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  • Küçük Resim
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    Analysis of cases with primary retroperitoneal tumors
    (Yerküre Tanıtım & Yayıncılık Hizmetleri A S, 2019) Çalışkan, Müjgan; Evren, İsmail; Acar, Aylin; Ekşi, Mithat
    Objective: Retroperitoneal tumors are rare and most of them arise from mesodermal or neuroectodermal tissues and residues of the embryonic urogenital body. Retroperitoneal malignant tumors are seen more often than benign lesions. Due to their anatomic location and slow growth, pain and neurological symptoms do not appear until later stages. In this article, we aim to present our experience in eight cases with primary retroperitoneal tumor. Methods: Eight patients who underwent retroperitoneal tumor excision between April 2009 and April 2016 were included in the study. Gender, age, patients' complaints, the location, type and size of the tumor, surgical techniques, and morbidity, recurrence, and mortality rates were evaluated. The mean follow-up period was 41.3 months. Results: Four of the eight patients were females and the mean age was 48.6 years. The retroperitoneal mass was located in the abdomen (n= 4) and in the pelvis (n= 4). In addition to abdominal pain, some patients experienced back and leg pain, difficult urination, and constipation. Intra-operative biopsy was performed previously during a laparotomy (n= 2). Mass excision was performed by open and laparoscopic surgery. Variable histopathological diagnoses were determined, such as schwannoma, cystic mesothelioma, angiomyolipoma, epidermoid cyst, liposarcoma, ganglioneuroma, and neurofibroma. Morbidity included intra-operative bleeding (n= 1), post-operative deep vein thrombosis (n= 2), and pulmonary embolism (n= 1). Postoperatively there were neither recurrences nor mortality. Conclusion: Primary retroperitoneal tumors can be located in different regions, but we did not find any tumors localized in the left lumbar region. The pathological diagnoses were heterogeneous, including seven benign lesions and one malignant lesion.
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    Comparison of common surgical procedures in non-complicated pilonidal sinus disease, a 7-year follow-up trial
    (Springer, 2020) Çalışkan, Müjgan; Koşmaz, Koray; Subaşı, İsmail Ege; Acar, Aylin; Evren, İsmail; Baş, Gürhan; Atayoğlu, Ali Timuçin
    Background: Pilonidal disease is a common problem in primary health care which may require immediate surgical referral. Although various management options have been proposed, so far there is no gold standard treatment. The aim of the present study was to determine which of the following techniques was superior as regards postoperative complications and recurrence, midline unshifted adipofascial turn-over flap, midline shifted adipofascial turn-over flap or Karydakis flap. Methods: A randomized clinical trial was conducted in the Department of General Surgery. Patients with non-complicated pilonidal sinus were enrolled in the study from April 2009 to January 2012. All patients were randomized the day of surgery at the coordinating center by means of a computer program. Patients were randomized to receive midline unshifted adipofascial turn-over flap, midline shifted adipofascial turn-over flap or Karydakis flap. All procedures were performed under local anesthesia and patients were discharged 6 h after surgery. Demographic characteristics, skin color, body hair type, family history, preoperative complaints and duration of symptoms, cyst size, intraoperative iatrogenic cyst rupture, the presence of a tuft of hairs in the cyst, surgical techniques, duration of drainage, length of hospital stay, postoperative complications and recurrence were evaluated. Results: One hundred and ninety-two patients with non-complicated pilonidal sinus were enrolled. Seventy-two patients were randomized to midline unshifted adipofascial turn-over flap, 67 patients to midline shifted adipofascial turn-over flap and 53 patients to Karydakis flap. The mean age was 25.66 ± 7.67 years. At 76-month follow-up, the overall complications and recurrence rates were not significantly different between groups (p > 0.05). Conclusion: In cases of non-complicated pilonidal sinus, we recommend surgical management using local anesthesia, outpatient surgery and the surgical approach with which the surgeon is most familiar.