Incidental gallbladder cancer: a retrospective clinical study of 40 cases.

Purpose: Cholecystectomy is one of the most common surgeries today due to gallbladder diseases. The most prevalent malignancy of the biliary tract is gallbladder cancer. We aimed to discuss the results of our patients who underwent cholecystectomy for benign reasons in our clinic and who had gallbladder cancer due to pathology. Methods: The results of cholecystectomy performed in General Surgery Clinic of Seyhan Government Hospital were evaluated. Cases diagnosed as gallbladder as a result of histopathological examination were included. Preoperative ultrasonography, laboratory findings, and postoperative pathology results of the patients were reviewed retrospectively. The pathologist repeated histopathological evaluations. Results: Between 2010 and 2019, incidental gallbladder cancer (IGBC) was detected in 40 patients (0.3%) in 11,680 cholecystectomy operations. Of the patients diagnosed with IGBC, 14 (35.0%) were T1a, 11 (27.5%) were T1b, 11 (27.5%) were T2, and 4 (10.0%) were T3. T4 tumor was not seen in any patient. Three patients who were T1b at initial evaluation were identified as T2 at evaluation for the study. The pathology results of 37 patients (92.5%) were adenocarcinoma, 2 (5.0%) were adenosquamous type, and 1 (0.5%) was squamous cell carcinoma. Conclusion: There has been a remarkable increase in the number of IGBCs over the past 20 years. Appropriate staging and histopathological evaluation are essential in guiding the surgeon's operation. It is crucial to accurately determine the T stage, the most influential parameter on patient survival and residual recurrences. The distinction between pathologic (p) T1a and pT1b should be made carefully. Surgery is the only potentially curative method.

Effect of platelet-rich plasma on healing in laser pilonidoplasty for pilonidal sinus disease.

The aim of this study was to evaluate the effects of application of platelet-rich plasma in addition to laser pilonidoplasty for the treatment of pilonidal sinus. Twenty-five patients who were treated by laser pilonidoplasty for pilonidal sinus (group 1) and 25 patients who were treated by platelet-rich plasma in addition to laser pilonidoplasty (group 2) at this clinic were included in the study. Patients were classified according to the Irkorucu and Adana Numune's classification and treatment concept. Duration of stay of the patients in the hospital, time to start daily activities, duration of wound healing, recurrence, and complications were evaluated. Among the 50 patients included in the study, 41 (%82) were males and 9 (%18) were females. The mean age was 25.6 ± 2.4 years and 24.8 ± 3.8 years in groups 1 and 2, respectively. The locations of the pilonidal sinus were similar in the two groups. No statistically significant differences were found in the duration of hospital stay, duration of the procedure, time to return to work, and complication rates between the two groups. Nevertheless, duration of wound healing was 6.1 ± 2.3 and 4.1 ± 0.9 weeks in groups 1 and 2, respectively, and was shorter in group 2. Duration of wound healing was statistically significantly different in the two groups. We concluded in this study that application of platelet-rich plasma in addition to laser pilonidoplasty significantly shortens the time of wound healing.

Surgical and histopathologic outcomes of gastrointestinal stromal tumors.

BACKGROUND: Gastrointestinal stromal tumors are encountered more frequent as a result of increased imaging examinations. The purpose of the study is to define the patient profile, histopathologic and treatment outcomes of cases that underwent surgical treatment for neoplasms of the gastrointestinal tract and diagnosed as gastrointestinal stromal tumor. METHODS: The outcomes of 32 patients operated in our department of general surgery for tumors of the gastrointestinal tract and diagnosed as gastrointestinal stromal tumor between January 2014 and December 2019 are evaluated retrospectively from the medical records and hospital treatment registry. RESULTS: Within the study period a total of 32 patients were operated and diagnosed gastrointestinal stromal tumor. There were 19 male (59.4%) and 13 female (40.6) patients and the average age of the patients was 60.2 11.8 years. The average tumor size was 5.95 3.3 centimeters. The tumor localization was mainly the stomach (n=17) and the small bowel (n=11). Distant metastasis was detected in 6 (18.75%) patients, four of them in the liver and two in the peritoneum and omentum. In half of the cases (n=16) there were reactive lymph nodes and 5 (83.3%) of the metastatic patients were within them. CONCLUSION: Gastrointestinal stromal tumors are more frequently encountered by the surgeons with the help of imaging techniques. The primary treatment is surgery and the results are promising. Patients with reactive lymph nodes should be examined for metastasis. Chemotherapy with imatinib can be used for inoperable patients. Patients should be followed up with computed tomography. KEY WORDS: Gastrointestinal System, Histopathology' Stromal Tumor, Surgery.

Gender differences in trauma mechanisms, and outcomes in a rural hospital which is not designed as trauma centre.

OBJECTIVES: This study aimed to investigate how trauma characteristics and outcomes differ between genders in a rural hospital. METHODS: Records of trauma patients admitted to a state emergency department (ED) in eastern Turkey, between January 2006 and December 2007 were reviewed and data were analysed based on gender. RESULTS: In total, 5379 (87.0%) men and 806 (13.0%) women, totalling 6185 patients, were assessed. Mean age was 26.5 (1 month - 80 years) years for men and 24.7 (2 month - 81 years) years for women. Men comprised 90.2%, 81.3% and 77.3% of the patients injured by assault, motor vehicle incidents and falls, respectively. Women comprised a significantly larger share of suicide attempts (70.8%) than men. Of the men injured, 90.6% were discharged after treatment in the ED. The per cent of hospitalised women (5.8%) was increased compared with the per cent of hospitalised men (p=0.011). There was a higher frequency of transfer among women (8.6%) when compared with men (p<0.001). Women had a mortality frequency of 1.2%, which was similar to the mortality per cent calculated for men. CONCLUSIONS: Men were at an increased risk for trauma, especially assault. The percentage of women injured and admitted to the ED due to assault was low compared with statistics reported in the literature. However, assault is the most common cause of trauma among women. The high per cent of hospitalisation and transfer among women may indicate that women are exposed to more severe trauma, and therefore experience increased morbidity compared with men.

Analysis of trauma patients in a rural hospital in Turkey.

BACKGROUND: There is a grey zone about the epidemiology of trauma in eastern Turkey. The present study was aimed at obtaining data on this subject. METHODS: Trauma patients who applied to the emergency department (ED) between January 2006 and December 2007 were analyzed. RESULTS: There were 6183 patients, of whom 87% were male. The mean age was 26.2 ± 13.6 years. Assault was the most common cause (63.2%). Motor vehicle injury (MVI) and fall were encountered at frequencies of 21.2% and 6.5%, respectively. The most frequently injured body regions were head-neck and extremities. The majority of patients were managed and discharged from the ED (89.8%) with no consultation (81.8%). Interestingly, the discharge rate of assault cases was 98.7%. Patients were hospitalized (4.2%) mostly for MVI (32.6%) and fall (19%); however, hospitalization rates for firearm and piercing/cutting injury (36.1% and 16.7%) were significantly high. Among the transported patients (5.3%), the rates of MVI and fall were high (41.5% and 24.3%, respectively). In groups, for burn and firearm injuries, these were 42.1% and 24.1%, respectively. Forty-eight patients (0.8%) died, mostly from MVI by number, but by self-infliction and firearm by rate (8.3% and 6%). CONCLUSION: Assault cases caused an excessive trauma patient density in the ED, as 98.7% were discharged from the ED. Further studies are needed regarding the high rate of assault cases.