Background: Idiopathic granulomatous mastitis (IGM) is a rare benign breast disease which often mimics breast carcinoma both clinically and radiologically. Confirmation of diagnosis is only made by histopathological analysis. This study aims to defin

Background: Surgical procedures applied in the treatment of early breast cancer (EBC) to achieve satisfactory oncological results lie in a wide spectrum. There has been a major shift toward less-invasive treatments during the past decades. We compared the outcomes of oncoplastic breast surgery (OBS), non-oncoplastic breast conserving surgery (NBCS) and mastectomy in the treatment of EBC. Methods: The records of 412 patients with EBC who underwent OBS, NBCS or mastectomy at our institution between January 2012 and June 2019 were retrospectively analyzed. Postoperative complications, local recurrences (LR) and disease-free survival (DFS) were compared between the groups. EBC patients with unilateral stage-I, IIa and IIb tumors were studied. All patients received adjuvant, targeted and/or endocrine therapy according to the tumor characteristics, followed by radiotherapy (all OBS and NBCS cases, and selected mastectomy patients). Results: Postoperative complications were similar in all groups except for six fat necrosis and partial nipple-areola necrosis in two diabetic patients treated with OBS. Re-excision rate was lower in OBS (6.5%) than NBCS (8%). There was no statistical difference between the groups regarding recurrence (P=1.000) or DFS (P=0.937). Conclusion: OBS, NBCS and mastectomy are equally acceptable procedures in EBC in terms of both oncological and surgical aspects.

The importance of the complete absence of a hemidiaphragm or unilateral diaphragmatic agenesis in adulthood in relation to performing laparoscopic procedures has not been well documented. This article reports for the first time in literature a case of successful laparoscopic cholecystectomy in an adult with previously undiagnosed unilateral diaphragmatic agenesis. A 36-year-old female complaining of stubborn right upper abdominal pain radiating to her upper back was diagnosed as having cholelithiasis and was scheduled for laparoscopic cholecystectomy. There were also bilateral upper extremity malformations to a certain level. Routine diagnostic tests demonstrated that her entire liver and some bowel loops were in the right hemithorax, suggesting right-sided diaphragmatic hernia. Laparoscopic procedure was performed with the insertion of four trocars. Exploration of abdomen revealed total absence of the right hemidiaphragm. Cholecystectomy was completed laparoscopically in about 45 minutes without need for additional trocars. Patient had an uneventful recovery and was discharged on the second postoperative day without any complaint. Laparoscopic cholecystectomy in adults with diaphragmatic agenesis and intrathoracic abdominal viscera can be performed successfully. Nevertheless, any bile duct aberrations must be documented prior to surgery, and the surgeon should be able to convert to open procedure if necessary.

Background: Colonic diverticulitis is correlated with age, body mass index (BMI), and increased visceral or subcutaneous fat. Obesity contributes to diverticulosis, diverticulitis and its complications onset, as visceral fat activates inflammatory pathways that exacerbate these conditions. The aim of this study was to evaluate the association of visceral adiposity and BMI on complications of acute colonic diverticulitis. Method: A prospective cohort study was conducted on patients with acute diverticulitis admitted to the general surgery ward of a university hospital in Istanbul from September 2017 to February 2022. A total of 208 patients were classified into uncomplicated and complicated diverticulitis per the World Society of Emergency Surgery guidelines. After documenting demographic, clinical, and laboratory data, along with BMI and computed tomography measurements of visceral and subcutaneous fat areas (VFA, SFA), we conducted a statistical analysis to assess the relationships between VFA, SFA, and BMI in both groups. Results: Complicated diverticulitis group was found to have significantly lower values of BMI and VFA ( p = 0.037 and p = 0.046 respectively). Similarly, BMI and VFA values of patients who underwent all interventional procedures including percutaneous drainage and surgery were found to be significantly lower than the conservative treatment group ( p = 0.007, p = 0.025 respectively). V/S < 0.68 is an independent predictor in the complicated group. Conclusion: Our study shows that complicated diverticulitis cases have lower BMI and visceral fat area. We suggest that increased visceral adipose tissue may serve a protective role by preventing these diverticula from developing into more complicated forms. Therefore, visceral adiposity metrics can be integrated in the predictive analyses.