ABSTRACT
Background Pilonidal sinus disease (PSD) is a chronic inflammation and infection of the sacrococcygeal region. It often affects young adult males and produces clinical findings with abscess and discharge in the sacrococcygeal region or painful sinus tract in the natal cleft. The best surgical technique for sacrococcygeal PSD is still disputed. This study aimed to compare the Karydakis flap technique (KFT) and Limberg flap technique (LFT) used in the surgical treatment of the sacrococcygeal pilonidal sinus. Methodology A total of 140 patients diagnosed with pilonidal sinus between 2010 and 2012 were included in the study. The patients were divided into two groups, namely, LFT (n = 73) and KFT (n = 67). Preoperative findings of the patients, surgical findings, and short and long-term postoperative findings were recorded and statistically compared. Results Regarding cosmetic results, the Karydakis flap was better than the Limberg flap with a faster return to normal life. There was no statistical difference between the two groups concerning wound dehiscence, postoperative visual analog scale scores, seroma formation, and recurrence. Conclusions Considering the faster return to normal life and greater cosmetic satisfaction of the patients, the KFT should be chosen instead of the LFT as the standard technique in pilonidal sinus surgery.
ABSTRACT
PURPOSE: The ratio of c-reactive protein-to-albumin (CRP/Alb) is a biochemical marker of systemic inflammatory response and has been associated with poor survival in cancer. The purpose of this study was to investigate the effect of CRP/Alb ratios on prognosis in gastric cancers. METHODS: This study included a retrospective review of a total of 147 patients with locally advanced gastric cancer. Mean platelet volume (MPV) was analyzed statistically to find a prognostic relationship between monocyte/lymphocyte ratio, platelet distribution volume (PDW), MPV/platelet, c-reactive protein/albumin ratio (CAR), and gastric cancer. Patients were staged according to the American Joint Cancer Committee (AJCC) Staging Guidelines. RESULTS: The CRP/Alb ratio was independently associated with overall survival (OS) in patients with gastric cancer (GC). The CAR was above 0.25 in 52.7% (77) of the patients and below 0.25 in 47.3% (69) of the patients. Patients under 0.25 had statistically longer survival rates. CONCLUSION: A high preoperative CAR value could predict poor prognosis in locally advanced gastric patients. The same predictive value was not observed in other hematological parameters. This simple and cost-effective ratio can be used as a clinically accessible biomarker to assist clinicians in determining future treatment plans.
ABSTRACT
OBJECTIVE: Although laparoscopic colon cancer surgeries have increased in recent years, their oncological competence is questioned. In our study, we aimed to evaluate oncological competence by comparing laparoscopic and open surgery. METHOD: The study was planned retrospectively. A total of 94 patients were included in the study, 42 of whom underwent laparoscopy, and 52 patients underwent open surgery. Both groups were compared in terms of demographic characteristics, staging, number of benign/malignant lymph nodes, histological findings, and complications. RESULT: The final pathology report of all patients was adenocarcinoma. The median number of dissected lymph nodes was 20.9 in the open group (8-34) and 19.46 in the laparoscopy group (7-31) (p = 0.639). The median number of dissected malignant lymph nodes was 1 (0-13) in the open surgery group and 3.1 (0-8) in the laparoscopy group (p = 0.216). The laparoscopy group exhibited a longer operation time (281.2 ± 54.2 and 221.0 ± 51.5 min, respectively; p = 0.036) than the open surgery group, but a shorter intensive care unit (ICU) discharge, quicker initiation oral feeding, and shorter length of hospital stay (4.0 ± 0.9 vs 5.7 ± 2.0 days, respectively; p < 0.001). DISCUSSION: Laparoscopic surgery elicits many benefits such as less wound infection, lower requirement for blood transfusion, shorter hospitalization, quicker initiation of oral feeding, and mobilization. Our study has shown that laparoscopic surgery provides quite adequate lymph node dissection when compared to oncological surgery, which is viewed with suspicion in the light of these benefits of laparoscopy.