The purpose of this study was to assess the predictive effect of preoperative CEA and CA 19-9 levels on the prognosis of colorectal and gastric cancer patients. CEA and CA 19-9 were evaluated preoperatively in patients undergoing surgery for colorectal cancer (n=116) and gastric cancer (n=49). Patients with CEA levels 30 ng/ mL were classified as CEA Group 3. Similarly the patients with a CA 19-9 level 100 U/mL as Group and 3. TNM stages and histologic grades were noted according to histopathological reports. Patients with a TNM grade 0 or 1 were classified as Group A, TNM grade 2 patients constituted Group B and TNM grade 3 and 4 patients constituted Group C. Demographic characteristics, tumor locations and blood types of the patients were all recorded and these data were compared with the preoperative CEA and CA19-9 values. A significant correlation between CA 19-9 levels (>100 U/mL) and TNM stage (in advanced stages) was determined. We also determined a significant correlation between TNM stages and positive vlaues for both CEA and CA 19-9 in colorectal and gastric cancer patients. In comparison between CEA and CA 19-9 levels and age, gender, tumor location, ABO blood group, and tumor histologic grade, no significant correlation was found. Positive levels of both CEA and CA 19-9 can be considered to indicate an advanced stage in colorectal and gastric cancer patients.

Surgery is a major stress factor for patients, and is associated with significant anxiety or depression. The Hospital Anxiety and Depression Scale is one of the most common instruments used for assessment of patients' psychological stress. Here, we aimed to identify predictors of anxiety and depression in surgical inpatients. The study group consisted of consecutive two-hundred patients who completed the Hospital Anxiety and Depression Scale questionnaire. A patient scoring more than cut-off values (10 for anxiety and seven for depression) was considered as being at risk of anxiety or depression. Demographical data, socioeconomic status, education level and diagnoses were recorded. The Chi-square, Fisher's exact, Mann-Whitney, Kruskal-Wallis tests and binary logistic regression analysis were used to identify the predictive parameters for anxiety and depression. It was found that female patients, patients older than 35 years, patients with low socioeconomic status and low education level had a relatively higher risk of anxiety. In addition, patients with low education and a hospital stay greater than seven days were at risk of depression. Logistic regression analysis revealed that socioeconomic status and education level were strongly predictive for anxiety. However, presence of anxiety was shown to be strongly predictive for depression. Healthcare providers should be aware of their patients' psychology and, therefore, it is recommended to consider predictive factors for anxiety and depression.

Introduction: Cholecystectomy for benign gallbladder diseases can lead to previously undiagnosed gallbladder cancer during histopathological evaluation. Despite some controversy over its usefulness, histopathological evaluation of all gallbladder specimens is common in most hospitals. We evaluated the results of routine pathology of the gallbladder after cholecystectomy for benign gallbladder diseases with regard to unexpected primary gallbladder cancer (UPGC). Methods: Patients undergoing cholecystectomy because of benign gallbladder diseases between 2009 and 2013 were enrolled in this study. All gallbladder specimens were sent to the pathology department, and histopathological reports were examined in detail. The impact of demographic features on pathological diagnoses and prevalence of UPGC assessed. Data on additional interventions and postoperative survival for patients with UPGC were collected. Results: We enrolled 1,747 patients (mean age, 48.7±13.6 years). Chronic cholecystitis was the most common diagnosis (96.3%) and was associated significantly with being female (p=0.001). Four patients had UPGC (0.23%); one was stage T3 at the time of surgery, and the remaining three cases were stage T2. Conclusions: Routine histopathological examination of the gallbladder is valuable for identification of cancer that requires further postoperative management.

Background. The exact nature of learning curve of totally extraperitoneal inguinal hernia and the number required to master this technique remain controversial.Patients and Methods. We present a retrospective review of a single surgeon experience on patients who underwent totally extraperitoneal inguinal hernia repair.Results. There were 42 hernias (22 left- and 20 right-sided) in 39 patients with a mean age of48.8±15.1years. Indirect, direct, and combined hernias were present in 18, 12, and 12 cases, respectively. The mean operative time was55.1±22.8minutes. Peritoneal injury occurred in 9 cases (21.4%). Conversion to open surgery was necessitated in 7 cases (16.7%). After grouping of all patients into two groups as cases between 1–21 and 22–42, it was seen that the majority of peritoneal injuries (7 out of 9, 77.8%,P=0.130) and all conversions (P=0.001) occurred in the first 21 cases.Conclusions. Learning curve of totally extraperitoneal inguinal hernia repair can be divided into two consequent steps: immediate and late. At least 20 operations are required for gaining anatomical knowledge and surgical pitfalls based on the ability to perform this operation without conversion during immediate phase.