Europeanatolia Health Sciences Journal

Single Center Experience in Comparison of Crystalized Phenol and Surgical Excision in The Treatment of Pilonidal Sinus Disease

Fırat Aslan — 2024-12-20

Introduction: Pilonidal sinus is a common disease of the sacrococcygeal region, usually seen in young men. In the treatment of this disease, there are minimally invasive methods as well as classical excisional surgical methods.

Objective: The aim of this study is to compare the postoperative morbidity and complications of conventional excision and flap closure versus curettage and crystallized phenol(CP), in the treatment of pilonidal sinus disease(PS), and to evaluate the effectiveness of crystallized phenol application in the treatment of PS.

Method: Medical records of patients who underwent sinus excision due to PS and patients who underwent crystallized phenol application for PS between January 2018 and December 2022 in our clinic were retrospectively evaluated. Two groups were formed by including patients who underwent PS excision with flap closure (e.g. Limberg, Karidakis) and patients who underwent curettage of the sinus area followed by CP application. Patients with unknown previous surgical history and those who could not be followed up postoperatively were not included in the study. A total of 240 patients in the excision group and 93 patients in the CP group were included in the study. Data regarding age at the time of surgery, gender, number of sinus orifices, history of abscess drainage, history of previous surgeries, recurrence after surgery, reoperation, wound site infection, and length of hospital stay were obtained for all patients.

Results: There was no significant difference in demographic characteristics between the two groups (p>0.05). Patients treated with CP had a lower number of sinus orifices compared to the excision group. The history of abscess drainage was significantly higher in the CP group (p<0.05). There was no statistically significant difference between the two groups regarding previous surgeries (p>0.05). Recurrence and the need for reoperation were significantly lower in the CP group (p<0.05). Patients in the CP group had lower surgical site infections after the procedure compared to the excision group(p<0.05).

Conclusion: Data from our analysis indicates that a minimally invasive approach for the treatment of PS is suitable for appropriate patients. This method is also associated with shorter hospital stay, lower recurrence and reoperation rates, and lower surgical site infection rates. Notably, previous sinus surgery and drainage do not preclude this method.

The Impact of BMI on ESWL Outcomes: An Examination of Treatment Success

Erhan Erdoğan — 2024-12-20

Objective: The aim of this study is to evaluate the impact of body mass index (BMI) on the success of Extracorporeal Shock Wave Lithotripsy (ESWL) treatment.

Methods: This retrospective study includes data from patients who underwent ESWL treatment for kidney stones. A total of 196 patients who received ESWL treatment were included in the study. The data from these patients were thoroughly analyzed to examine the relationship between BMI (Body Mass Index) and ESWL treatment outcomes

Results: The findings indicate that BMI does not significantly affect the success of ESWL treatment. The treatment outcomes revealed no statistically significant difference in BMI between the successful and unsuccessful groups. These results suggest that BMI should not be considered a determining factor in ESWL treatment, and other clinical factors should be prioritized in treatment planning regardless of BMI. All statistical analyses were conducted using SPSS software, with a significance level set at p<0.05.

Conclusion: It was found that BMI does not have a significant impact on the success of ESWL in the treatment of kidney stones. These findings suggest that BMI should not be considered a primary factor in predicting ESWL outcomes.

Comparison of the Prognostic Value of Hematologic Inflammatory Markers in Patients with Acute Pancreatitis

Aydın Sarıhan — 2024-12-20

Introduction: Acute pancreatitis (AP) is an inflammatory disease that can also cause a life-threatening clinical picture. AP causes the disease by activating the inflammatory system. Therefore, hematological parameters used as inflammatory markers help to determine the disease progression.

Objective: In this study, we investigated the relationship between hematological parameters and imaging findings with AP severity and survival.

Methods: Data from 312 patients over 18 years of age diagnosed with acute pancreatitis were used for this study. Demographic data, hematologic parameters, and computed tomography of the abdomen were analyzed during hospitalization.

Results: When platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte raito (NLR), amylase/neutrophil and lipase/neutrophil ratios were analyzed according to the severity of AP; while elevated NRL, amylase/neutrophil and lipase/neutrophil ratios were significant in distinguishing between mild and moderate pancreatitis (p < 0.001, p=0.001, p=0.001 and p=0.001, respectively), PLR was not significant (p=0.055). High amylase/neutrophil and lipase/neutrophil ratios were statistically significant in discriminating between moderate and severe pancreatitis (p < 0.001, p=0.01, respectively). When patient survival rates were analyzed after discharge regardless of pancreatitis onset, 90.2% (n=229) of patients were alive, while 9.8% (n=25) died. Statistically, there was no significant difference between pancreatitis severity and death (p=0.837).

Conclusion: The results of our study suggest that systemic immune inflammatory index (SII), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and modified CT severity index (MCTSI) are valuable in the diagnosis of AP. In addition, the ratios of amylase/neutrophilia and lipase/neutrophilia, which we coincidentally found to be significant in our study, have the potential to lead many studies in determining the severity of pancreatitis.

Relationship Between Axillary Metastasis and Tumoral Response and Biomarkers in Breast Cancer Patients Who Received Neoadjuvant Chemotherapy

Uğraş Daban — 2024-12-20

Introduction: The molecular subtype of the disease is related to the patient's clinical course, response to chemotherapy, and pathological response rates.

Objective: The molecular subtype of the disease is related to the patient's clinical course, response to chemotherapy, and pathological response rates. This research aimed to elucidate the relationship between neoadjuvant chemotherapy and treatment response in breast cancer patients who received neoadjuvant therapy and were evaluated with axillary lymph nodes after surgery.

Method: This retrospective analysis investigated the relationship between axillary metastasis status, tumoral and pathological complete response status, and molecular subtypes in 103 patients who received neoadjuvant chemotherapy for breast cancer and whose axillary lymph nodes were evaluated. Patients' age, menopause status, type of surgery, tumor side, axillary involvement, nodal involvement, T staging, histopathological type and subtypes, tumor receptors, perineural invasion, lymphovascular invasion, and tumor necrosis data were obtained from hospital records.

Results: A total of 103 female patients were included in the study. Histopathologically, the most common subtype was invasive ductal carcinoma (89.3%), and hormone receptor status was determined as ER-positive (73.8%) and PR positive (63.1%). Molecular subtypes were defined as Luminal B (36.9%) and Luminal A (34%), and the most common tumor grade was grade 2 (57.3%). The most common surgical method after neoadjuvant chemotherapy was radical mastectomy (97.1%). Among the cancer subgroups evaluated after neoadjuvant therapy, the most frequent subgroups with tumoral complete response were HER2 positive (47.4%), and triple-negative (45.5%) groups, the most frequent groups showing nodal complete response were HER2 positive (47.4%) and triple negative (63.6%) groups. The most frequent subgroups showing pathological complete response were HER2 positive (21.1%) and triple negative (36.4%) groups.

Conclusion: Breast cancer genetic subgroups are associated with treatment responses following neoadjuvant chemotherapy. Among breast cancer subgroups, the subgroups that provide the best tumoral, nodal, and pathological complete response to neoadjuvant chemotherapy are HER2-positive breast cancers and triple-negative breast cancer types.

Changes In The Radial Styloid Bone: Can They Affect The Choice Of Treatment Method In De-Quervaın Tenosynovitis?

Gözde Kırgın — 2024-12-20

Introduction: De Quervain tenosynovitis is a stenosing tenosynovitis of the Abductor Pollicis Longus (APL) and M. Extensor Pollicis Brevis (EPB) tendons located in the 1st dorsal compartment of the wrist, under the dorsal carpal ligament and radial tunnel. This research aimed to define and investigate the radial styloid bone changes and to evaluate which treatment option was applied to patients with bone changes.

Method: A total of 55 patients with De Quervain tenosynovitis were included in this study. Two separate radiologists analyzed the anterior-posterior wrist radiographs of patients at different times to investigate and define the radial styloid bone changes and evaluate which treatment option was applied to patients with radial styloid bone changes. The impact of treatment was assessed to determine the extent to which the appropriate treatment option can be decided for patients via X-ray.

Results: According to radiological imaging findings, changes were detected in the radial styloid bone in 72.2% of the patients, while no such changes were observed in 27.8%. The analyses show no significant relationship between X-ray findings and pre-FTR status, conservative or surgical treatment (p>0.05). The age variable was statistically significant in predicting X-ray changes (p = 0.049). The probability of X-ray changes increases with age (p = 0.049), which shows that age is an essential factor in X-ray changes.

Conclusion: Regarding the outcomes of this research, the age variable was statistically significant in predicting X-ray changes. The probability of X-ray changes increases with age, which shows that age is an essential factor in X-ray changes.

English Diaphragmatic Eventration After COVID-19 Disease: Evaluation of Plication via VATS and Changes in Respiratory Functions

Onur Derdiyok — 2024-12-20

Objective: Diaphragmatic eventration after COVID-19 infection is a rare condition that can seriously and adversely affect respiratory functions and requires surgical intervention. This research aimed to elucidate whether VATS diaphragm plication is an effective treatment option for improving pulmonary functions in patients with diaphragmatic eventration developed secondary to COVID-19.

Method: This prospective research enrolled 54 patients who underwent diaphragm plication via VATS procedure. demographic and anthropometric measurements such as weight, age, and BMI were recorded before and after surgery. All patients underwent preoperative and postoperative pulmonary function tests (PFTs). These tests included standard pulmonary function tests such as spirometry, peak expiratory flow (PEF), and forced expiratory volume in the first second (FEV1). An experienced respiratory physiotherapist performed the tests.

Results: There was a statistically significant difference between the patients' preoperative FEV1 measurement and postoperative FEV1 measurement (p <0.05). The FEV1 value of the patients increased in the postoperative period. Postoperative pulmonary function tests showed a significant improvement in all patients. FEV1 values of all patients increased postoperatively by an average of 23% (p <0.05). Similarly, significant improvements were observed in other pulmonary function parameters.

Conclusion: VATS diaphragm plication may be an effective treatment option in improving pulmonary functions and alleviating clinical symptoms in patients with diaphragmatic eventration developed after the COVID-19 infection.