Search

Introduction: We evaluated neutralizing antibody and anti-spike antibody (anti-S) response against omicron variant in solid organ (SOT) or hematopoietic stem cell (HSTC) receivers after third dose of BNT162b2 (BNT) or CoronaVac (CV) following two doses of CV. Methods: In total, 95 participants who underwent SOT (n=62; 44 liver, 18 kidney) or HSCT (n=27; 5 allogeneic, 22 autologous) were included from five centers in Turkey. The median time between third doses and serum sampling was 154 days. The vaccine-induced antibody responses of both neutralizing antibodies and Anti-Spike antibodies were assessed by plaque neutralizing assay and immunoassay. Results: Neutralizing antibody and anti-spike IgG levels were significantly higher in transplant patients receiving BNT compared to those receiving CV (GMT:26.76 vs 10.89; p=0.03 and 2116 Au/ml vs 172.1 Au/ml; pConclusion: This study highlights the superiority of BNT responses against omicron as a third dose among transplant recipients after two doses of CV. Lack of neutralizing antibody against omicron after CV in liver transplant recipients should be taken into consideration particularly in countries where inactivated vaccines are available in addition to mRNA vaccines.

The RAD51 gene encodes proteins that are important for the repair of double-strand DNA breaks by recombination. Thus, genetic variability in the gene may contribute to the occurrence and progression of breast carcinoma. We investigated the association of polymorphisms in the DNA repair genes RAD51-site 135G/C with the breast cancer risk. Genotypes were determined by PCR-RFLP assays in 55 female patients with breast cancers and 80 age-matched healthy controls. Bloods samples were taken from all the patients and health controls and DNA was isolated. The region of interest was amplified based on PCR. After amplification, we used a restriction enzyme (RAD51; MvaI) and digested the PCR product. Then, these DNA fragments were size separated in gel electrophoresis. We identified changes in the nucleotides in these specific regions and confirmed the genotyping via sequencing a subset of PCR products using an Applied Biosystems Automated Sequencer. We observed that both allele and genotype frequencies significantly differed between breast cancer patients and healthy control. The frequency of variant allele, C, was increased to 0.25 in breast cancer group as opposed to the frequency of 0.125 in control group. Similarly, the genotypes carrying the variant allele C (CC + GC) had an elevated frequency and increased odd’s ratio among breast cancer group. The obtained results indicate that the polymorphism of RAD51 genes may be associated with the incidence of breast cancer in the Eastern Mediterranean region population. We hypothesized that common polymorphisms in DNA repair and cell cycle regulator genes modify DNA repair machinery which contribute to breast cancer susceptibility.

Aim:Pilonidal sinus is a chronic intermittent disease, usually involving the sacrococcygeal area. This study was undertaken to compare the long-term results of peroperative methylene blue use in patients with pilonidal disease who underwent Limberg flap technique with and without methylene blue application.Method:Patients who underwent Limberg flap for pilonidal sinus surgery between January 2014 and November 2018 were divided into two groups: methylene blue-guided surgery (group 1) and unguided surgery (group 2). Data of the patients were collected from the files, and the long-term recurrence data of the patients were obtained by one-to-one phone calls and outpatient controls at 36 months. Age and body mass index (BMI) were also evaluated. BMI of the patients was categorized as 18.1-20.0 kg/m2, 20.1-22.5 kg/m2, 22.6-25.0 kg/m2, 25.1-27.5 kg/m2, 27.6-30.0 kg/m2 and >30.1 kg/m2.Results:Methylene blue was performed in 62 of 100 patients who underwent Limberg flap procedure and there was one recurrence in both groups. Methylene blue application did not have an effect on long-term recurrence (p=0.98). BMI groups and recurrence were analyzed regardless of methylene blue use, and BMI greater than 27.5-30.0 kg/m2 was statistically significant in the development of recurrence in long-term results (p=0.040).Conclusion:Although it is considered as an integral part of pilonidal sinus surgery, there is no superiority of methylene blue guided surgery on longterm recurrences.

Study objectives Sleeve gastrectomy has been one of the most commonly performed bariatric surgery methods. The study aimed to compare the effects of 2 most commonly used inhalation anesthetics, sevoflurane and desflurane, on the peroperative hemodynamic alterations and postoperative respiratory functions in morbidly obese patients undergoing sleeve gastrectomy. Design Nonrandomized cohort. Settings Operating room, postoperative period. Patients Eighty-four morbidly obese patients with a body mass index greater than 40 kg/m 2 who had scheduled to undergo sleeve gastrectomy operation were prospectively included in the study. Interventions Patients were divided into 2 groups. The maintenance of inhalation anesthesia was performed by sevoflurane in 1 group (sevoflurane group) and desflurane (desflurane group) in the other group. Measurements Demographic features, peroperative hemodynamic alterations, and the results of preoperative and postoperative 24th hour respiratory function tests were recorded. Results There was not any statistically significant difference between groups regarding age, sex, body mass index, anesthesia time, peroperative mean arterial pressure, arterial oxygen saturation, end-tidal carbon dioxide, and preoperative or postoperative forced expiratory volume 1/forced vital capacity ratios. Conclusion We determined that both desflurane and sevoflurane provide similar intraoperative hemodynamic and early postoperative respiratory functions in morbidly obese patients in laparoscopic sleeve gastrectomy. Both agents can be regarded as alternatives for inhalation anesthetics in maintenance of anesthesia.

OBJECTIVE We aimed to show Turkish surgeons' current status of experience and perception about single-incision laparoscopic surgery. MATERIAL AND METHODS The experience and perception of general surgeons, who were members of the Turkish Surgical Association (3.5%, 116/3312), about single-incision laparoscopic surgery were analyzed according to demographic characteristics and a self-report questionnaire with the following four domains: surgeons' perception regarding the performance of single-incision laparoscopic surgery in their clinical practice; their experience of laparoscopic surgery; education, experience, and attitude for single-incision laparoscopic surgery; and the reason for performing/not performing single-incision laparoscopic surgery in their practice. RESULTS There were no significant factors affecting Turkish surgeons' preference of surgical approach. Although, most surgeons performing single-incision laparoscopic surgery were educated (72.2%), the dominant factor driven them to perform this surgery seemed to be personal achievement and satisfaction (57%). Most surgeons who did not perform single-incision laparoscopic surgery were not interested to do so and considered it unnecessary (62.1%). In addition, the need for special equipment and training were dominant barriers (61%). CONCLUSION It seems that Turkish surgeons' perception to perform single-incision laparoscopic surgery was more related to their personal achievement and satisfaction.

The aim of this study was to investigate the effect of platelet-rich plasma (PRP) on the healing of colonic anastomosis in the presence of sepsis.Fifty Wistar-albino male rats were used. Ten healthy rats were euthanized to prepare PRP, the rest were subjected to colonic anastomosis and randomly allocated into four groups of 10 rats each as anastomosis without PRP (C), without PRP in sepsis (SC), anastomosis with PRP (C-PRP), and with PRP in sepsis (S-PRP). Sepsis was induced by cecal ligation and puncture procedure. All animals were euthanized on postoperative day 7. The body weight change, anastomotic bursting pressure (ABP), tissue hydroxyproline (TH) and histopathological examination of each group were analyzed by using one-way analysis of variance (ANOWA) and Tukey's HSD post-hoc test to assess the differences between the groups.There was no statistical difference among the groups in terms of body weight changes. The ABP was measured at a mean value of 179.5 ± 10.3, 129.3 ± 14.2, 209 ± 14.4, and 167.5 ± 7.5 mm-Hg, in group C, SC, C-PRP, and S-PRP, respectively. The ABP and TH of C-PRP group was significantly higher than three groups (p.05, for each comparison). In sepsis, PRP significantly raised the mean ABP and TH levels up to the levels of C group. Tissue regeneration was significant with increased collagen formation in C-PRP group than the other groups (p.05). The healing effect of PRP in the presence of sepsis was significant than S-group (p.05), while similar to C group (p = .181).PRP application to colonic anastomosis promotes the healing process in rats with intra-abdominal sepsis.

As part of the vascular access procedures, venous ports, commonly referred to as catheters, are placed under the skin to enable safe and easy vascular access for administration of repeated drug treatments. 122 patients who had received a venous port catheter insertion procedure in the general surgery department between January 1012 and January 2014 were involved in this study. Patients were divided into two groups: those who had undergone a fluoroscopy (group 1) and those who had not undergone a fluoroscopy (group 2). Complications that emerged during and after the port catheter insertion procedure and successful insertion rates were recorded in the database. Data of these patients were presented in a prospective manner. There were 92 to 30 patients in groups 1 and 2, respectively. In group 1, the mean age was approximately 56.8, total catheter stay time was 20,631 days, and mean time of port use was 224.2 days. In group 2, the mean age was approximately 61.2, total catheter stay time was 13,575 days, and mean time of port use was 452.5 days. Successful insertion rate was 100% and 90% in groups 1 and 2, respectively (P < 0.05). The proper insertion of the port catheter accompanied by monitoring methods can decrease procedure-related complications. Statistical comparisons between the two groups in terms of malposition and successful insertion rates also support this view (P < 0.05). The findings support the view that in cancer patients, a venous port catheter insertion accompanied by a fluoroscopy can be safely performed by general surgeons.

Objective: Today, minimal invasive surgery has gained wide acceptance by general surgeons, even in complex oncological procedures. Despite the increased experience on laparoscopic distal gastrectomy, limited number of surgeons prefer laparoscopic total gastrectomy for proximal or middle-third gastric cancer, due to the concern of technical difficulties which can alter the quality of oncological outcomes. Methods: We retrospectively analyzed gastric cancer patients who underwent curative intent laparoscopic gastrectomy by single surgeon from October 2013 to April 2014. Five total gastrectomy + D2 (-No 10 and 11d) and 1 distal gastrectomy + D2 lymphadenectomy were analyzed for patient demographics, pathological characteristics, morbidity and in-hospital mortality. Results: The mean operating time was 255,8±37.2 minutes. The mean blood loss was 121.6±20.4 ml. In all patients, R0 resection were performed. The mean number of harvested lymph nodes were 22.6±7.3. The median number of metastatic lymph nodes was 16 (0-23). In one patient, less than 15 lymph nodes were retrieved. Complication rate was 33.3% (n=2). In one patient, who underwent laparoscopic distal gastrectomy, afferent loop syndrome developed. In another patient, who underwent total gastrectomy plus splenectomy a massive pulmoner embolism developed. The median hospital stay was 10 (6-18) days. Conclusion: With increased experience in advanced laparoscopic procedures, laparoscopic total gastrectomy may be considered as the first line treatment approach for gastric cancer patient even in a low-volume center. Key words: Gastric cancer, Laparoscopic gastrectomy, distal gastrectomy, total gastrectomy, Amaç: Günümüzde minimal invazif cerrahi genel cerrahlar tarafından kompleks onkolojik prosedürler için bile kullanılır hale gelmiştir. Ancak, laparoskopik distal gastrektomi deneyiminin artmasına rağmen, teknik zorlukların onkolojik sonuçları etkileyebileceği endişesi ile az sayıda cerrah total gastrektomi için laparoskopik yöntemi tercih etmektedir.Yöntemler: Eylül 2013 ile Nisan 2014 arasında tek cerrah tarafından küratif amaçlı laparoskopik gastrektomi uygulanmış mide kanseri hastalarını retrospektif olarak değerlendirdik. 5 total gastrektomi + D2 (-No 10 ve 11d) ve 1 distal gastrektomi + D2 lenfadenektomi hastası, demografik özellikler, patolojik karakteristikler, morbidite ve hastane mortalitesi açısından değerlendirildi. Bulgular: Ortalama ameliyat süresi 255,8±37,2 dakika, ortalama kan kaybı 121.6±20.4 mL idi. Tüm hastalara R0 rezeksiyon uygulandı. Çıkartılan lenf nodu ortalaması 22,6±7,3, metastatik lenf nodu ortancası 16 idi. 1 hastada 15’ten az lenf nodu çıkartıldı. Komplikasyon oranı %33,3 (n=2) idi; laparoskopik distal gastrektomi uygulanan bir hastada aferent loop sendromu gelişti; laparoskopik total gastrektomi ve splenektomi uygulanan diğer bir hastada masif pulmoner emboli gelişti. Ortanca hastanede kalım süresi 10 gündü.Sonuç: Laparoskopik cerrahi prosedürlerin uygulanmasında gelişen deneyim düzeyi ile birlikte, ileri gastrik kanser hastaları için, ileri laparoskopik işlemlerin az sayıda ve düşük yoğunlukta yapıldığı merkezlerde dahi laparoskopik total gastrektomi ilk düşünülecek tedavi seçeneği olabilir

Schwannomas arising from the peripheral nerve sheath is very slow-growing benign tumor. A 34 -years-old male patient was hospitalized with a diagnosis of acute appendicitis, and the digital rectal examination revealed extraluminal mass of rectum. After diagnosis appendectomy and biopsy of the mass was performed. 1 month after, the mass was completely excised by laparotomy. Although extirpation is the optimal surgical treatment of tumors of the presacral region, the surgical approach and type of surgery is controversial.

Patient: Male, 56 Final Diagnosis: Pancreatic GIST Symptoms: Abdominal pain Medication: None Clinical Procedure: Whipple procedure Specialty: Surgery Objective: Rare disease Background: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors in the gastrointestinal system. These types of tumors originate from any part of the tract as well as from the intestine, colon, omentum, mesentery or retroperitoneum. GIST is a rare tumor compared to other types of tumors, accounting for less than 1% of all gastrointestinal tumors. Case Report: A 56-year-old male patient was hospitalized due to an upper gastrointestinal hemorrhage and the start of abdominal pain on the same day. In the upper gastrointestinal endoscopy that was performed, a solitary mass was found in the second section of the duodenum and a blood vessel (Forrest type 2a) was seen. The extent and location of the mass was detected by abdominal tomography. After hemodynamic recovery, a Whipple procedure was performed without any complications. A subsequent histopathological examination detected a c-kit-positive (CD117) pancreatic GIST with high mitotic index. Conclusions: The most effective treatment method for GISTs is surgical resection. In patients with a head of pancreatic GIST, the Whipple procedure can be used more safely and effectively.

Objective Despite the recent increase in the use of laparoscopic appendectomy procedures to treat acute appendicitis, laparoscopic appendectomy is not necessarily the best treatment modality. The aim of this study is to examine the value of laparoscopic intracorporeal knotting and glove endobag in terms of various parameters and in terms of reducing the costs related to laparoscopic appendectomy procedures. Material and methods Seventy-two acute appendicitis patients who underwent laparoscopic appendectomy and open appendectomy surgery were enrolled in the study and were evaluated prospectively. The patients were divided into two groups: group 1 was treated with laparoscopic appendectomy using laparoscopic intracorpreal knotting and glove endobag (n=36) and group 2 was treated with open appendectomy (n=36). The two groups were statistically compared in terms of preoperative symptoms and signs, laboratory and imaging findings, operation time and technique, pain score, gas and stool outputs, duration of hospital stay, return to normal activity, and complications. Results No statistically significant differences were found between the groups in relation to gender, age, body mass index, or pre-operation findings, which included loss of appetite, vomiting, time when pain started, displacement of pain, defense, rebound, imaging methods, and laboratory and pathology examinations (p>0.05). Moreover, there were no differences between the groups with respect to drain usage, hospital stay time, or complications (p>0.05). In contrast, a statistically significant difference was found between the groups in terms of operation time, pain scores, gas-stool outputs, and return to normal activity in the laparoscopic appendectomy group (p=0.001). Conclusion Laparoscopic appendectomy can be performed in a facile, safe, and cost-effective manner with laparoscopic intracorporeal knotting and glove endobag. By using these techniques, the use of expensive instruments can be avoided when performing laparoscopic appendectomy.

INTRODUCTION Pneumatosis sistoides intestinalis (PSI) is a rare condition with unknown origin, defined as the appearance of gas-filled cysts in the intestinal wall. It usually occurs due to respiratory infections, tumor or collagen disease, traumas, immunosuppression. PRESENTATION OF CASE Three patients with PSI were examined that followed up and treated in our clinic. The first patient was hospitalized for emergency treatment of previously diagnosed free-air under the diaphragm. He had a defense on physical examination and free-air was detected in X-ray and abdomen CT. We decided to laparatomy and peroperatively, stenotic pylorus with an abnormally increased stomach and gas-filled cysts were seen in the terminal ileum. Antrectomy and gastrojejunostomy with partial ileum and cecum resection and end ileostomy were performed. The second patient underwent laparatomy because of intraperitoneal free-air and acute abdomen. Partial ileum and cecum resection and ileotransversostomy were performed. The third patient with intraperitoneal free-air was treated with antibiotics, oxygen treatment and bowel rest. DISCUSSION PSI is usually asymptomatic. Plain radiographs, USG, CT, upper gastrointestinal endoscopy, colonoscopy can use for diagnosis. Treatment of PSI depends on the underlying cause; include elemental diet, antibiotics, steroids, hyperbaric oxygen therapy and surgery. CONCLUSION In patients with asymptomatic and symptomatic PSI are different treat. Symptomatic PSI can be safely treated antrectomy and gastrojejunostomy with partial ileum and cecum resection.

Objective: The aim of this study is to compare the results of four different surgical techniques used for pilonidal sinus. Methods: A total of 339 patients who underwent surgery for pilonidal sinus between Januray 2000 and April 2008 were evaluated prospectively. The patients were operated with one of four surgical techniques: excision and primary closure (n=76), excision and marcupialisation (n=112), excision without closure (n=104) and excision and Limberg flap (n=47) techniques. Postoperative complications (hematoma and infection) and recurrences in four groups were compared. Results: 286 male patients and 53 female patients were included in this study. Mean age of patients was 24.2 (14-57) years. The mean follow up time was 41 months. The recurrence rates after excision and primary closure, excision and marcupialization, excision without closure and excision and Limberg flap were 18.4%, 13.4%, 9.6% and %4.3%, respectively. There were not significant differences in postoperative hematoma between four groups. The postoperative infection rate in patients treated with excision without closure was the lowest but time to return to work was highest in this group partients. Patients with infection had higher rates of recurrence than patients without infection. Conclusion: Although optimal surgical technique has not been established according to our study, Limberg flap is preferable technique as compared to other techniques because of quicker healing time and decreased rates of recurrence., Amaç: Bu çalışmanın amacı pilonidal sinüs hastalığında dört farklı cerrahi tekniği karşılaştırmaktır. Yöntemler: Ocak 2000 ile Nisan 2008 arasında pilonidal sinüs nedeniyle opere edilen 339 hasta prospektif olarak değerlendirildi. Hastalara uygulanan cerrahi yöntemler eksizyon ve primer kapatma (76 hasta), eksizyon ve marsupializasyon (112 hasta), eksizyon ve açık bırakma (104 hasta) ve eksizyon ve Limberg flep (47 hasta) idi. Dört cerrahi grupta postoperatif komplikasyonlar (kanama ve enfeksiyon) ve nüks karşılaştırıldı. Bulgular: 286 erkek hasta ve 53 kadın hasta bu çalışmaya dahil edildi. Hastaların yaş ortalaması 24,2 (14-57) yıl olarak bulundu. Ortalama takip süresi 41 ay oldu. Nüks oranları eksizyon ve primer kapatmada %18,4, eksizyon ve marsupializasyonda %13,4, eksizyon ve açık bırakmada %9,6 ve eksizyon ve Limberg flep yönteminde %4,3 olarak bulundu. Gruplar arasında posteperatif hematom açısından anlamlı fark yoktu (p>0,05). Eksizyon ve açık bırakılan grupta cerrahi sonrası enfeksiyon oranları en düşük fakat işe dönme zamanı ise en yüksek olarak tespit edildi. Tüm gruplarda enfeksiyon olan hastalarda olmayanlara göre daha yüksek oranda nüks görüldü. Sonuç: Çalışmamızda optimal cerrahi yöntem ortaya konulamamasına rağmen daha hızlı iyileşme süresi ve daha az oranda nüks göstermesi nedeniyle Limberg flep yöntemi diğer yöntemlerle karşılaştırıldığında tercih edilebilir.

Background Living-donor liver transplantation with inferior vena cava resection and reconstruction is rarely indicated for Budd-Chiari syndrome. The aim of this case presentation was to present and discuss the inferior vena cava reconstruction with the use of cadaveric aortic allograft after resection of the suprahepatic inferior vena cava in a patient with Budd-Chiari syndrome who was treated with living-donor liver transplantation. Case Report A 29-year-old male patient with end-stage liver disease and suprahepatic inferior vena cava obstruction was referred to our center. He was scheduled for living-donor liver transplantation. The suprahepatic inferior vena cava was resected and reconstruction was achieved by means of interposition of the cadaveric aortic allograft between the right atrium and inferior vena cava. Postoperative course was uneventful. Discussion Liver transplantation and vena cava reconstruction is indicated in some patients with end-stage liver disease and Budd-Chiari syndrome. Limitations in cadaveric organ donation may be compensated for with the use of living-donor liver. In this condition, various aspects of inferior vena cava reconstruction may be discussed. Conclusions Budd-Chiari syndrome due to suprahepatic inferior vena cava obstruction close to the right atrium may be treated with vascular reconstruction with the use of a cadaveric aortic allograft.

Intraabdominal hypertension is a common occurrence, especially in intensive care unit patients, and it has high mortality and morbidity rates. The onset is commonly insidious and the poor prognosis is attributed to the long delay in diagnosis. Unfortunately, diagnosis is often delayed until loss of function in the affected tissues has already occurred. The aim of this study was to determine the predictive value of mean platelet volume (MPV) in assessing the risk of intraabdominal hypertension. Materials and methods: Pneumoperitoneum during elective laparoscopic cholecystectomy was used as a model for intraabdominal hypertension. The study included 103 patients who met the inclusion criteria. MPV evaluations were made at 3 distinct times during laparoscopic cholecystectomy based on the actual intraabdominal pressure. Results: MPV values during preinsufflation, insufflation, and desufflation were 8.483 fL (range: 6.7 to 11.1), 8.901 fL (range: 6.8 to 11.9), and 8.538 fL (range: 5.8 to 10.9), respectively. A statistically significant increase in MPV values was found during high intraabdominal pressures (P < 0.001). A significant decrease in MPV values was also detected with desufflation (P < 0.001). Conclusion: Increasing MPV values may reflect increased intraabdominal pressures, which may have a clinical implementation in intraabdominal hypertension.

Ultrasound-guided FNAB of thyroid nodules is considered to be the most reliable and feasible test for the diagnosis of thyroid malignancy. We aimed specifically to assess the accuracy of surgeon-performed ultrasound (SPUG)-guided FNAB on a per-nodule basis, with a subanalysis of nodule size and on-site evaluation. During the study period, 470 thyroid FNABs were performed. In the first 155 biopsies, the attending pathologist determined the adequacy of the specimen based on the number of cells. Nodules were categorised as group A: nodule size 2 cm in width. The FNAB results were classified and described according to the Bethesda system. The overall non-diagnostic rate of ultrasound-guided thyroid FNAB in this study was 10% (47 of 470). The percentage of non-diagnostic cases was 12.06% (38 of 315) in patients without on-site evaluation and 5.8% (9 of 155) in patients with on-site evaluation; this difference did not reach statistical significance (p = 0.051). The nondiagnostic FNAB rates were 10.6% (42 of 395) and 6.6% (5 of 75) with respect to nodule sizes 2 cm. Although nodules smaller than 1.9 cm had higher non-diagnostic FNAB rates, these results were not statistically significant (p = 0.401). In conclusion, this study demonstrates that ultrasound-guided FNAB in the hands of an experienced surgeon can be performed with a low non-diagnostic FNAB rate.

The aim of this study is to evaluate the effect of the Viking 3-dimensional (3D) system on performance time of laparoscopic cholecystectomy.Twenty-two patients were included in the study. The groups were standardized using a multiparameters filter (MPF) depending on preoperative ultrasonography and perioperative exploration findings. The 11 patients operated with the Viking 3D system (group A) were compared with 11 patients operated with the Olympus 2D/HD system (group B).The mean performance time was 20.63 ± 5.66 and 30.0 ± 6.03 minutes in the group A (3D) and group B (2D), respectively (P0.01).The 3D imaging systems may cause a significant reduction in the performance time of laparoscopic cholecystectomy.

Introduction: This study aimed to analyze the initial experience of our center in laparoscopic colorectal resections and compare it with conventional open surgery. Materials and Methods: In this retrospective case-controlled study, prospective data of colo: rectal cancer patients was analyzed retrospectively. Fifteen laparoscopic (3 right, 6 left, and 6 rectum) and fi fteen open (3 right, 6 left, and 6 rectum) colorectal resections were analyzed for patient demographics, pathological characteristics, and early postoperative complications. Results: Mean operating time was longer in the laparoscopic group (227 ± 83.9 vs. 174.6 ± 54.7 : min) (p= 0.077). On the other hand, mean estimated blood loss was lower in the laparoscopic group as compared with the open group (215.3 ± 97 vs. 223.3 ± 56 mL) (p= 0.500). In the laparoscopic group, retrieved total and metastatic lymph node numbers were higher than in the open group (18 ± 8.3 and 14.7 ± 3.3; 1.1 ± 2.1 and 0.8 ± 1.3, respectively) (p= 0.243 and 0.692). Overall early postoperative complication rate was 23.3%. Surgical site infection (SSI) was seen in 6 (20%) patients; four in the open and two in the laparoscopic group. In one patient, after laparoscopic total mesorectal excision (TME) for rectal cancer, anastomotic leakage was seen and managed successfully with conservative methods. Conclusion: Our early results in laparoscopic colorectal surgery was comparable to open approach. Laparoscopic surgery for colorectal cancer is a feasible option, even in the surgeon’s learning period.

The aim of this study is to evaluate pain and further disabling complications in patients undergoing Lichtenstein technique for primary inguinal hernia repair by fixing the mesh with fibrin sealant versus sutures.This study was carried out on 116 patients between January 2009 and July 2009. All patients were male, between the ages of 20 and 75 years. Lichtenstein, using a polypropylene mesh as prosthetic material. A total of 116 hernias were operated on. Group I: 54 operations were done using the conventional repair procedure with polypropylene sutures (prolene 2/0) for mesh fixation. Group II: 62 operations were done using fibrin glue for fixation of the mesh. All patients were operated as day cases, with a maximum hospital stay of 12 hours; none required readmission.No complications were observed in follow-up at 1 week, 1 month, 6 months and 12 months. At 12 months, none of the patients had developed a recurrence. The mean time for complete healing of wound after herniorrhaphy plus fibrin sealant was 8.13±7.88 days (range 6-28 days). This was markedly increased in group 1 patients (mean 12.08±8.59days, and range 8-32) (p0.001).12 months after surgery, The median VAS pain score was significantly lower in group 2 patients (P0·001). The mean (SD) duration of incapacity for work was 5 (2-12) days in group 2(p0.001).This study confirms the effectiveness of fibrin glue in securing prosthetic meshes and reducing chronic inguinal pain.Chronic pain, Fibrin glue, Inguinal hernia repair.Valutazione comparativa del dolore e conseguenze disabilitanti nei pazienti sottoposti alla riparazione con la tecnica di Lichtenstein di un’ernia primitiva con la fissazione della rete con collante di fibrina o con suture. Lo studio è stato condotto tra gennaio e luglio 2009 su 116 pazienti, tutti di sesso maschile, e di età compresa tra 20 e 75 anni, operati col la tecnica secondo Lichtenstein, usando come protesi una rete di pilpropilene.Pazienti sono stati suddivisiin due gruppi: nel I Gruppo sono stati inseriti 54 pazienti operati con la tecnica convenzionale usando suture di polipropilene (Prolene 2/0) per la fissazione della rete. Nel II Gruppo sono stati considerati 62 interventi con fissazione della rte con colla di fibrina. Tutti i pazienti sono stati operati in day-surgery, con un massimo di soggiorno in ospedale di 12 ore, e senza nessuna necessità di nuovo ricovero. Non si è registrata nessuna complicazione nel follow-up a 1 settimana, 1 mese, 6 mesi e 12 mesi. Al docicesimo mese nessn paziente ha presentato recidiva. Il tempo medio per la guarigione completa dell’incisione dell’erniectomia eseguita con colla di fibrina è stato di 8.13±7.88 giorni (da 6 a 28 giorni). Questo tempo è stato significativamente maggiore nel I Gruppo (tempo medio 12.08±8.59 giorni (da 8 a 32 giorni) - p0.001.12 mesi dopo l’intervento il valore medio del punteggio VAS del dolore è stato significativamente inferiore nel II Gruppo di pazienti (p0·001). Il tempo medio di incapacità lavorativa (SD) è stato di 5 giorni (tra 5 e 12) nel II Gruppo (p0.001).Lo studio conferma l’efficacia della colla di fibrina nel fissare le meshes e per la riduzione del dolore inguinale cronico.

PubMedID: 27355746 PURPOSE: To investigate the potential efficacy of beractant (Survanta®) and Seprafilm® on the prevention of postoperative adhesions. METHODS: Forty Wistar-albino female rats were used. The rats were randomly allocated into four groups of 10 rats each as control group (CG), beractant group (BG), Seprafilm® group (SG), and combined group (COG). All rats underwent cecal abrasion via midline laparotomy. Before abdominal closure, isotonic saline, beractant, Seprafilm, and combined agents were intraperitoneally administered. Adhesions were classified macroscopically with Canbaz Scoring System on postoperative day 10. Ceacum was resected for histopathological assessment. RESULTS: Macroscopic adhesion scores were significantly lower in BG, SG, and COG than CG (p

Objective: Obesity remains an increasing public health and socioeconomic problem. Life style changes including healthy diet and physical activity are the first-line therapy for successful weight loss. The intragastric balloon has been considered as an effective and reversible, non-surgical method for weight loss. In this study, we aimed to investigate the effects of Intragastric balloon on weight loss, lipid profiles and blood glucose regulation in obese patientsMethods: 75 consecutive Intragastric balloon patients (55 Female, 20 Male) with a mean age of 35.2±9.6 years were included in this study. The study was conducted prospectively and an air-filled intragastric balloon was introduced in ambulatory settings. In this study, patients’ pre-intervention body mass index, peripheral blood parameters such as HbA1c, lipid profiles were recorded and compared with post-intervention values.Results: The median intervention time for intragastric balloon application was 13 min (8-19). After follow-up period of median 186 days (180-211), BMI was reduced significantly, 41.6±6.7 vs. 34.9±6.4 kg/m2 (p0.05). On the other hand, only pre and post-intervention HbA1c level was to be statistically significant (p=0.001)Conclusion: There was significant change in BMI and HbA1c level with the intervention of intragastric balloon after follow-up period. For long-term benefit of balloon, further studies are needed.Key words: Body mass index, HbA1c, Intragastric balloon, obesity, Amaç: Obezite giderek artan bir halk sağlığı ve sosyoekonomik sorun olmaya devam etmektedir. Sağlıklı beslenme ve fiziksel aktivite de dâhil olmak üzere yaşam tarzı değişiklikleri başarılı kilo kaybı için ilk basamak tedavi şekli olarak kabul görülmektedir. Gastrik balon kilo kaybı için etkili, geri dönüşümlü ve cerrahi olmayan bir yöntemdir. Çalışmanın amacı, obez hastalarda intragastrik balonun kilo kaybı, lipit profili ve kan şekeri düzenlenmesine etkilerini araştırmaktır. Yöntemler: Bu çalışmada hastaların 35,2 ± 9,6 yaş ortalaması ile 75 ardışık mide balonu hastası (55 Bayan, 20 Erkek) çalışmaya dâhil edildi. Çalışma prospektif olarak planlandı ve hava-dolu mide balonu kontrolleri ayaktan poliklinikte yapıldı. Bu çalışmada, hastaların uygulama öncesi vücut kitle indeksi, HbA1c ve lipid profilleri gibi periferik kan parametreleri, kaydedilerek müdahale sonrası değerleri ile karşılaştırıldı.Bulgular: Mide balonu uygulaması için medyan müdahale süresi 13 dakika idi. Medyan 186 gün izlem süresinden sonra, BMI, önemli ölçüde 41,6 ± 6,7 ‘den 34,9 ± 6,4‘e azalma tespit edildi (p

Objective We aimed to investigate the technical feasibility of single-incision laparoscopic cholecystectomy (SILC) with our new facilitative maneuver and to compare it with the gold standard four-port laparoscopic cholecystectomy (LC). Material and methods Operation time, cosmetic score and incisional hernia rates between LC (n=20) and SILC-1 (first 20 consecutive operations with the new technique) and 2 (subsequent 20 operations with the new technique) were compared. Results The median operation time for LC, SILC-1 and SILC-2 were; 35 min (12-75), 47.5 min (30-70), and 30 min (12-80), respectively (p=0.005). The operation duration was similar in LC and SILC-2 (p=0.277) groups. Wound seroma rate was higher in SILC-1 (45%) and SILC-2 (30%) groups than LC (5%) group (p=0.010). Cosmetic score was similar between all the groups. Hernia rates were 15.8% and 5.3% in the SILC-1 and SILC-2 groups, respectively, while there was no hernia in the LC group. Conclusion SILC with new facilitating maneuver is comparable with classical four-port laparoscopic cholecystectomy in terms of ease, operation time, reproducibility and safety. Besides these advantages, the single-incision access technique must be optimized to provide comparable wound complication and postoperative hernia rates before being recommended to patients.

Aim: The aim of this study is to compare the postoperative morbidity and mortality of patients with gastric cancer who had D1 and D2 lymph node dissection (LND). Material and Method: This study was carried out on total 137 patients retrospectively who were operated by for gastric carcinoma between 1995 and 2006. 111 patients who were operated with curative intent were included in the study. The two groups on whom D1 and D2 LND was applied were compared from the number of patients, sex, age, stage of disease and ASA grade. The two groups were analyzed in respect of surgical methods, the use of staplers, operative time, additional organ resections, hospital stay, postoperative complications and the need for re-operation, and operative mortality. Results: It was seen that D1 LND was applied to 50 of the 111 patients; D2 LND was applied to 61 of them. 23 of the patients were female and 88 were male. It was seen that the ratio of Female/Male as 1/4. The mean age of the D1 LND group was 59, and the D2 LND group was 58,7. There was no statistically significant difference between the groups with regard to age, gender, stage of disease, tumor location, tumor type, the average length of hospital stay and ASA grade (p>0.05). A statistical difference in operative time was seen between the two groups (p

RESULTS: There was not any signifi cant difference between groups in terms of the duration of the surgery and the hospital stay, and postoperative morbidity and mortality rates (p>0.05). Bowel resection was performed mostly in women and elderly patients. In addition, patients having bowel resection had longer hospital stay times. The risk of having a complication and a recurrent hernia was higher in these patients.

Background Congenital bands cause 3 % of all intestinal obstruction and almost always lead to small bowel obstruction. In adults, obstruction due to bands is even rarer. Materials and methods A multicenter study in Turkey. From January 2000 to December 2010 inclusive - a period of 10 years - all adult patients admitted to the emergency departments with a clinical diagnosis of acute intestinal obstruction due to congenital peritoneal band were included in the study. Surgery was defined as emergency. Recorded operative findings included the site of obstruction, and the operative procedure to relieve it. In the present study, the findings in adult patients with congenital band reported in the literature together with findings in ten cases operated at four center were retrospectively assessed with respect to their demographic, preoperative, peroperative, and postoperative characteristics. Results There were 8 males and 2 females aged between 18 and 72 year. There were no history of abdominal or inguinal surgery. Plain abdominal X-rays radiography revealed air- fluid levels in all patients. All the bands were ligated and divided. On histopathological examination, the bands were composed of loose connective tissue containing blood vessels. There were no calcification in the bands. Conclusion an anomalous congenital band could be included in the differential diagnosis of intestinal obstruction. This clinical situation requires early surgical intervention that will be diagnostic and therapeutic (Tab. 1, Fig. 4, Ref. 21).

The effect of cholecystectomy on quality of life in patients with gallbladder polyps Objective: To investigate the effect of cholecystectomy procedure on quality of life and the factors associated with patient satisfaction in patients with gallbladder polyps. Material and Methods: Between January 2000 and December 2005, 59 patients diagnosed gallbladder polyps preoperatively and postoperatively, were completed the questionary using Gastrointestinal Quality of Life Index and global patient satisfaction parameters and the datas were analyzed. Results: Our study showed that cholecystectomy procedure for gallbladder polyp statistically increased patient satisfaction and gastrointestinal quality of life scores. Having symptoms, cholesterol polyp as the histological type and laparoscopic surgery were observed as independent influencing factors to the scores. Conclusion: If nonspecific complaints cannot be explained by other reasons in nonspecific patients with high scores, proposing cholecystectomy to this group of patients have been noted. More randomized prospective studies are needed to demonstrate the etiology of healing process of nonspecific complaints.

yildirim, kadir/0000-0001-7208-2170 WOS: 000392193500008 PubMed: 28149123 Objective: Inappropriate or insufficient knowledge of health care professionals about puerperal mastitis can lead mothers to premature weaning, as well as the lack of education on proper breastfeeding. However, the importance of education regarding puerperal mastitis seems to be underestimated. Material and Methods: From July to August 2014, 317 female health care professionals were surveyed in Samsun, Turkey. Participants were classified into three groups; nurses, maternity care nurses (obstetrics and gynecology nurses and pediatrics clinic nurses), and midwives. A specifically prepared questionnaire was used to collect data. Results: 69.1% (n=219) of female health care professionals had one or more child/ren. The median length of breastfeeding duration was 11 months (0-36) while the overall puerperal mastitis rate was 13.3% (n=29). Puerperal mastitis related cessation of breastfeeding was similar between the groups, with an overall rate of 3.1%. 61.1% of the participants stated that they had one or more hours of education regarding puerperal mastitis while 5.4% indicated that they learned about the pathology from their experiences. Midwives and maternity care nurses were found to be more knowledgeable than nurses regarding the reasons, risk factors, prevention, symptoms, and treatment of puerperal mastitis. Conclusion: As a result, the current level of education regarding breastfeeding and puerperal mastitis and daily practice in female health care professionals in Turkey is far from desired levels. The breastfeeding education of health care professionals must be adapted to an effective program, such as UNICEF/WHO 20-hour breastfeeding training course, and puerperal mastitis should be accepted as a public health care issue.

Background and study aims Infliximab (IFX) is a chimeric anti-TNF-α body which is effectively used in the treatment of inflammatory bowel diseases and a variety of autoimmune diseases. The effect of IFX on the healing of intestinal anastomosis has been evaluated in several studies, however with conflicting results. Furthermore, the effect of IFX on colonic anastomosis in sepsis has not been evaluated to date. In this study, we aimed to investigate whether IFX has an adverse effect on the healing process of colonic anastomosis either under normal or septic condition. Material and method The efficiency of IFX was assessed with respect to anastomotic bursting pressure (ABP), tissue hydroxyproline levels (THL) and histopathological examination of left colonic anastomosis in 40 male rats. The rats were randomly allocated into four groups of 10 rats each as control (C), septic control (SC), control IFX (C-IFX) and septic IFX (S-IFX). Results The anastomotic bursting pressure was measured at 182 ± 19.1, 158 ± 15.4, 161 ± 26.8 and 100 ± 10.3 mm/Hg, in C, SC, C-IFX and S-IFX; respectively. IFX administration did not influence the anastomotic strength under normal condition whereas in sepsis significantly induced the reduction of APB. The mean THL was almost similar in both control groups ( p = 0.87), whilst IFX reduced the level of TH in sepsis comparing with control groups ( p = 0.01). IFX significantly impaired immune response in sepsis resulting in poor anastomotic healing in S-IFX group. Conclusion Our study demonstrated that IFX had no detrimental effect on the healing of colonic anastomosis under normal condition whilst significantly impaired the healing process in sepsis.

Schwannomas arising from the peripheral nerve sheath is very slow-growing benign tumor. A 34 -years-old male patient was hospitalized with a diagnosis of acute appendicitis, and the digital rectal examination revealed extraluminal mass of rectum. After diagnosis appendectomy and biopsy of the mass was performed. 1 month after, the mass was completely excised by laparotomy. Although extirpation is the optimal surgical treatment of tumors of the presacral region, the surgical approach and type of surgery is controversial, Schwannoma, periferik sinir kılıfından kaynaklanan, oldukça yavaş büyüyen benign tümördür. Akut apandisit teşhisiyle servise yatırılan 34 yaşındaki erkek hastanın dijital rektal muayenesinde rektum posterior kısmında ekstraluminal kitle tespit edildi İlk operasyonda appendektomi ve kitleden biopsi yapıldı. 1 ay sonra tekrar laparotomi yapılarak kitle tamamen çıkarıldı. Presakral bölge tümörlerinde optimal tedavi cerrahi ekstirpasyon olmakla birlikte, yaklaşım ve operasyon şekli konusu tartışmalıdır. Anahtar kelimeler: Presakral kitle, schwannoma, cerrahi ekstirpasyon

aktimur, sude hatun/0000-0002-7468-1721; aktimur, recep/0000-0001-8781-9075; yildirim, kadir/0000-0001-7208-2170; Cetinkunar, Suleyman/0000-0001-9111-2734 WOS: 000380703500014 PubMed: 26059561 Purpose Due to the diagnostic challenges and dreadful consequences of delayed treatment of acute mesenteric ischemia (AMI), a variety of diagnostic markers have been previously studied. However, the diagnostic value of neutrophil-to-lymphocyte ratio (NLR), which has been suggested to be a predictor of inflammation, has never been studied for AMI. Methods The data of 70 patients who underwent laparotomy (n = 8) and/or bowel resection (n = 62) for AMI (n = 70) between January 2009 and March 2014 were retrospectively analyzed. To investigate the studied parameters' role in the differential diagnosis of AMI, control groups were selected from most common reasons of inflammation-related emergent surgery, acute appendicitis (AA, n = 62) and normal appendix (NA, n = 61). White blood cell (WBC), red cell distribution width (RDW), NLR and mean platelet volume (MPV) values were recorded. Outcome variables of the study were defined as diagnostic and prognostic role of NLR in AMI. Results RDW and NLR values were found to be higher in the AMI group than the AA group (p < 0.001 and p < 0.001). Also, WBC and MPV values were higher in the AMI group than the NA group (p = 0.001 and p < 0.001). Combined sensitivity, specificity, positive predictive value and negative predictive value of RDW and NLR for recommended cutoff values were 69.4, 71.2, 57.8 and 80.4 %, respectively. Conclusion High NLR value (>9.9) seems to be a valuable diagnostic marker of acute mesenteric ischemia. Combined use of NLR, RDW and other clinical assessment, could help the diagnosis of AMI, especially in the absence of advanced imaging modalities and expert radiologic interpretation.

WOS: 000370846700005, PubMed ID: 26668527, Objective: Bariatric surgery with multidisciplinary management is a more effective method to treat morbid obesity and obesity-related comorbidities compared with nonsurgical treatments. Laparoscopic sleeve gastrectomy (LSG) was initially performed as the first stage of biliopancreatic diversion with duodenal switch in the super-obese population. In the past few years, however, LSG has been performed as a definitive procedure because of its promising early and midterm results. The aim of this study is to evaluate the efficacy of our initial LSG series of 73 patients on excess weight loss (EWL) and resolution of obesity-related comorbidities in short-term follow-up. Material and Methods: From March 2013 to May 2014, 78 morbid obese patients with an average body mass index (BMI) of 46.3 kg/m(2) underwent LSG. There is a 9-month follow-up period on average. Five patients were excluded from the study, because they could not be contacted. Comorbidities, preintervention BMI, glucose, HbA1c, and lipid profiles were recorded at 1, 6, and 12 months postintervention. Results: After the surgery, the percent EWL was 58%. The mean serum glucose level, HbA1c level, LDL-cholesterol level, triglyceride level, insulin, and insulin resistance decreased significantly and the mean HDL-cholesterol level increased. Conclusion: For the resolution of comorbidities, LSG may be used as an effective bariatric and metabolic surgery.

Ischemia/reperfusion (IR) injury of the intestine is a major problem in abdominal pathological condition and is associated with a high morbidity and mortality. The purpose of the study is to investigate the effects of curcumin on the bacterial translocation incidence and inflammatory response in rats submitted to bowel ischemia reperfusion injury. Thirty-two Wistar albino rats with a weight of 200 to 250 g were used in the study. They were randomly divided into 3 groups (n = 10 for each group): sham only operated group(group I); IR group (group II); and IR + curcumin treatment group (group III). Curcumin (curcumin from Curcuma longa) 20 mg/kg/day was given orally to the curcumin group. All animals were given 109 E. Coli by orogastric intubation 12 hours before sampling. Seventy-two hours after the first operation, mesenteric lymph node and blood samples were obtained and cultured. Blood samples of 2 mL were obtained for a polymerase chain reaction study. A piece of terminal ileum was also sampled for histopathologic examination. Mesenteric lymph node and blood cultures of all control animals were positive for microbiological growth, and polymerase chain reaction results were positive in seven of the eight rats. Histopathologically, edema, vasodilatation and inflammatory cell infiltration were found to be less in the other groups in comparison to the control group. Curcumin reduced bacterial translocation in blood, hepatocellular damage, and plasma cytokine levels. Curcumin reduced the incidence of bacterial translocation in intestinal I/R. rats. These results suggest that Curcumin would be clinically useful in the treatment of intestinal I/R injury.

Objective The rate of adrenal incidentalomas detected in routine diagnostic imaging techniques is approximately 4-7%. Although the lesions are generally benign, carcinoma and functional adenomas can be diagnosed with careful clinic and laboratory evaluation. Material and methods Data of 13 patients who underwent surgery for an adrenal mass between January 2010-June 2014 were analyzed retrospectively. Results Seven (54%) patients were male, 6 (46%) were female, and the mean age was 38.2. The clinical diagnosis was pheochromacytoma in 5 patients (38.4%), non-functional adenoma in 5 (38.4), and metastatic lesion, Cushing syndrome, and adrenal carcinoma each in one patient (7.6%). Conventional open adrenalectomy was performed in 8 patients, while 5 patients underwent laparoscopic adrenalectomy. Conclusion Adrenal incidentalomas should be carefully evaluated for hormonal activity even if asymptomatic, and non-functional lesions should be considered as suspicious-for-malignancy. Laparoscopic adrenalectomy has become the gold standard for patients with a mass less than 6 cm, and without infiltration to adjacent organs.

The aim of this study is to investigate the efficacy of tadalafil against pentoxifylline in rat model of ischemic colitis (IC).Thirty-two Wistar albino rats were subjected to laparotomy and left colon devascularization to create an IC model and then randomly placed into four groups. Group-1 (sham group) was administered 0.9% NaCl following laparotomy, group 2 (control group) was administered 0.9% NaCl following induced IC, group 3 was given pentoxifylline (n = 8), and group 4 was given tadalafil. On the third day; macroscopic findings, Gomella's ischemic area and Wallace scoring, histopathological analysis, and Chiu scoring were performed, and malondialdehyde (MDA) measurement in ischemic colon tissue was carried out through chemical analysis.Significant differences were observed in acidic fluid, bowel dilatation, and serosal change (p.05). The ischemic area measured 63.3 mm(2) in the control group, 2.8 mm(2) in the pentoxifylline group (p = .0001), and 2.4 mm(2) (p = .0001) in the tadalafil group. A significant difference was seen between the sham group and the control and pentoxifylline groups (p.01), in terms of Wallace score and Chiu classification. Similarly, a significant difference was determined between the control group and pentoxifylline and tadalafil groups (p.01), but no significant difference was established between the pentoxifylline group and tadalafil group (p = .33). MDA measurement was found on an average to be 63.7 in the control group, 22.7 in group 3 and 22.8 in group 4 (p = 001).Although tadalafil is superior to pentoxifylline, both drugs are considered to have positive effects.

We studied the prevalence of polymorphisms in genes XRCC2 and XRCC3 in stomach cancer patients who lived in North Eastern Turkey. A total of 61 cancer patients and 78 controls were included in this study. Single nucleotide changes were studied in XRCC2 and XRCC3 genes at locus Arg188His and Thr241Met. Blood samples were taken from the patients and controls, and DNA was isolated. The regions of interest were amplified using a polymerase chain reaction method. After amplification, we used restriction enzymes (HphI and NcoI) to digest the amplified product. The digested product was then run through gel electrophoresis. We identified changes in the nucleotides in these specific regions. It was found that the Arg188His polymorphism of the XRCC2 gene was about 39% (24 out of the 61) among cancer patients. However, only 15% (12 out of 78) of the control group indicated this polymorphism. We also observed that 18 of the 61 cancer patients (29%) carried the Thr241Met polymorphism of the XRCC3 gene whereas 11 of the 78 (14%) individuals in the control group had the polymorphism. Our results showed a significant difference in polymorphism ratios between the cancer patients and healthy control group for the regions of interest. This result clearly showed that these polymorphisms increase the risk of stomach cancer and might be a strong marker for early diagnosis of gastric cancer.

BACKGROUND: This study aimed to evaluate the diagnostic value of gray-scale and power Doppler sonography for acute cholecystitis and show a correlation between sonographic and intraoperative findings, quantitively. METHODS: Forty chronic and forty acute cholecystitis patients were examined. Early laparoscopic cholecystectomy was performed for acute cholecystitis. Demographic characteristics, sonographic findings, and adhesion scores were analyzed. Data were collected prospectively (clinicaltrials.gov: NCT02156947). RESULTS: Wall thickness (≥3 mm) and vascularity increased in acute cholecystitis (p

research Amaç: Bu çalışmanın amacı pilonidal sinüs hastalığında dört farklı cerrahi tekniği karşılaştırmaktır. Yöntemler: Ocak 2000 ile Nisan 2008 arasında pilonidal sinüs nedeniyle opere edilen 339 hasta prospektif olarak değerlendirildi. Hastalara uygulanan cerrahi yöntemler eksizyon ve primer kapatma (76 hasta), eksizyon ve marsupializasyon (112 hasta), eksizyon ve açık bırakma (104 hasta) ve eksizyon ve Limberg flep (47 hasta) idi. Dört cerrahi grupta postoperatif komplikasyonlar (kanama ve enfeksiyon) ve nüks karşılaştırıldı. Bulgular: 286 erkek hasta ve 53 kadın hasta bu çalışmaya dahil edildi. Hastaların yaş ortalaması 24,2 (14-57) yıl olarak bulundu. Ortalama takip süresi 41 ay oldu. Nüks oranları eksizyon ve primer kapatmada %18,4, eksizyon ve marsupializasyonda %13,4, eksizyon ve açık bırakmada %9,6 ve eksizyon ve Limberg flep yönteminde %4,3 olarak bulundu. Gruplar arasında posteperatif hematom açısından anlamlı fark yoktu (p>0,05). Eksizyon ve açık bırakılan grupta cerrahi sonrası enfeksiyon oranları en düşük fakat işe dönme zamanı ise en yüksek olarak tespit edildi. Tüm gruplarda enfeksiyon olan hastalarda olmayanlara göre daha yüksek oranda nüks görüldü. Sonuç: Çalışmamızda optimal cerrahi yöntem ortaya konulamamasına rağmen daha hızlı iyileşme süresi ve daha az oranda nüks göstermesi nedeniyle Limberg flep yöntemi diğer yöntemlerle karşılaştırıldığında tercih edilebilir. Objective: The aim of this study is to compare the results of four different surgical techniques used for pilonidal sinus. Methods: A total of 339 patients who underwent surgery for pilonidal sinus between Januray 2000 and April 2008 were evaluated prospectively. The patients were operated with one of four surgical techniques: excision and primary closure (n=76), excision and marcupialisation (n=112), excision without closure (n=104) and excision and Limberg flap (n=47) techniques. Postoperative complications (hematoma and infection) and recurrences in four groups were compared. Results: 286 male patients and 53 female patients were included in this study. Mean age of patients was 24.2 (14- 57) years. The mean follow up time was 41 months. The recurrence rates after excision and primary closure, excision and marcupialization, excision without closure and excision and Limberg flap were 18.4%, 13.4%, 9.6% and %4.3%, respectively. There were not significant differences in postoperative hematoma between four groups. The postoperative infection rate in patients treated with excision without closure was the lowest but time to return to work was highest in this group partients. Patients with infection had higher rates of recurrence than patients without infection. Conclusion: Although optimal surgical technique has not been established according to our study, Limberg flap is preferable technique as compared to other techniques because of quicker healing time and decreased rates of recurrence.