Benign Epidermal Perianal Inclusion Cysts

Epidermal kistler çok yaygın lezyonlardır. Bu makalede, perianal yerleşimli epidermal inklüzyon kist olgusu sunmaktayız. Yüzeyel ultrason ile perianal bölgede yerleşmiş olan kistik kitlenin olduğu görüldü. Histopatolojik değerlendirme için kitleye total eksizyon uyguladık. Patoloji sonucu epidermal inklüzyon kisti geldi. Perianal yerleşimli epidermal inklüzyon kistleri ender görülen lezyonlardır. Anal ve perianal bölge benign ve malign hastalıklarının ayırıcı tanısında bu bölgenin epidermoid kistleride akılda tutulmalıdır.Epidermal cysts are very common lesions. We present a perianal epidermal inclusion cyst in this article. Cystic lesion in the perianal region was detected with superficial ultrasound. We performed total excision of the mass for histopathological evaluation. Pathology turned out to be epidermal inclusion cyst. Perianal localization of epidermal inclusion cysts is rarely encountered. In the differential diagnosis of benign and malignant diseases of the anal and perianal region, epidermoid cyst should be taken into consideration

Benign epidermal perianal ınclusion cysts

İstanbul Bilim Üniversitesi, Tıp Fakültesi.Epidermal kistler çok yaygın lezyonlardır. Bu makalede perianal yerleşimli epidermal inklüzyon kist olgusu sunmaktayız. Yüzeyel ultrason ile perianal bölgede yerleşmiş olan kistik kitlenin olduğu görüldü. Histopatolojik değerlendirme için kitleye total eksizyon uyguladık. Patoloji sonucu epidermal inklüzyon kisti geldi. Perianal yerleşimli epidermal inklüzyon kistleri nadir görülen lezyonlardır. Anal ve perianal bölge benign ve malign hastalıklarının ayırıcı tanısında bu bölgenin epidermoid kistleride akılda tutulmalıdır.Epidermal cysts are very common lesions.We offer a perianal epidermal inclusion cysts located in the article. Cystic in the perianal region with superficial ultrasound showed that the mass. We performed total excision of the mass for histopathological evaluation. Pathology results came epidermal inclusion cyst. Perianal localization of epidermal inclusion cysts are rare lesions.In the differential diagnosis of benign and malignant diseases of the anal and perianal epidermoid cyst should be considered in this area

Day-case surgery for inguinal hernia: Lichtenstein inguinal hernia repair under local anesthesia performed by surgical residents.

Background: Lichtenstein inguinal hernia repair with local anesthesia as a day-case surgery is one of aspects of education in inguinal hernia surgery as a surgical training program. In this study, we aimed to present these surgery performed by residents. Methods: Forty years and older male patients diagnosed as primary inguinal hernia were included prospectively between June 2009 and March 2011. Surgical outcomes with respect to recurrence and chronic postoperative pain were studied.Results: There were 151 patients with a mean age of 55.7±10.8. Intraoperative evaluation revealed direct in 84 (55.6%), indirect in 58 (38.4%) and combined hernia in 9 (6.0%). Mean operation time was 51.2±13.2 minutes which was significantly higher in obese patients (p<0.05). Patients were discharged at postoperatively 8 hours or less in 143 (94.7%). Most of the patients (90.7%) were reported to choose local anesthesia again. Eleven and four patients reported pain scores of 0.23±0.7 (range 0-4) and 0.07±0.4 (range 0-3) at 6th and 12th month evaluations, respectively. At the postoperative 1st day, 137 (90.7%) patients could return to daily activities. There were 28 (18.5%) hematoma and seroma formation, and 18 (11.9%) wound infection. There was no mesh reaction; however, 2 (1.3%) recurrences were detected after one year of the operation. Conclusions: Lichtenstein inguinal hernia repair under local anesthesia as a day case surgery should be chosen as a primary treatment method, and can be performed by surgical residents under supervision in a safe manner

Comparison of common surgical procedures in non-complicated pilonidal sinus disease, a 7-year follow-up trial

Background: Pilonidal disease is a common problem in primary health care which may require immediate surgical referral. Although various management options have been proposed, so far there is no gold standard treatment. The aim of the present study was to determine which of the following techniques was superior as regards postoperative complications and recurrence, midline unshifted adipofascial turn-over flap, midline shifted adipofascial turn-over flap or Karydakis flap. Methods: A randomized clinical trial was conducted in the Department of General Surgery. Patients with non-complicated pilonidal sinus were enrolled in the study from April 2009 to January 2012. All patients were randomized the day of surgery at the coordinating center by means of a computer program. Patients were randomized to receive midline unshifted adipofascial turn-over flap, midline shifted adipofascial turn-over flap or Karydakis flap. All procedures were performed under local anesthesia and patients were discharged 6 h after surgery. Demographic characteristics, skin color, body hair type, family history, preoperative complaints and duration of symptoms, cyst size, intraoperative iatrogenic cyst rupture, the presence of a tuft of hairs in the cyst, surgical techniques, duration of drainage, length of hospital stay, postoperative complications and recurrence were evaluated. Results: One hundred and ninety-two patients with non-complicated pilonidal sinus were enrolled. Seventy-two patients were randomized to midline unshifted adipofascial turn-over flap, 67 patients to midline shifted adipofascial turn-over flap and 53 patients to Karydakis flap. The mean age was 25.66 ± 7.67 years. At 76-month follow-up, the overall complications and recurrence rates were not significantly different between groups (p > 0.05). Conclusion: In cases of non-complicated pilonidal sinus, we recommend surgical management using local anesthesia, outpatient surgery and the surgical approach with which the surgeon is most familiar

Natal Cleft Deeper in Patients with Pilonidal Sinus: Implications for Choice of Surgical Procedure

PURPOSE: The study was planned to evaluate the depth of natal cleft in patients with pilonidal sinus disease and in healthy persons