Solid Pseudopapillary Neoplasm of the Pancreas: A Good Prognostic Tumor of the Bad Lucky Organ

Introduction Solid pseudopapillary neoplasm (SPN) of the pancreas is a rare clinical entity with low malignant potential and good clinical prognosis. It was first defined by Frantz Virginia in 1959 and was renamed solid pseudopapillary tumor by the World Health Organization (WHO) in 2010. SPN is more common in young women with an average age of 28-32 years and a female: male ratio of 3-10:1 in different publications. Material & Method The data were retrospectively analyzed for 26 patients whose pathology was compatible with SPN and operated on between 2003 and 2019 in the General Surgery Clinic at XXX. Results Of the patients, 25 (96.2%) were female and 1 (3.8%) was male; the mean age at diagnosis was 37.1 (range: 18-69, eight patients <30 years); mean body mass index was 28.8 kg/m(2). The most common reason for referral was abdominal pain (n=13, 50%); three patients (11%) had nausea and vomiting, and one patient (3.8%) had jaundice with mass at the head of the pancreas. Ten patients (38%) were asymptomatic and were diagnosed incidentally during examinations performed for other reasons. The most frequent tumor localization was the head and neck part of the pancreas (n=10, 38%); eight patients (31%) had body, and eight patients (31%) had tail localization. Ten patients (38%) had Whipple procedure (pancreaticoduodenectomy), 15 patients (53%) had distal pancreatectomy, and one patient had intra-abdominal mass excision and segmental small bowel resection operation in addition to distal pancreatectomy. Six (37%) of the 16 patients who underwent distal pancreatectomy had splenectomy too. One of the patients had laparoscopic distal pancreatectomy and splenectomy. The mean tumor diameter was 7.2 cm (range: 2-23 cm). Conclusion SPN is a rare tumor, and even though it is diagnosed late and in large sizes, it has prolonged survival when appropriate surgical resection is applied. The ability to perform surgery even in cases with relapse or meta stasis during the SPN follow-up reveals the importance of accurate diagnosis

Incidental lesions in appendectomy specimens: Rare or rarely sampled?

OBJECTIVE: During the microscopic examination of the specimens after appendectomy operations performed due to acute appendicitis, pathologists may encounter some incidental and unusual lesions. Appendectomy specimens are sampled as 3 sections/1 paraffin block in many centers. In this study, we aimed to evaluate whether multiple and dense sampling of appendix specimens has an impact on the incidence of incidental lesions of the appendix

Laparoscopic cystogastrostomy for the management of pancreatic pseudocysts

Aims: To assess the value of laparoscopic cystogastrostomy in the treatment of pancreatic pseudocysts. Materials and Methods: Patients who underwent laparoscopic surgery for pancreatic pseudocysts were included in the study. All the cysts were non-resolving, symptomatic and large, as a result of acute pancreatitis. Laparoscopic cystogastrostomies were performed by either anterior transgastric or posterior techniques. Results: From February 2001 to November 2006, seven patients were included into the study. The etiology of pancreatitis was gallstone disease in six cases and hyperlipidemia in one. The mean age was 58.7 years (5269) and the mean pseudocyst size was 15.1 cm (7-20). Transgastric cystogastrostomy and posterior cystogastrostomy were carried out in three and four patients, respectively, with no conversion. Mean hospital stay was 13.4 days (6-30). Neither mortality nor procedure-related major complication was encountered, Follow-up computerized tomography studies confirmed complete resolution of the cyst in all cases, in the first month. Conclusions: Laparoscopic cystogastrostomy is an effective and safe treatment of pancreatic pseudocysts

Fournier's gangrene: Five years' experience from a single center in Turkey

BACKGROUND: Is the present study aims to analyze demographic, clinical and surgical data of all patients with FG (Fournier's gangrene) admitted to a tertiary healthcare hospital in the largest city of Turkey

Laparoscopic surgery in pregnant patients with acute abdomen

AIM: Notwithstanding the significant advantages compared to open surgery, laparoscopic surgery was considered to be contraindicated in pregnant patients. Currently, there are opposing views on the safety of laparoscopic surgery during pregnancy, especially in last trimester. The aim of this study was to examine feasibility of laparoscopic surgery in pregnant women with acute abdomen

Surgery for Isolated Liver Metastasis of Ovarian Cancer

Few studies have been published on liver resection alone or in combination with cytoreductive surgery for liver metastases of ovarian carcinoma. Methods: Eight patients who underwent liver resection for metastasis of ovarian cancer were included in the study. Total abdominal hysterectomy and bilateral salpingo-oophorectomy had been performed before liver surgery in all patients. The demographic data, follow-up details before and after liver resection, histopathology of the primary ovarian cancer, type of surgery and outcome were evaluated. Results: The mean age of the patients was 56.1 (46–68) years. The mean hospitalization time was 8 (7–10) days. The mean disease-free interval was 5.38 years from the time of initial surgery to surgery for metastatic liver lesions, and 39 months after liver resection to secondary metastases. Four patients did not have any evidence of disease after liver surgery. Conclusion: Indications for liver resection should be considered in selected patients who have a limited extent of metastatic disease from ovarian carcinoma. Liver resection for metastases of ovarian carcinoma could be an effective and feasible approach