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Background: Rhomboid excision with Limberg flap repair (RELIF) is an effective surgical procedure in pilonidal sinus disease (PSD) treatment. This study aimed to compare outcome of diathermy and scalpel in RELIF procedure in PSD surgery., Methods: Patients undergoing RELIF procedure due to PSD at Adana Numune Training and Research Hospital between January 2012 and September 2012 were randomly assigned to diathermy (n=30) or scalpel (n=30) groups. The primary outcomes measured were duration of operation, drainage volume, postoperative numerical pain intensity scale (NPIS) scores, complications, duration of hospitalization length and time to return to daily activity., Results: The mean age was 26.2 years (17-44 years). The mean operation duration was significantly lower in diathermy group (p=0.0001). Postoperative total NPIS score within the first 24 h was significantly lower in diathermy group (p=0.001). However, there were not any significant differences in term of NPIS scores in day 3 and day 7. There were no significant differences in terms of total drain output, drain removal time and length of hospital stay. There were no significant differences between groups in terms of duration to sit comfortably, return to daily activity and work. Recurrence of PSD was emerged in one patient in the diathermy group., Conclusion: Diathermy dissection in RELIF procedure in pilonidal sinus surgery is a safe technique and decreased operation time and postoperative pain.

Solitary rectal ulcer syndrome is a rare clinical entity. Several treatment options has been described. However, there is no consensus yet on treatment algorithm and standard surgical procedure. Rectopexy is one of the surgical options and it is generally performed in patients with solitary rectal ulcer accompanied with overt prolapse. Various outcomes have been reported for rectopexy in the patients with occult prolapse or rectal intussusception. In the literature; outcomes of laparoscopic non-resection rectopexy procedure have been reported in the limited number of case or case series. No study has emphasized the outcomes of laparoscopic non-resection rectopexy procedure in the patients with solitary rectal ulcer without overt prolapse. In this report we aimed to present clinical outcomes of laparoscopic non-resection posterior suture rectopexy procedure in a 21-year-old female patient with solitary rectal ulcer without overt prolapse.

Solitary rectal ulcer syndrome is a rare clinical entity. Several treatment options has been described. However, there is no consensus yet on treatment algorithm and standard surgical procedure. Rectopexy is one of the surgical options and it is generally performed in patients with solitary rectal ulcer accompanied with overt prolapse. Various outcomes have been reported for rectopexy in the patients with occult prolapse or rectal intussusception. In the literature; outcomes of laparoscopic non-resection rectopexy procedure have been reported in the limited number of case or case series. No study has emphasized the outcomes of laparoscopic non-resection rectopexy procedure in the patients with solitary rectal ulcer without overt prolapse. In this report we aimed to present clinical outcomes of laparoscopic non-resection posterior suture rectopexy procedure in a 21-year-old female patient with solitary rectal ulcer without overt prolapse.

Background: The first aim of this study was to discuss the factors affecting mortality rate in patients with severe intraabdominal sepsis treated with planned relaparotomy. The second aim was to compare APACHEE II, P-POSSUM and SAPS II scoring systems to allow identification of high-risk patients., Material and Methods: A series of 34 patients who had intra-abdominal sepsis and treated with planned relaparotomy between January 2009 and January 2012 were included the study. The source of the peritonitis, type and number of surgical procedures, number of planned relaparatomies, microbiology surveillance, total intensive care unit (ICU) and hospital stay duration, number of intubated days, morbidity and mortality were analyzed. APACHEE II, SAPS II, P-POSSUM scores and estimated mortality ranges at admission were compared., Results: The mean age was 46 (16-76 years) and 73.5 % (n=25) were male. A total of 119 operations and 50 surgical procedures were performed. The overall mortality rate was 20.6% (n=7). Complications developed in %53 (n=18) of the patients. Mortality was higher in upper GIS leaks (6/20 versus 1/14 patients). Areas under the curve calculated by ROC curve analysis for APACHE II, SAPS II and P-POSSUM were 0.958, 0.955 and 0.931, respectively. The highest values for sensitivity (100%) and specivity (85.2%) together were reached in APACHE II, when cut off value for it was set to 20.5. The SAPS II and P-POSSUM physiology scores were correlated with overall hospital stay (p=0.022 r=0.438 and p=0.001 r=0.609 respectively), but this correlation was not found for APACHEE II score (p=0.085 r=0.337). However, all three scoring systems provided clear estimation of ICU stay duration., Conclusion: We suggest that, in secondary peritonitis patients reserved for planned relaparotomy, APACHE II is more reliable for prediction of mortality and P-POSSUM scoring system is more reliable for prediction of overall hospital stay duration.