A new technique to simplify the minimally invasive parathyroidectomy: Ultrasound-assisted guided wire localization for solitary parathyroid adenomas.

OBJECTIVE: To investigate the benefits of ultrasound-assisted guided wire localization in MIP for selected cases. METHODS: In this prospective, nonrandomised study, we included 36 patients with solitary parathyroid adenomas diagnosed preoperatively by 99m Tc sesta MIBI scintigraphy and/or neck ultrasonography. An ultrasound-guided wire was placed in the solitary parathyroid adenoma preoperatively. MIPs were performed under local anaesthesia plus sedation. After the excision, the parathyroidectomy was confirmed with postoperative ultrasonography. RESULTS: There were 36 patients included in our study. The mean age was 54.89±11.28 years, and 30 patients were females (83.3%). Preoperative PTH and calcium (Ca) levels were 269.5 pg/mL (83.5-5,000 pg/mL) and 12.2 mg/dL (11.1-20 mg/dL), respectively. Postoperative serum PTH and Ca levels were 42.04±26.65 pg/mL and 8.95±0.74 mg/dL, respectively. The mean operation time was 21.69±6.4 minutes and the average hospitalisation time was 18 hours (range: 10-72 hours). CONCLUSIONS: Ultrasound-assisted guided wire localization may be useful in selected MIP cases. The MIP advantages include higher success rates and being easy to learn and practise.

Assessment of the relationship between neutrophil lymphocyte ratio and prognostic factors in non-metastatic colorectal cancer.

OBJECTIVE: Neutrophil-lymphocyte ratio still has a limited clinical use due to many non-cancer factors affecting neutrophils or lymphocytes in the present time. We aimed to evaluate the association between preoperative neutrophil-lymphocyte ratio and poor prognostic factors after curative elective colorectal surgery. MATERIAL AND METHODS: This clinical retrospective study was initiated with 95 patients, who had a curative surgical resection between 2003 and 2013. The patients were divided into two groups based on the preoperative neutrophil-lymphocyte ratio cut-off value above and below 3. The groups were compared for tumor localization, diameter, and staging; the histopathological perineural invasion; lymphovascular invasion; and overall survival. Univariate and multivariate Cox regression analyses were used to determine the role of neutrophil-lymphocyte ratio after stratification by several clinicopathological factors. RESULTS: The mean age of patients was 59.79±1.48 (range, 23-90) years, and median follow-up period was 20.77±14.85 months. There was no significant difference in perineural or lymphovascular invasion, tumor size, stage, age, sex, and tumor location between the groups [Group 1 ratio >3 (n=52) and Group 2 ratio ≤3(n=43)]. Hemoglobin (p=0.035) and albumin levels (p=0.004) were lower in the Group 1. When the stage increased, differences between the rectal cancer groups were found. Overall survival was significantly lower in the Group 1 (p=0.013). CONCLUSIONS: The study showed that a high neutrophil-lymphocyte ratio had an adverse effect on overall survival in colorectal cancer patients who had a curative surgery. However, we could not establish any association between neutrophil-lymphocyte ratio and the factors such lymphovascular invasion, perineural invasion, tumor size expect hemoglobin and serum albumin levels.