Diagnostic value of fine needle aspiration biopsy in non-thyroidal head and neck lesions: a retrospective study of 866 aspiration materials.

AIM: We aimed to investigate the diagnostic value of fine needle aspiration biopsy (FNAB) and compared our FNAB results of non-thyroidal head and neck lesions with excisional biopsy results. MATERIALS AND METHODS: A total of 866 aspiration material taken from different parts of head and neck region out of thyroid were evaluated at Haydarpasa Numune Training and Research Hospital Pathology Laboratory, between January 2002 and May 2013 and 248 of which has histopathologic response were included in the study. Patients depending on origin of the masses were divided into three categories as; salivary gland, lymph nodes and soft tissue/cystic lesions. The sensitivity, specificity, diagnostic accuracy values of fine needle aspiration biopsies have been investigated for all the series and individually for each category. FINDINGS: Diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive values of non-thyroidal head and neck masses were respectively; For all of the series; 94.6%, 97.9%, 96.7%, 95.9%, 97.2%, Salivary gland: 88.9%, 100%, 98.8%, 100%, 98.7%, Lymph nodes: 94.7%, 89.3%, 92.9%, 94.7%, 89.2%, Soft tissue/cystic lesions: 100%, 100%, 100%, 100%, 100%. For all of the series; there were 4 false negative (FN) cases; and 3 false positive (FP) cases. CONCLUSION: FNAB in the diagnosis of head and neck masses; it is an easy, cheap and usefull procedure.

Comparison of barbed and conventional sutures in adhesion formation and histological features in a rat myomectomy model: randomized single blind controlled trial.

OBJECTIVE: To compare the adhesion and histologic scoring of barbed and standard suture material after incision and serosal closure of both uterine horns for myomectomy model in rats. STUDY DESIGN: In this single blind randomized controlled trial, one cm incisions were performed on the right and left uterine horns of ten non-pregnant rats, and these incisions were randomly allocated for closure by a suture material with either polyglyconate (V-Loc™) or polyglactin-910 (Vicryl(®)). Each rat served as its own control. Six weeks after the operation, the abdomen was re-opened and the abdominal and surgical sites were evaluated by a researcher blinded to the side of the suture materials in the first operation. Adhesions were scored according to their severity, and specimens were also evaluated and scored histologically according to the following features: collagen deposition and inflammatory reaction. RESULTS: The median macroscopic adhesion scores in the barbed and standard suture group were 3.5 and 2, respectively (p=.008). There was significant difference between the barbed and standard suture group with regard to the median inflammatory cell scores for macrophages-foreign body giant cell (1 vs. 3, respectively, p=.01) and mononuclear cell (2 vs. 3, respectively, p=.04). CONCLUSION: Based on the results of the present study, we suggest that in the rat model, the type of the suture used for myometrial closure has an effect on subsequent adhesion formation, and this adverse outcome was more frequently observed with the barbed suture.

Peritoneal closure over barbed suture to prevent adhesions: a randomized controlled trial in an animal model.

STUDY OBJECTIVE: To compare adhesion formation and histological features of peritoneal closure and nonclosure over an intra-abdominally placed barbed suture. DESIGN: Single-blind randomized controlled trial (Canadian Task Force Classification I). SETTING: Certified animal research facility. SUBJECTS: Eight nonpregnant rats. INTERVENTIONS: Abdominal cavities were entered via midline incision. Left and right parietal peritoneal surfaces were incised 1.5 cm long separately and stitched with unidirectional barbed suture material (3/0 V-Loc). The parietal peritoneum was approximated over the barbed suture using polypropylene suture material (7/0 Prolene) to embed the barbed suture (peritonization) on one side, and left open on the other side. The side of the barbed suture to be peritonized was allocated at random. On the postoperative day 32, all rats were sacrificed, adhesion formations on each side were macroscopically scored, and histological features were evaluated microscopically. MEASUREMENT AND MAIN RESULTS: The median adhesion score was 2.00 (range, 1-4) on operative fields. There was no statistically significant difference in median adhesion score between the peritonized and nonperitonized sides (1.5 vs 2, respectively; p = .13). Microscopically, there were no statistically significant differences in median acute and chronic inflammation scores between the peritonized and nonperitonized sides (p = .58 and p = .45, respectively), but a significantly higher median fibrosis score on the peritonized side (3 vs 1.5, respectively; p = .02). CONCLUSION: Based on the results of the present study in a rat model, barbed suture material might be associated with adhesion formation when used intra-abdominally, and these adhesions could not be prevented by peritonization.