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

Meperidine, As An Effective Adjuvant Agentin Unilateral Spinal Anaesthesia For Knee Arthroscopy

Aim: Unilateral spinal anaesthesia permits early recovery and short ambulatory stay. Our study aimed to search if meperidine may prolong sensory block time when added to hyperbaric bupivacaine. Methods: This is a prospective, double blinded study: Ambulatory, 46 consenting patients aged 18-60 years, undergoing unilateral knee arthroscopy were randomized in two groups. saline group (n=20): 1.3 ml of hyperbaric bupivacaine and 0.2 ml of serum physiologic was used. Meperidine group (n=20): 1.3 ml of hyperbaric bupivacaine and 0.2 ml of 5% meperidine was used. Sensory block times, duration of spinal anaesthesia, intraoperative adverse effects and patient satisfaction were recorded. Results: Mean duration of sensory block was greater in the meperidine group compared with the saline group. Strict unilateral block and hypotension were comparable among groups. Conclusion: Addition of meperidine to hyperbaric bupivacaine in unilateral spinal anaesthesia prolonged analgesia without effecting total anesthesia time with minimal adverse effects

Two Different Clinical Approaches with Mortality Assessment of Four Cases: Complete and Incomplete Type of Abdominal Cocoon Syndrome

Abdominal cocoon syndrome (ACS), also called sclerosing encapsulated peritonitis, is a condition characterized by encapsulation of all or some of small bowel loops by a thick fibrous membrane. Etiologic cause is not fully known. It is among the rare causes of intestinal obstruction in adults. Preoperative diagnosis is difficult, and high suspicion is required. Diagnosis is generally made during laparotomy performed due to mechanical obstruction. In treatment of the condition, large scale surgical resections should be avoided. In the present study, we aimed to evaluate all clinical and radiological characteristics and surgical treatment of ACS in light of the literature through four patients operated in our clinic

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