BACKGROUND: Accurately diagnosing appendicitis can be difficult. This retrospective study aimed to evaluate the ability of the neutrophil-to-lymphocyte ratio (NLR) to predict acute appendicitis pre-operatively and to differentiate between simple and complicated appendicitis.

Background/Aims: The incidence and prevalence of peptic ulcer disease has decreased in recent years, but it is not so easy to make the same conclusion when complications of peptic ulcer are taken into consideration. The aim of this study is to determine the time trends in complicated peptic ulcer disease and to state the effects of H2 receptor blockers, proton pump inhibitors (PPI), and H. pylori eradication therapies on these complications. Materials and Methods: This study retrospectively evaluated the patients who were operated on for complications (perforation, bleeding, and obstruction) of peptic ulcer for the last 50 years. Patients were grouped into four groups (G1-G4) according to the dates in which H2 receptor blockers, PPIs, and eradication regimens for H. pylori were introduced The time periods that were studied were: (G1) 1962-1980, (G2) 1981-1990, (G3) 1991-1997, and (G4) 1998-2012. Results: In total, 2953 patients were operated on for complications of peptic ulcer disease, of which 86% of the patients were male. In G1, perforation and obstruction were significantly the most frequent complications (p<0.001), followed by bleeding. In groups G2 and G3, obstruction was still the most frequent complication requiring surgery (p<0.001). In G2 and G3, obstruction was followed by perforation and bleeding, respectively. In G4, perforation was significantly the most frequent complication (p<0.001). Conclusion: From 1962 to 1990 obstruction was the most common complication requiring surgery. In the last decade, perforation became the most common complication. In contrast to reports in the literature, bleeding was the least common complication requiring surgery in Turkey.

We report herein the cases of five patients with alveolar hydatid disease (AHD) of the liver who were diagnosed and underwent surgery at the Department of Surgery of Ankara University between 1989 and 1994. In all five patients, the final diagnosis was established by frozen section of the lesion during laparotomy. Lesions of AHD were found only in the liver. Hepatic resections including right lobectomy and segmentectomy were performed in three patients while palliative procedures were carried out in the remaining two patients with unresectable disease. There was no operative mortality, and only one late death occurred 3 years after the hepatic resection. In this paper, we present the clinical and operative findings of these five patients and their outcomes, followed by a review of the surgical treatment of AHD.

No abstract

Determination of the resection margins during surgery for gastric malignancy is a subject of controversy because accurate detection of horizontal limits of tumor spread is difficult by current methods. In this study, we investigated the value of intraoperative-ultrasonography (IUS) in the detection of proximal and distal limits of horizontal tumor spread (HTS) in 19 gastric adenocarcinoma (Group I) and five gastric lymphoma (Group II) patients. After sonographic and clinical limits of HTS were marked, resections were carried out 2 cm away from the IUS limits, and biopsies from IUS limits and resection margins were obtained. Then, the gap between IUS and clinical limits were recorded and compared with results of pathology. In both groups, the distance from clinical to IUS limits ranged from 0 cm to 3 cm and IUS limits were never inside the clinical limits. In Group I, results of sonographic proximal limit detection were satisfactory in all patients excluding recurrent cases (n:2) and a patient with early gastric cancer. Sonographic accuracy of distal limit detection was 68%. In Group I, only one resection margin (distal) was found to be infiltrated with cancer. In Group II, the success rate of IUS-guided HTS detection was 40%. IUS seems to be a valuable method for determining the extent of HTS during operation for gastric adenocarcinomas, especially so for the most problematic proximal limits. In recurrent cancers and lymphomas, however, results of IUS may be frequently misleading. IUS can be advocated as a routine procedure to determine the tumor limits and thus the resection margins during surgery for primary gastric adenocarcinomas.