Background Gonadectomy is necessary due to the risk of malignancy in children with disorders of sex development (DSD) carrying Y chromosome. We aimed to investigate the efficacy of laparoscopic gonadal surgery in DSD patients. Methods Fourteen female phenotype patients carrying Y chromosomes with DSD who underwent laparoscopic gonadal surgery between February 2015 and December 2022 are retrospectively evaluated. Results The mean age of the patients at the time of surgery was 11.71 ± 6.4 years (1–18 years). The underlying disease was androgen insensitivity syndrome in four, 46,XY gonadal dysgenesis in three patients, lipoid congenital adrenal hyperplasia (CAH) in two, Leydig cell hypoplasia in two, 45,X/46,XY mixed gonadal dysgenesis in one, ovotesticular DSD in one, 46X, dic(Y) gonadal dysgenesis in one patient. The average operation time was 33 ± 2 (25–64) minutes. None of the cases were converted to open surgery. All patients were discharged on the first day. No postoperative complication is reported. The histological evaluation of the patients with lipoid CAH, Leydig cell hypoplasia, and androgen insensitivity syndrome revealed immature testis, ovotesticular DSD patients revealed ovotestis, 45XO/46XY mixed gonadal dysgenesis patients' and 46 X,dic(Y) mixed gonadal dysgenesis patients revealed ovarian tissue, 46,XY gonadal dysgenesis' patients revelead gonadoblastoma, immature testis on the right side and ovary on the left side and bilateral mesonephric remnants. Conclusions In Y chromosome carrying DSD patients, laparoscopic gonadectomy should be the preferred treatment method as an efficient, safe, and well-tolerated procedure, for gonads that are planned to be removed due to the risk of malignancy or non-compliance with the determined gender.
Objective Our study aimed to retrospectively evaluate Enterobius -associated appendicitis cases and compare them with acute appendicitis cases in terms of parameters such as the neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP)-to-lymphocyte ratio (CLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII). We primarily aimed to evaluate the utility of SII in the differential diagnosis of Enterobius -associated appendicitis. Methods The appendectomy specimens of pediatric patients who were operated on for acute appendicitis between June 2016 and August 2022 were retrospectively evaluated. Enterobius -associated appendicitis cases were included for analysis. All patients were evaluated regarding age, gender, blood count, surgery, and pathology reports. Pathology reports were evaluated for the presence of histological signs of acute appendicitis. The patients were classified into an Enterobius -associated appendicitis group and a regular acute appendicitis group. CRP, white blood cell (WBC), red cell distribution width (RDW), neutrophils, lymphocytes, NLR, monocytes, eosinophils, platelet (PLT), PLR, CLR, and SII values were compared between the two groups. Results Eleven cases of Enterobius -associated appendicitis were identified out of 430 total cases (2.55%) examined. The mean age of the group with acute appendicitis was 12.83 ±3.16 years, while the mean age of the group with Enterobius -associated appendicitis was 8.55 ±2.54 years. There was no statistically significant difference in terms of CRP, WBC, RDW, lymphocytes, neutrophils, NLR, monocytes, eosinophils, PLT, PLR, and CLR values between the two groups (p>0.05). However, when the SII values of the participants were analyzed, it was observed that the SII values of the participants in the regular appendicitis group were significantly higher than those of the participants in the Enterobius group (p<0.05). Among the 11 Enterobius -associated appendicitis patients, seven appendectomy specimens revealed no inflammation and were regarded as negative appendectomy (63.63%). Conclusion This is the first study to demonstrate the utility of preoperative SII evaluation in Enterobius -associated appendicitis. SII is a simple, easy-to-calculate indicator of Enterobius -associated appendicitis and aids in the preoperative differential diagnosis of acute appendicitis.
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