Objective: Perianal fistulas are a common yet complex anorectal condition requiring precise anatomical assessment and tailored surgical management. Magnetic resonance imaging (MRI) is increasingly utilized for guiding preoperative surgical planning. This study, therefore, aimed to evaluate the clinical characteristics, the diagnostic performance of MRI, and the postoperative outcomes in patients who underwent surgical treatment for perianal fistulas. Methods: A retrospective analysis was conducted on 111 patients who underwent perianal fistula surgery between January 2018 and January 2020. Demographic data, fistula classification (Parks and St. James's), surgical techniques, recurrence, morbidity, and Wexner incontinence scores were recorded. The diagnostic accuracy of MRI was calculated using intraoperative findings as the reference standard. Results: The median patient age was 45 years, with a strong male predominance (87 patients, 78.4%). The most common fistula type was intersphincteric (70 patients, 63.1%), followed by transsphincteric (33 patients, 29.7%) and suprasphincteric (8 patients, 7.2%). Seton placement was the most frequently performed surgical intervention (72.1%) [Düzeltme Gerekli - Ana Metin Kontrolü]. Postoperative fecal incontinence was observed in 7.2% of patients, and the recurrence rate was 8.1%. MRI demonstrated the highest diagnostic accuracy for suprasphincteric fistulas (sensitivity 100%, specificity 99%). Intersphincteric fistulas also showed high sensitivity (96%) but lower specificity (67.5%). Transsphincteric fistulas, however, demonstrated the lowest sensitivity (68.9%). Conclusion: Conclusion: MRI is confirmed as a highly effective tool in the preoperative evaluation of perianal fistulas, particularly for identifying suprasphincteric tracts. Surgical treatment is generally safe, yielding acceptable rates of recurrence and continence impairment. Further prospective studies are warranted to validate these findings and optimize treatment strategies.

Objective: Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are important treatment modalities used in advanced gastrointestinal malignancies. YouTube is among the most frequently consulted sources of information about these procedures by both the public and healthcare professionals. This study aimed to evaluate the content, quality, comprehensibility, and accuracy of CRS and HIPEC videos on YouTube.Methods: A YouTube search was performed using the keyword “cytoreductive surgery HIPEC,” and the first 180 videos were analyzed. Videos were categorized by source (physician, institutional, media, patient). Data on voice narration, subtitles, language, comments, likes, views, and video length were recorded. In addition, each video was assessed for quality, comprehensibility, and accuracy using a 5-point Likert scale.Results: In total, 52.2% of the analyzed videos were media-based, 28.3% institutional, 17.4% physician, and 2.2% patient-based. While 91.8% had voice narration, only 5.4% included subtitles. The mean video length was 13.3±21.8 minutes, and the mean number of views was 4667±16,932. The mean quality score was 2.47±1.08, comprehensibility score 2.69±1.02, and accuracy score 2.80±1.04. Physician and institutional videos had significantly higher quality (p

SUMMARY OBJECTIVE: In T4 colorectal cancer, the risk of peritoneal carcinomatosis is high, and the prognosis is poor. The aim of this study was to assess recurrence risk factors, peritoneal recurrence rates, and survival outcomes in patients radiologically diagnosed with T4 tumors who underwent curative surgery with prophylactic hyperthermic intraperitoneal chemotherapy. METHODS: Between January 2018 and December 2022, 38 radiologically diagnosed T4 colorectal cancer patients who underwent prophylactic hyperthermic intraperitoneal chemotherapy were retrospectively analyzed. All patients had R0 resection; those with intraoperative macroscopic peritoneal or distant metastases were excluded. Demographic data, tumor location, histopathology, and pathological T/N stages were recorded. During follow-up, local/distant recurrence, peritoneal carcinomatosis, metastatic sites, and mortality were assessed. RESULTS: The median age was 57 years, and 57.9% were male. The primary tumor originated mainly from the colon (81.6%), with moderately differentiated adenocarcinoma being the most common histology (57.8%). Recurrence occurred in four patients (10.5%): 2 hepatic, 1 pulmonary, and 1 peritoneal, with no local recurrence. One patient (2.6%) died within 90 days; no additional mortality was observed. Median overall survival was 55 months (95%CI 49.82–60.90). Univariate analysis showed no significant association between recurrence and tumor location, differentiation, pT or pN stage, or histologic subtype. CONCLUSION: In cT4 colorectal cancer patients treated with prophylactic hyperthermic intraperitoneal chemotherapy, recurrence was infrequent, peritoneal recurrence was rare, and radiological staging frequently overestimated tumor depth, supporting a potential benefit of prophylactic hyperthermic intraperitoneal chemotherapy in this setting.

Background: Incisional hernia is a common late complication after extensive abdominal surgery and may significantly impair quality of life. The incidence and risk factors of incisional hernia in patients undergoing cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal surface malignancies of colorectal or appendiceal origin remain insufficiently studied. This study aimed to evaluate the incidence of incisional hernia and to identify factors associated with incisional hernia in this specific patient population. Methods: This retrospective, single-center cohort study included 147 patients who underwent CRS+HIPEC between January 2018 and January 2024. Demographic data, tumor characteristics, surgical details, and comorbidities were obtained from a prospectively maintained database. All patients underwent midline laparotomy, and HIPEC was performed using either mitomycin C or oxaliplatin with 5-fluorouracil/leucovorin via the closed technique at 42–43 °C for 30–90 min. Patients were followed for at least 18 months, and incisional hernia was diagnosed by physical examination and/or radiologic imaging. Univariable and multivariable logistic regression analyses were used to identify associated factors. Results: The mean age was 54.07 ± 11.70 years, with an equal sex distribution, and the mean follow-up was 30.7 ± 16.2 months. During follow-up, 83 patients (56.5%) developed an incisional hernia. Prior open abdominal surgery (OR 2.621; 95% CI 1.155–5.946; p = 0.021) and a history of hernia (OR 13.682; 95% CI 2.928–63.941; p < 0.001) were significant predictors in univariable analysis and remained independently associated with incisional hernia in multivariable analysis. Conclusions: The incidence of incisional hernia after CRS+HIPEC is high, and patients with previous open abdominal surgery or preexisting hernia should be considered at increased risk during preoperative assessment and postoperative follow-up.

Prognostic Value of Log Odds of Positive Lymph Nodes (LODDS) in Gastric Cancer: A Comparative Analysis with Lymph Node Ratio and N Stage - Archives of Basic and Clinical Research