March 2020, 20 patients underwent TAMIS at one center. The median age of the patients was 67 (37-79). The procedure was performed in all of the patients with a lithotomy position. Full-thickness defect after complete resection of the lesion was observed in 5 (25%) patients. However, abdominal cavity was not exposed through the TAMIS procedure in any of the patients. The rectal wall defect was not repaired in any of the patients. No major complication occured in the patients. The hospital stay was 1 (1-4) days. The surgical margin was negative in 19 patients (95%). After the follow-up period of 9 (1-43) months, 3 (17%) patients had a recurrence and further surgery was performed. Conclusion: TAMIS using SILS port for the management of rectal neoplasms is a safe and effective for treatment benign rectal lesions.Amaç: Benign rektal neoplazmların tedavisi için geleneksel transanal eksizyon on yıllar önce tanımlanmıştır. Bununla birlikte, bu tekniğin zorlukları, alternatif yaklaşımların kullanılmasına yol açar. Bu çalışmada benign rektal neoplazmların tedavisinde tek insizyon laparoskopik cerrahi (SILS) portu ile transanal minimal invaziv cerrahi (TAMIS) sonuçlarını değerlendirdik. Yöntem: Merkezimizde SILS portu ile TAMIS uygulanan benign rektal neoplazmalı hastaların verileri retrospektif olarak incelendi. SILS portu anal kanal içerisine yerleştirildi ve tümörlerin eksizyonu için ultrasonik mühürleme cihazı kullanıldı. Ameliyat sırasında veya sonrasında komplikasyonlar rapor edildi. Hastalar proktoskopi ve rektal muayene ile takip edilerek nüksler değerlendirildi. Bulgular: Temmuz 2015 ile Mart 2020 arasında 20 hastaya TAMIS uygulandı. Hastaların ortanca yaşı 67 (37-79) idi. Tüm hastalarda litotomi posizyonunda ameliyat edildi. 5 (%25) hastada lezyonun tam olarak çıkarılmasından sonra tam kat defekt görüldü. Ancak hiçbir hastada abdominal boşluğa girilmedi. Hiçbir hastada rektal duvar defekti onarılmadı. Hastalarda majör komplikasyon izlenmedi. Hastanede kalış süresi 1 (1-4) gündü. 19 hastada (%95) cerrahi sınır negatifti. 9 (1-43) aylık takip süresinden sonra 3 (%17) hastada nüks görüldü ve ileri cerrahi yapıldı. Sonuç: Rektal neoplazmların yönetimi için SILS portunu kullanılan TAMIS, benign rektal lezyonların tedavisi için güvenli ve etkilidir