OBJECTIVE:Sacrococcygeal pilonidal sinus is common in young men and may recur over time after surgery. We investigated whether a factor exists that can aid in the determination of the preferred technique between the early Limberg flap and Karydakis flap techniques for treating recurrent pilonidal sinus.MATERIALS AND METHODS:This prospective and randomized study enrolled 71 patients with recurrent pilonidal sinus in whom the Limberg flap or Karydakis flap techniques were applied for reconstruction after excision. Patients were divided into two groups as follows: 37 patients were treated with the Limberg flap technique and 34 patients were treated with the Karydakis flap technique. Fluid collection, wound infection, flap edema, hematoma, partial wound separation, return to daily activities, pain score, complete healing time, painless seating and patient satisfaction were compared between the groups. ClinicalTrial.gov: NCT02287935.RESULTS:The development rates of total fluid collection, wound infection, flap edema, hematoma, and partial wound separation were 9.8%, 16%, 7%, 15% and 4.2%, respectively; total flap necrosis was not observed in any patient (p<0.001). During the average follow-up of 28 months, no patients (0%) developed recurrent disease. The two groups differed with respect to early surgical complications (p<0.001).CONCLUSION:In this study, use of the Limberg flap was associated with lower complication rates, shorter length of hospital stay, early return to work, low pain score, high patient satisfaction and better complete healing duration. Therefore, we recommend the Limberg flap for treatment of recurrent pilonidal sinus.

The aims of this study are to evaluate whether or not there is a relationship between mastalgia with anxiety and depression in young women with mastalgia who do not have organic breast pathology and to examine the effect of pain on the quality of life. Forty female pre-menopausal patients between the ages of 20-40 years with mastalgia and 40 totally healthy volunteers with the same characteristics were investigated with the Short Form 36 (SF-36), Hamilton Depression Scale, and the Hamilton Anxiety Rating Scale prospectively following breast examination and radiological examination. Statistical assessments were performed using the SPSS 11.5. Anxiety levels were observed to be higher in the patient group (p = 0.04). The depression level was higher in the patient group; however, this was not statistically significant (p = 0.08). The quality of life of the mastalgia group was determined to be lower than that of the control group, and the sub-parameters of physical function (p = 0.04), body pain (p = 0.02), general health (p = 0.03), and energy (p = 0.008) were found to be significantly low. There may be a relationship between mastalgia and depression in young women with mastalgia; however, a closer relationship between anxiety and mastalgia is observed. Mastalgia affects the quality of life of an individual negatively at a significant degree.

The high rate of positive LVI shows a close relationship with known markers of poor prognosis. The presence of LVI can predict a worse outcome for patients with invasive breast cancer. LVI may be used as an indicator of aggressive behaviour, metastatic ability (nodal and systemic) of the primary malignancy.

Generally, ingested foreign bodies are excreted from the digestive tract without any complications or morbidity. In adults, ingestion of foreign bodies frequently occurs in alcoholics and elderly individuals with dentures. The most commonly ingested foreign bodies are food stuffs or their parts, such as fish bones or fragments of bone and phytobezoars. Sharp foreign bodies like fish and chicken bones can lead to intestinal perforation and peritonitis. We report herein two cases, one of bowel perforation and another of anal impaction, both caused by ingested bone fragments. Complications due to ingested bone fragments are not common and preoperative diagnosis remains a challenge and therefore it must be considered in susceptible cases.

Abstract:Background: Congenital bands cause 3 % of all intestinal obstruction and almost always lead to small bowel obstruction. In adults, obstruction due to bands is even rarer. Materials and methods: A multicenter study in Turkey. From January 2000 to December 2010 inclusive -a period of 10 years -all adult patients admitted to the emergency departments with a clinical diagnosis of acute intestinal obstruction due to congenital peritoneal band were included in the study. Surgery was defi ned as emergency. Recorded operative fi ndings included the site of obstruction, and the operative procedure to relieve it. In the present study, the fi ndings in adult patients with congenital band reported in the literature together with fi ndings in ten cases operated at four center were retrospectively assessed with respect to their demographic, preoperative, peroperative, and postoperative characteristics. Results: There were 8 males and 2 females aged between 18 and 72 year. There were no history of abdominal or inguinal surgery. Plain abdominal X-rays radiography revealed air-fl uid levels in all patients. All the bands were ligated and divided. On histopathological examination, the bands were composed of loose connective tissue containing blood vessels. There were no calcifi cation in the bands. Conclusion: an anomalous congenital band could be included in the differantial diagnosis of intestinal obstruction. This clinical situation requires early surgical intervention that will be diagnostic and therapeutic (Tab. 1, Fig. 4, Ref. 21). Full Text in PDF www.elis.sk.