Laparoscopic antireflux surgery is a frequently performed procedure for the treatment of gastroesophageal reflux in surgical clinics. Reflux can recur in between 3% and 30% of patients on whom antireflux surgery has been performed, and so revision surgery can be required due to recurrent symptoms or dysphagia in approximately 3% to 6% of the patients. The objective of this study is to evaluate the mechanism of recurrences after antireflux surgery and to share our results after revision surgery in recurrent cases.From 2001 to 2014, revision surgery was performed on 43 patients (31 men, 12 women) between the ages of 24 and 70 years. The technical details of the first operation, recurrence symptoms, endoscopy, and manometry findings were evaluated. The findings of revision surgery, surgical techniques, morbidity rates, length of hospitalization, and follow-up period were also recorded and evaluated.The first operation was Nissen fundoplication in 34 patients and Toupet fundoplication in 9 patients. Mesh hiatoplasty was performed for enforcement in 18 (41.9%) of these patients. The period between the first operation and the revision surgery ranged from 4 days to 60 months. The most common finding was slipped fundoplication and presence of hiatal hernia during revision surgery. Revision fundoplication and hernia repair with mesh reinforcement were used in 33 patients. The other techniques were Collis gastroplasty, revision fundoplication, and hernia repair without mesh. The range of follow-up period was from 2 to 134 months. Recurrence occurred in 3 patients after revision surgery (6.9%). Although revision surgery is difficult and it has higher morbidity, it can be performed effectively and safely in experienced centers.

This was a randomized, double-blind, sham-controlled study.Thyroidectomy is a frequently performed surgical procedure and head and neck extension during this operation facilitates surgery. Patients may experience postoperative neck pain and cervical range of motion (ROM) limitation due to the surgical position following thyroidectomy. It was aimed herein to investigate the short-term effects of kinesiotaping(KT) applied to the cervical spine on neck pain, ROM, and disability in patients following thyroidectomy. A total of 74 patients were randomly assigned to be treated with either KT (Group 1, n = 37) or sham taping (Group 2, n = 37) using a computer-generated random number list. Neck pain, cervical ROM, and neck disability were evaluated with a visual analog scale (VAS), inclinometer, and the Neck Disability Index (NDI) questionnaire, respectively. There were no significant differences with respect to age, sex, educational background, or body mass index between the groups.While there were no significant differences with respect to improvement of the VAS and change of the ROM and NDI values between the groups, patients in Group 1 needed less paracetamol than patients in Group 2 (P = 0.011). This study showed that cervical KT application following thyroidectomy does not have a positive effect on neck pain, ROM, or disability, but nonetheless, it reduces analgesic consumption.

Postoperative hypocalcemia is one of the major concerns following thyroidectomy and the most frequent cause of prolonged hospital stay. The aim of this study was to evaluate the relationship between body composition parameters and symptomatic hypocalcemia following total thyroidectomy. In addition, the effects of disease- and patient-related factors on hypocalcemia were investigated. A total of 144 patients were prospectively included between March 2014 and September 2017. Patients were divided into 2 groups according to the presence or absence of clinical symptoms of hypocalcemia. Subsequently, the relationship between body composition parameters and hypocalcemia was evaluated. Postoperative hypocalcemia-related symptoms occurred in 28 patients (19.4%). Permanent hypocalcemia was not encountered in any patient. Patients with hypocalcemic symptoms were more likely to have nodules ≥40 mm (39.3% vs. 17.2%, P = .011), retrosternal goiters (25.0% vs. 7.8%, P = .017), central lymph node dissection (LND) (32.1% vs. 11.2%, P = .015), and parathyroid autotransplantation (28.6% vs. 3.4%, P < .001) than those without symptoms. However, no differences were observed in the body composition parameters between symptomatic and asymptomatic patients. On multivariate analysis, lower preoperative intact parathyroid hormone (iPTH) levels (odds ratios (ORs) .96, 95% confidence intervals (CIs) .93-.99), the presence of retrosternal goiters (OR 10.26, 95% CI 2.23-47.14), central LND (OR 16.05, 95% CI 3.90-66.07), and parathyroid autotransplantation (OR 36.22, 95% CI 6.76-194.13) predicted hypocalcemia. This study demonstrates that patients with lower preoperative iPTH levels, retrosternal goiters, central LND, and parathyroid autotransplantation are at an increased risk of developing clinical symptoms of hypocalcemia. Body composition parameters have no effect on the incidence of hypocalcemia after total thyroidectomy.

Background/aim: This research examined the association between the triglyceride-glucose (TyG) index and metabolic, hepatic, and hematologic variables in a population of severely obese subjects, with a focus on the assessment of glycemic control. Materials and methods: This retrospective study included 315 adult patients with a body mass index (BMI) ≥ 35 kg/m² who were evaluated for bariatric surgery. Participants were grouped according to HbA1c levels: those with HbA1c ≥ 6.5% and those with HbA1c < 6.5%. TyG, atherogenic index of plasma (AIP), fibrosis-4 (FIB-4), aspartate aminotransferase-to-platelet ratio index (APRI), and hematological inflammation markers were assessed and compared between groups. To investigate associations, correlation and regression analyses were conducted. Results: Individuals with HbA1c ≥ 6.5% had significantly higher TyG, AIP, APRI, and FIB-4 values than those with lower HbA1c. The TyG index showed a strong correlation with both HbA1c (r = 0.403, p < 0.001) and AIP (r = 0.866, p < 0.001), and was identified as an independent predictor of HbA1c, explaining 20.5% of its variance. Moderate correlations were also found between liver fibrosis scores and systemic inflammatory indices. No significant differences were observed in hematologic markers across HbA1c groups, suggesting a closer link between inflammation and obesity rather than glycemic status. Conclusion: The TyG index may serve as a practical and accessible marker for metabolic risk and glycemic control in obese individuals. Its integration with other noninvasive indices like AIP, APRI, and FIB-4 may support a more comprehensive evaluation of cardiometabolic and hepatic risk profiles in clinical settings.