Although many surgical methods have been described for sacrococcygeal pilonidal sinus treatment, the best option is still controversial. We aimed to compare postoperative outcomes of these different methods in terms of advantages and disadvantages. The records of 320 patients undergone surgery for primary or recurrent pilonidal sinus between May 2013 and May 2017 were retrospectively analyzed. Demographical data, pre operative stories, wound site infection, seroma development, wound dehiscence, time of healing, duration of return to work, and if there is any recurrence of 303 patients included in the study were recorded. Upon wide local excision, the first surgeon performed marsupialisation and the lay open technique, second surgeon performed vertical excision and primary closure, third surgeon performed Limberg flap transposition and fourth surgeon performed Karydakis' flap transposition. There was no significant difference between the patients in terms of demographical characteristics. The duration of surgery was statistically significantly higher in primary closure method (p = 0.001). The mean duration of return-to-work was statistically significantly lower in primary closure method (p = 0.002). In primary closure method, the recurrence rate was found to be statistically significantly higher than the other methods (p = 0.009). We do not suggest the use of primary closure method in treatment of pilonidal sinus. Because of lower rates of recurrence and shorter durations of return to work, the Karydakis and Limberg methods are seen as safer methods when compared to lay-open and marsupialization method.

Objective: To study incidental gallbladder cancer (IGBC) incidence in patients who underwent cholecystectomy. Methods: The records of patients who underwent cholecystectomy between 2004-2019 were retrospectively reviewed. The demographic information, preoperative radiological findings of the patients diagnosed with gallbladder cancer (GBC), as a result of routine histopathological examination and operation records, were reviewed and findings were recorded. The preoperative radiological records of the patients with GBC and, if any, findings of GBC suspected during surgery were recorded. Results: Between 2004-2019, a total of 6314 patients underwent cholecystectomy. Of the patients, 5404 (85.59%) were female and 910 (14.41%) were male. The median age was 47 years (min:19, max:94) and the mean age was 47.28±14.60 years. Nine out of 6314 patients (0.14%) were diagnosed with GBC by postoperative histopathological examination. All patients with GBC were female and their mean age was 64.33±11.08 years. Two out of nine GBC cases were prediagnosed with GBC in preoperative radiological findings; the remaining seven (0.11%) had IGBC without any preoperative findings. Conclusion: Asian populations are reported to have a higher incidence of GBC. Turkey is located in the transition zone between Asia and Europe. However, the GBC rates in our study remain far below the rates reported in Asian publications. We believe that our results may be affected by the predominantly Mediterranean-type diet and the relatively higher socioeconomic level of the region where we conducted our study. Consequently, we recommend routine histopathological examination after cholecystectomies in regions with a high incidence of GBC.

Introduction The current study aims to identify the complications that occur during the postoperative three-week period, which is considered the period of recovery in patients who undergo pilonidal sinus surgery. This identification of complications will help reduce morbidity and treatment costs and improve return to work. Methods This study included a total of 196 patients who underwent pilonidal sinus surgery by a combination of the resection and Limberg flap techniques under spinal anesthesia between the years 2012 and 2016. The postoperative three-week period was examined as the hospital stay period and the post-discharge period. The complications were classified into two groups: surgical and anesthesia. Results were recorded and analyzed using the SPSS statistical software (IBM Corp., Armonk, NY, US). p<0.05 was considered significant. Results The female-to-male ratio of the patients was 1:4, whereas their average age was 24.15 years, the median age was 22 years, and the average body mass index was 24.79 kg/m(2). The average lengths of hospital stay in the postoperative period were 1.10, 2.15, and 3.95 days in patients without complications, all of the patients studied, and patients with complications, respectively. The difference between the groups was found statistically significant (p<0.001). Conclusion Anesthesia-related and surgical complications were prominent in the postoperative hospital stay and post-discharge periods, respectively. The average length of hospital stay in patients with complications during hospital stay was found to be 3.59 times higher than those without complications. The difference between these two categories was statistically significant (p<0.001).

Background: To evaluate the results obtained from the combination of intragastric botulinum toxin A (IGBTA), intragastric balloon (IGB), and IGBTA(+)IGB in the treatment of obesity. Materials and Methods: Three separate treatment groups were set up. IGBTA, IGB, and IGBTA(+)IGB were administered to Group 1, 2, and 3, respectively. The body mass indexes (BMI) of patients were measured before and 6 months after the treatment. The intragroup and intergroup treatment results have been evaluated. P<0.05 was considered significant. Results: The mean BMI decreased by 1.6 kg/m² in 40 patients who received IGBTA in group 1 (P<0.001), 3.95 kg/m² in 42 patients who received IGB in group 2 (P<0.001), and 4.9 kg/m² in 39 patients who received IGBTA and IGB in group 3 (P<0.001) after 6 months of treatment. The intolerance because of the application was the highest in group 3, followed by group 2. Conclusion: The treatment was most successful in group 3 followed by group 2 and group 1, respectively. The authors recommend the group 3 treatment, provided that nausea, vomiting, and flatulence have a high index of probability in such a treatment. However, when deciding between group 1 and group 2 treatments, the authors recommend opting for group 2 treatment that shows to be more efficient.

This study aimed to assess the relapse rates at the long-term follow-up of the Limberg flap repair (LFR) and primary closure (PC) methods in the surgical treatment of pilonidal sinus disease (PSD). The records of primary PSDs who underwent LFR and PC due to PSD were retrospectively examined. The study included patients whose surgical intervention was performed at least two years ago. The patients were contacted by phone to obtain information. They were asked whether they had a relapse or not, and their answers were recorded. The recording and analysis were ensured using the SPSS statistical program (IBM Corp, Armonk, NY, US). The groups were compared using the chi-square test. p˂0.05 was considered significant. The patients’ mean age was 23.68 ± 8.21 years, and their median age was 22 years. The overall follow-up period was 4.38 ± 2.12 years. LFR-treated patients numbered 292; 38 (13.01%) females and 254 (86.99%) males. Of the LFR-treated patients, 23 (7.87%) had a relapse, including five (13.15%) females and 18 (7.08%) males (p˂0.03). PC-treated patients numbered 184; 58 (31.52%) females and 126 (68.48%) males. Of PC-treated patients, 39 (21.19%) had a relapse, including 15 (25.86%) females and 24 (19.04%) males (p˂0.04). The relapse was more than three times higher in PC when compared to LFR (p˂0.01). LFR clearly takes precedence over PC. In both methods, the relapse rate is higher in females. We believe that this is due to our tendency to be more limited in resection in women.