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Copyright of Gulhane Medical Journal is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background/aim: Postoperative pain control constitutes a major problem and studies have focused on reducing opioid requirements using regional techniques. We aimed to investigate the efficacy of wound infiltration with lornoxicam on postoperative pain control following thyroidectomy. Materials and methods: In this prospective, randomized-controlled study, 80 patients scheduled for thyroidectomy were randomly assigned to 2 groups. After the thyroidectomy was performed, patients in group I underwent wound infiltration with 4 mg of lornoxicam and patients in group II received the same amount of saline. Rescue analgesia was provided with additional doses of lornoxicam delivered by an on-demand patient-controlled analgesia device. Total analgesic consumption during the postoperative 24 h, and pain intensities assessed using a visual analog scale score at 0, 2, 4, 8, 12 and 24 h postoperatively were recorded. Results: Pain scores during the postoperative 24 h were slightly lower in group I than in group II, but the difference was not significant (P > 0.05). The mean analgesic consumption was 8.87 ± 1.87 mg and 10.33 ± 1.25 mg in groups I and II, respectively (P > 0.05). Conclusion: Wound infiltration with lornoxicam neither improved postoperative pain control nor decreased total analgesic consumption. [ABSTRACT FROM AUTHOR]

Copyright of Gulhane Medical Journal is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

AIM: According to recent studies, %2.6 of all malignant melanomas are primary unknown. Surgical approach to MUP is still controversial. MUP presented with visceral organ metastasis is grade 4 tumor with surveillance of 3-16 months however MUP presented with nodal metastasis is grade 3C with surveillance of more than 24 months. The aim of this study is to share our experiences about primary unknown axillary metastatic lymph node excision. CASE REPORT: 61-years-old male patient with history of displastic nevus excision 2 years ago from lumbar region; applied to our clinic with axillary mass. Only finding was 4.5x4cm, mobile, well circumscribed mass with minimal pain. No any other physical findings located at breast or subclavicular region was found during examination. 4.5cm in diameter suspicious lymph node with cortex-hilus discordance was detected with ultrasonography, and excisional biopsy was performed. Histopathological examination resulted as malign melanoma metastasis. Patient was evaluated for primary tumor localization with physical examination and PET. No primary tumor could be found. The tumor was graded as 3C and curative ALND was performed to patient with final histopathology of 30 reactive lymph nodes. CONCLUSION: Surgical treatment algorithm of metastatic malignant melanoma with unknown origin is still not certain. There are articles advocating that regional lymph node dissection increases the surveillance. They also suggest that at least level 1-2 axillary dissection with additional regional lymph node dissection (if any) must be performed for malignant melanoma presented with metastatic axillary lymph node; in which as we also suggest. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Excisional lymph-node-biopsy is currently becoming a must for diagnosis of lymph-node associated systemic disease. The most accessible lymphnode was prefered for excision, however current modality is to excise the most radiologically suspicious one. ROLLguided lymph-node excision is favorable for minimalinvasive- surgery modality. Our purpose is to share our experience about ROLL-guided excision of non-breast axillary lesions that are performed in our clinic. MATERIAL-METHOD: ROLL-guided axillary non-breast related lesions of 33 patients excised between 2008-2013 in our clinic are evaluated retrospectively. RESULTS: Data from 25-female and 8-male patients with an average age of 51.8(21-84) were evaluated. 7/33 patients had history of breast-cancers surgery and had suspicious lymph node(s) located at axilla. Other 26 patients had suspicious lymph node(s) that was detected radiologically without diagnosis. Totally 49 lymph nodes (range:0.4- 4.5cm) were excised. Result of histopathological evaluation was; breast carcinoma metastasis in 4-patients, granulomatous disease in-2 patients, Hodgkin lymphoma in 1-patient, malign melanoma in1- patient, apocrine carcinoma metastasis in 1-patient and reactive lymphadenopathy in 24-patients. CONCLUSION: ROLL method is frequently used to localize and mark lesions, which can‟t be palpated on breast, however it is also used to localize relapsed thyroid carcinomas and parathyroid adenomas. This new application enables us to excise the difficult to localize or radiologically suspicious lymph nodes rapidly by minimal invasive surgery modality resulting less morbidity rates. Consequently, this efficient and easily applicable new method also decreases repeated excisional lymph node biopsies by enabling the selective excision of suspicious lymph node(s). [ABSTRACT FROM AUTHOR]

Geriatrics patients have higher morbidity and mortality rates than young patients. This higher rate is generally because of co-morbid diseases and malnutrition. In this study we wanted to detect factors that influence mortality after surgery among geriatric patients. Study included 297 patients who are 65 or more years old and who had been operated from september 2003 to september 2004. Preoperative, operative and postoperative datas of patients were recorded. Median age of patients was 72 years. Mostly performed operations were biliary tract (%22,6), hernia (%18,9), colon and rectum (%17,5), upper gastrointestinal system (%15,8) surgeries. In univariant analysis, nutritional status, ASA score, albumin level, creatinine level, hemoglobin level, performance of laparotomy, presence of emergent operation, presence of reoperation and presence of complication were found to be associated with mortality. In multivariant analysis nutritional status, albumin level and creatinine level were found to be associated with mortality. In geriatric patients undergoing operation nutritional status, albumin level and creatinine level are most important factors that influence mortality. [ABSTRACT FROM AUTHOR]