BACKGROUND: An incarcerated hernia is a part of the intestine or abdominal tissue that becomes trapped in the sac of a hernia. An increase in morbidity and mortality occurs after intestinal resections from strangulated hernias. This study aims to examine the markers that may be effective in determining the risk of small bowel resection due to incarcerated hernias. In particular, we aimed to investigate the effect s of blood lactate levels in determining this risk. METHODS:A cross-sectional retrospective study was designed. Patients, whose preoperative diagnosis were reported as incarcerated hernia and had essential information, were included in this study. They were divided into two groups according to whether they had resection or not. Age, gender, hernia type, hernia side, resection material, blood lactate level (BLL), white blood cell (WBC), neutrophil count (NE), lymphocyte count (LY), neutrophil/lymphocyte ratio (NLR), platelet count (PLT), lactate dehydrogenase (LDH), radiologic bowel obstruction sign and comorbidities were evaluated. RESULTS:Sixty-seven patients were included in this study. It was observed that 16 (23.9%) of these patients underwent small intestinal resection, 16 (23.9%) had an omentum resection, while no resection was performed on 35 (52.2%) patients. There was a statistically significant difference regarding radiologically intestinal obstruction (p=0.001), hernia type (p=0.005), BLL (p<0.001), WBC, NLR and LDH values (p<0.05). In incarcerated hernia patients with a lactate value ≥1.46 mg/dL, sensitivity was observed to be 84.0% and specificity 86.0% (p<0.001). CONCLUSION:In patients with a preliminary diagnosis of an incarcerated hernia, the risk of possible small bowel resection is the most important point in deciding for an operation. The presence of an intestinal obstruction in radiological examinations, and particularly the high levels of WBC, NLR, LDH and BLL, may indicate a necessity for possible small bowel resection. Concerning the risk associated with small bowel resection, blood lactate levels ≥1.46 mg/dL may be alerting.

No abstract

Background/Aim: Pilonidal sinus is an inflammatory condition that affects the intergluteal sulcus. Since there is no standard treatment for pilonidal sinus, comparative studies are needed. Our study aimed to comparatively evaluate the treatment success, postoperative complications and recurrence in excision/primary repair surgery and crystallized phenol application in pilonidal sinus disease. Methods: A total of 376 pilonidal sinus patients over the age of 18 years who visited our general surgery clinic between January 2017-January 2020 were included in this retrospective cohort study. They were divided into two groups based on whether they underwent phenol treatment or surgery. The patients' age, body mass index (BMI), gender, number of pits, length of stay in the hospital, return to normal life, mean follow-up times, complications, and satisfaction data were recorded. At the end of the follow-up period, all patients were contacted by telephone and the recurrence rates were noted. Results: Both groups were similar in terms of age, gender, and BMI (P>0.05 for all). The mean age of 374 patients included in the study was 23.38 (4.9) years. The mean follow-up time was 25.47 months. Patients in the crystallized phenol group did not require hospitalization. In the primary repair group, the median length of hospital stay was 1.15 days. Complications such as wound infection, hematoma, and wound dehiscence were significantly less in the phenol group. The recurrence rates in the phenol and primary repair groups were 8% and 10%, respectively (P=0.326). Return to normal life was significantly faster in the phenol group. The success rate in the phenol group was 92%. Conclusion: Although the recurrence rates are similar, crystallized phenol therapy is superior to primary repair due to better wound healing rates, ease of application, and fewer complication rates. More than one application is recommended in phenol treatment.

No abstract

IntroductionBiomarkers such as the neutrophil-lymphocyte ratio (NLR) and the platelet-lymphocyte ratio (PLR) are associated with the colon tumor stage and prognosis. Therefore, in our study, we investigated whether these biomarkers are important in determining the colon cancer stage. Materials and methodsThe outcomes in 268 patients operated on with the diagnosis of colon cancer between January 2011 and March 2019 were retrospectively analyzed. The relationship of the stage of the patients with the NLR or PLR was evaluated. In addition, according to the stage of colorectal tumors, stage I and other stages (stages II, III, and IV) were compared in terms of NLR and PLR. Groups that had lymph node (LN) metastasis were compared with those that did not. Finally, groups with and without metastasis were also compared. ResultsIn our cohort, 144 patients (57.6%) were male, and 84 (42.4%) were female. The mean age was found to be 68.28 ±12.71 years. The patients were evaluated according to their stages: 26 patients were stage I, 78 patients were stage II, 75 patients were stage III, and 19 patients were stage IV. There was a significant difference in NLR values between the groups (p: 0.05). Also, 104 patients were LN-negative (stages I-II), and 94 patients were LN-positive (stages III-IV). When PLR was compared between the two groups, no significant difference was found between tumor stages and these values (p: 0.099). However, there was a significant difference in NLR values (p: 0.034). ConclusionBased on our findings, it has been concluded that increased PLR may not be associated with the colon cancer stage. However, the increase in NLR was found to be correlated with tumor stage and LN metastasis.