Amaç Papillertiroid kanserinde santral lenf nodlarının metastazının cerrahi öncesi saptanması zordur. Papiller tiroid kanserinin tedavisinde santral lenf nodu diseksiyonunun rolü belirsizliğini koruyor. Bu çalışma, papiller tiroid kanserli hastalarda preoperatif santral lenf nodu metastazı oluşumunu öngörmek için hazır preoperatif klinik özelliklere dayalı bir nomogram oluşturmayı amaçladı Gereç ve Yöntemler 2013-2022 tarihleri arasında bilateral total tiroidektomi yapılmış papillertiroid karsinomu tanılı hastalar tarandı ve 314 hasta çalışmaya dahil edildi. Hastaların demografik verileri, operasyon süresi, TSH, T3, T4 düzeyleri, glukoz/lenfosit oranları (GLR), patoloji raporlarındaki lenfovasküler invazyon, kapsül invazyonu ve boyun metastazı durumu retrospektif olarak taranarak not edildi. Tüm istatistiksel analizler için IBM SPSS 26.0 kullanılarak değerlendirildi. p

Introduction: Acute mesenteric ischemia (AMI) is a condition in which there is a sudden cessation of blood supply to a particular intestinal segment and consequent cellular damage. Although it has a low incidence of approximately 0.09-0.2% of all emergency surgery admissions, AMI is a severe condition that can cause high early mortality. A direct relationship between an increased mean platelet volume (MPV) and acute thrombotic events has been shown in recent years. we aimed to find out whether the diagnosis of mesenteric ischemia and the amount of bowel segment affected by ischemia will guide clinicians preoperatively with these markers Material and Method: A total of 57 cases with bowel resection due to mesenteric ischemia were included in the study. The gender, age, serum platelet (PLT), MPV, white blood cell count (WBC), neutrophil count (NEU), lymphocyte count (LYM), Albumin, CRP, neutrophil-lymphocyte ratio (NLR), MPV/Platelet Count, and CRP-albumin ratio (CAR) levels at the time of admission, operation time, length of resected bowel segment, length of hospital stay, presence of necrosis and perforation from pathology reports, and length of bowel segment leading to necrosis were scanned. Results: A moderate negative correlation was found between the length of resected bowel segment and PLT (P

Introduction: Acute mesenteric ischemia (AMI) is a condition in which there is a sudden cessation of blood supply to a particular intestinal segment and consequent cellular damage. Although it has a low incidence of approximately 0.09-0.2% of all emergency surgery admissions, AMI is a severe condition that can cause high early mortality. A direct relationship between an increased mean platelet volume (MPV) and acute thrombotic events has been shown in recent years. we aimed to find out whether the diagnosis of mesenteric ischemia and the amount of bowel segment affected by ischemia will guide clinicians preoperatively with these markers Material and Method: A total of 57 cases with bowel resection due to mesenteric ischemia were included in the study. The gender, age, serum platelet (PLT), MPV, white blood cell count (WBC), neutrophil count (NEU), lymphocyte count (LYM), Albumin, CRP, neutrophil-lymphocyte ratio (NLR), MPV/Platelet Count, and CRP-albumin ratio (CAR) levels at the time of admission, operation time, length of resected bowel segment, length of hospital stay, presence of necrosis and perforation from pathology reports, and length of bowel segment leading to necrosis were scanned. Results: A moderate (moderate) negative correlation was found between the length of resected bowel segment and PLT (P<0.001; r=-0.685). A moderate positive significant correlation was found between resection length and MPV (P<0.001; r=0.565). A high significant positive correlation was found between resection length and MPV/PC (P<0.001; r=0.857). PLT, WBC and MPV/PC values were statistically different between the perforated group and no-perforation group (p=0.009, p=0.024, p=0.010). WBC and MPV/PC values were significantly higher in the perforated group. Conclusion: MPV/PC and PLT value at hospital admission is a reliable and simple predictive factor in determining perforation and the amount of bowel segment affected in patients with acute mesenteric ischemia.

<b>Aim</b>: In primary hyperparathyroidism patients, avoiding hypoparathyroidism and hypocalcemia after surgery is essential. We aimed to evaluate if the delta parathormone percent value (ΔPTH%) can identify patients with an increased risk of developing hypocalcemia after parathyroid surgery for primary hyperparathyroidism.<br /> <b>Material and methods</b>: Eighty patients with parathyroid adenomas who underwent single parathyroidectomy were analyzed, and demographical data, preoperative, and postoperative laboratory data were collected were included in the study. Postoperative hypocalcemia was defined as a corrected calcium value below 8.5 mg/dL calculated from the blood values taken on the first postoperative day. The ΔPTH value was calculated by finding the difference between the preoperative PTH value and the postoperative PTH value, and the percentage of ΔPTH was calculated by dividing the ΔPTH value by the preoperative PTH (ΔPTH = Preoperative PTH – Postoperative PTH, and ΔPTH% = ΔPTH / Preoperative PTH).<br /> <b>Results</b>: Postoperative hypocalcemia developed in 7.5% of the patients. Hypocalcemic patients had higher ΔPTH and ΔPTH% values. The selection of 130.95 ng/L as ΔPTH level cutoff level divided patients with and without postoperative hypocalcemia with 83.3% sensitivity and 62.2% specificity. As for ΔPTH%, a cut-off value of 71.4% had 100.0% sensitivity, 56.8% specificity, and a 16-fold increase in odds of postoperative hypocalcemia.<br /> <b>Conclusion</b>: ΔPTH and ΔPTH% values are helpful predictors of postoperative hypocalcemia after parathyroidectomy and can be used as a guiding tool.

Introduction: One of the most important causes of morbidity in pancreaticoduodenectomy (PD) surgery is pancreatic anastomosis leakage. There is a possibility of pancreatic fistula even in the most experienced hands. After PD, pancreatic fistula occurs between 10% and 20% in various series. This study aims to evaluate the effects of pancreatic duct size and pancreatic tissue on the development of pancreatic fistula after PD is performed in our center. Material and Method: Pancreatic duct size was categorized as small &lt;3 mm and large &gt;3 mm. Pancreatic gland tissue was categorized as a soft, medium, and hard. These variables were calculated preoperatively with the help of computed tomography (CT), ultrasonography(USG), and Endoscopic ultrasound (EUS), and postoperative pathology results. It was accepted that the 24-hour flow rate of the drain behind the pancreatic anastomosis was more than 50 ml during 3 days after PD and/or the amylase concentration of the drain content measured at 3 different times was 3 times higher than the serum amylase concentration. Results: A total of 90 patients were included in the study, anastomotic leakage was not observed in 63 (70%) of 90 patients, and leakage was observed in 27 (30%) patients. The mean age was 71.22±10.78 years (p=0.615). There was no statistically significant difference between the ductus diameters between the two groups (p=0.240). There was no statistical difference between the groups formed according to pancreatic duct width. (p=0.059). It was observed that 60.3% of the patients in the non-leakage group had a hard appearance, and this rate was statistically significantly reduced to 29.6% in the patients with leakage (p=0.008). Conclusion: In summary, our study showed that pancreatic fistula after PD is associated with soft pancreatic parenchyma. The surgeon should consider this risk factor when performing a PD and be more careful to reduce the rate of pancreatic fistula.