The coronavirus disease-19 (COVID-19) pandemic has changed the course of diseases that require emergency surgery. To evaluate the effect of the COVID-19 pandemic on colorectal cancer disease stage. Retrospective analysis in the city of Rize, Turkey. This was a comparative analysis on two groups of patients with various symptoms who underwent surgical colorectal cancer treatment. Group 1 comprised patients operated between March 11, 2019, and December 31, 2019; while group 2 comprised patients at the same time of the year during the COVID-19 pandemic. Groups 1 and 2 included 56 and 48 patients, respectively. The rate of presentation to the emergency service was higher in Group 2 (P < 0.02). The stage of the pathological lymph nodes and the rate of liver metastasis was higher in Group 2 (P < 0.004 and P < 0.041, respectively). The disease stage was found to be more advanced in Group 2 (P < 0.005). The rate of postoperative complications was higher in Group 2 (P < 0.014). The presentation of patients with suspicious findings to the hospital was delayed, due both to the fear of catching COVID-19 and to the pandemic precautions that were proposed and implemented by healthcare authorities worldwide. Among the patients who presented to the hospital with emergency complaints and in whom colorectal cancer was detected, their disease was at a more advanced stage and thus a higher number of emergency oncological surgical procedures were performed on those patients.

Aim: The objective of the study was to assess the impact of ozone (O₃) and trimetazidine on the intestines following ischemia–reperfusion (I/R) injury through the investigation of endoplasmic reticulum stress. Methods: Forty Sprague Dawley rats were separated into five groups. The groups were named as follows: control, O₃, I/R, I/R + trimetazidine (TMZ), and I/R + O₃. The control group had laparotomy and exploration of the superior mesenteric artery (SMA) only. Furthermore, alongside laparotomy and SMA exploration, an intraperitoneal (i.p.) administration of a 0.7 mg/kg ozone–oxygen (O₃-O₂) combination was given to the O₃ group. In the experimental groups, the SMA was blocked with the silk suture ligation technique for a duration of 1 h and then restored to normal blood flow for another hour. In the I/R + O₃ group, ozone was delivered i.p. at a dosage of 0.7 mg/kg, 30 min after ischemia. In the I/R + TMZ group, a dose of 20 mg/kg/day of trimetazidine was administered orally via gavage for a duration of 7 days, beginning 1 week prior to the induction of ischemia. Intestinal tissues were taken to assess indicators of intestinal mucosal injury and oxidative stress. Results: The level of the lipid peroxidation marker malondialdehyde (MDA) was significantly reduced in the experimental groups as compared to the I/R group (p < 0.05). The experimental groups had considerably greater levels of glutathione (GSH), which reflects antioxidant capacity, compared to the I/R group (p < 0.05). Nevertheless, the concentration of GSH was observed to be increased in the I/R + O₃ group in comparison to the I/R + TMZ group (p < 0.05). The histopathological damage score showed a substantial decrease in the experimental groups as compared to the I/R group (p < 0.05). The I/R + O₃ group had the lowest injury score. The experimental groups exhibited significantly reduced positivity of the endoplasmic reticulum (ER) stress markers C/EBP homologous protein (CHOP) and glucose-regulated protein (GRP)-78 compared to the I/R group (p < 0.05). Conclusions: The findings provide evidence for the potential advantages of utilizing ozone therapy in the treatment of intestinal ischemia–reperfusion injury. Additionally, they propose that ozone should be assessed in more extensive clinical trials in the future as a therapeutic agent that can disrupt endoplasmic reticulum stress.

Objective: This study was conducted to evaluate the potential radioprotective and therapeutic effects of dexmedetomidine (DEX), a selective α2-adrenergic receptor (α2AR) agonist, against ionizing X-ray-induced small intestinal injury in a dose-dependent manner. Methods: Male Sprague Dawley rats were randomly categorized into four groups. These groups were the Control, Ionizing Radiation (IR, 8 Gy X-ray), IR+DEX 100 µg/kg, and IR+DEX 200 µg/kg. DEX was administered intraperitoneally to the treatment groups 30 min before radiation exposure. All groups were sacrificed 24 h following irradiation. Firstly, the small intestinal tissues were evaluated histopathologically (H&E staining). Subsequently, levels of malondialdehyde (MDA) and glutathione (GSH), as markers of oxidative stress, were measured, and immunohistochemical expression of Caspase-3 and 8-hydroxy-2′-deoxyguanosine (8-OHdG) was analyzed. Results: In the IR group, significant histopathological alterations were observed, including villus atrophy and villus loss due to fusion, crypt loss, and mucosal degeneration. Additionally, there was an increase in MDA levels, a decrease in GSH levels, and a marked elevation in the expression of Caspase-3 and 8-OHdG. In the DEX-treated groups, particularly at the 200 µg/kg dose, significant improvements were noted in these parameters. It was determined that the histological architecture was largely preserved, oxidative stress was reduced, and apoptosis was suppressed. Conclusion: The findings suggest that DEX may effectively reduce X-ray-induced small intestinal injury in a dose-dependent manner, and that this effect is mediated through antioxidant and anti-apoptotic mechanisms. DEX holds potential for the prevention or treatment of radiation-induced gastrointestinal toxicities.

Introduction: Pilonidal sinus is most often seen in men between the ages of 15-30. It is regarded as a benign condition that most frequently affects the sacrococcygeal area. However, malignant degeneration can occur at a rate of 0.1%. Malignant degeneration patients tend to be older than 50, untreated for a long time, or to have relapsed frequently. Squamous cell carcinoma (SCC) is the most frequent type of cancer to appear on the pilonidal sinus's base. The first course of treatment is surgery. After surgery, local recurrence rates have been estimated at 40%. Adjuvant radiotherapy or chemoradiotherapy has an effect in reducing local recurrence. In this study, we looked at the frequency of cancer and potential risks as well as the value of routine pathological evaluation in patients who underwent pilonidal sinus surgery in our clinic during a ten-year period. Methods: We performed a retrospective analysis of 1070 patients who underwent pilonidal sinus surgery at the Recep Tayyip Erdoan University Training and Research Hospital between January 2012 and June 2022. Results: After a retrospective analysis of 1070 cases, 0.18% (n=2) of them had a malignancy developed on the basis of the pilonidal sinus, and the pathological result of both patients was reported as SCC. Additionally, one patient had histology that revealed tissue from the pilonidal sinus with a high Ki-67 index and significant mitotic activity. The mean age of the two patients with malignancy was 51. Patients with cancer were found to have complained for approximately 20 years. The patient with high Ki-67 index and mitotic activity was 60 years old, and had complaints for about 10-11 years. Conclusion: Pilonidal sinus has a risk of malignancy in patients with long-term existence, multiple recurrences, and those over 50 years of age. Despite the low rates of malignancy in the pilonidal sinus or the advanced age and long-term disease of the patients with malignancy risk, we advocate pathological examination of all specimens. ÖZ: Giriş: Pilonidal sinüs, sıklıkla 15-30 yaş aralığında ve erkeklerde görülmektedir. En sık olarak sakrokoksigeal bölgede görülmekte olup benign bir hastalık olarak kabul edilir. Ancak %0.1 oranında malign dejenerasyon da gelişebilmektedir Malign dejenerasyon saptanan hastaların büyük kısmı 50 yaş üstünde, uzun dönem tedavi olmamış veya birçok kez nüks etmiş vakalardır. Pilonidal sinüs zemininde gelişen malignitelerde en sık olarak squamoz sellüler karsinom (SCC) görülmektedir. Tedavide ise cerrahi ilk seçenektir. Cerrahi sonrası lokal nüks oranları %40 düzeylerinde bildirilmiştir. Lokal nüksü azaltmada adjuvan radyoterapi veya kemoradyoterapinin etkisi vardır. Çalışmamızda, pilonidal sinüs nedeniyle kliniğimizde 10 yıllık bir süreçte opere edilen olgularda, malignite insidansını ile olası riskleri saptamak ve rutin uygulanan patolojik incelemenin değerini gözden geçirmek amaçlanmıştır. Yöntem: Çalışmamızda Ocak 2012- Haziran 2022 tarihleri arasında T.C. Sağlık Bakanlığı Recep Tayyip Erdoğan Üniversitesi Eğitim ve Araştırma Hastanesi Genel Cerrahi Kliniğinde pilonidal sinüs hastalığı nedeniyle opere edişmiş 1070 olgu retrospektif olarak incelenmiştir. Bulgular: 1070 olgu retrospektif incelenmesi sonrasında %0.18’inde (n=2) pilonidal sinüs zemininde gelişmiş olan malignte mevcuttu ve her iki hastanın patolojik sonucu ise SCC olarak rapor edilmişti. Ayrıca bir hastada da patoloji sonucunda, Ki-67 indeks ve mitotik aktivitesi yüksek olan pilonidal sinüse ait doku saptandı. Malignite saptanan iki hastanın yaş 0rtalaması 51 idi. Malignite saptanan hastaların yaklaşık 20 yıl kadar süredir şikayetlerinin var olduğu saptandı. Ki-67 indeks ve mitotik aktivitesi yüksek olarak saptanan hasta ise yaşı 60 idi ve bu hastanın da yaklaşık 10-11 yıl kadar şikayetlerinin var olduğu saptandı. Sonuç: Pilonidal sinüs, uzun dönem var olan, çoklu olarak nüks eden ve 50 yaş üzerinde olan hastalarda malignite riskine sahiptir. Pilonidal sinüste malignite oranlarının düşük olması veya malignite riski olan hastaların da ileri yaş ve uzun dönem hastalıklı olmasına rağmen tüm spesmenlerin patolojik incelemesinin yapılması taraftarıyız.

SUMMARY OBJECTIVE: There are no guidelines regarding intraoperative or preoperative catheter removal in patients eligible for surgery following percutaneous drainage in acute cholecystitis. In this study, we evaluated the factors affecting the conversion to open surgery after percutaneous drainage and analyzed the relationship between catheter presence and time to operation in interval laparoscopic cholecystectomy. METHODS: In total, 50 patients with acute cholecystitis who underwent interval laparoscopic cholecystectomy after percutaneous drainage were retrospectively evaluated and grouped according to conversion to open surgery (Group 1) and non (Group 2). Factors that may be associated with conversion to open surgery and the presence of an intraoperative catheter were evaluated, and the time to surgery was calculated. RESULTS: There were 28 (56%) men and 22 (44%) women, and the mean age was 64 (±13) years. The severity of acute cholecystitis was moderate in 37 (74%) patients and severe in 13 (26%). When the groups were compared, no statistically significant difference was found between the presence of a catheter, the time of surgery 8 weeks before and after, and the conversion to open surgery. Postoperative hospitalization days were significantly higher in Group 1 (p=0.014). CONCLUSION: In patients who underwent interval laparoscopic cholecystectomy after insertion of a percutaneous drainage catheter in acute cholecystitis, the presence of a catheter and the waiting time for surgery after catheter insertion do not affect the rates of conversion to open surgery and complications.