BACKGROUND:Appendiceal neoplasms are rare and generally determined in appendectomy specimens for acute appendicitis. Depending on a tumor’s histopathology and size, appendectomy or right hemicolectomy are the surgical treatment options. Adenocarcin...

Introduction: To evaluate the impact of serum and peritoneal levels of tumour markers on peritoneal carcinomatosis and survival in gastric adenocarcinoma. Materials and methods: Patients with gastric adenocarcinoma were evaluated with regard to serum and peritoneal carcinoembryonic antigen (CEA) and CA19-9. Numeric values and groupings based on serum and peritoneal cutoff values were used. Development of peritoneal carcinomatosis, including positive washing cytology, was regarded as main outcome. Gastric cancer outcomes as disease free and overall survival were analysed. Results: There were 67 patients with a mean age of 60 ± 11 years. Positive peritoneal washing cytology was significantly associated with serum CA19-9 and high serum CA 19–9 group (P = 0.033 and P = 0.011, respectively). High peritoneal CEA was shown to be significantly associated with peritoneal carcinomatosis (P = 0.032). After a median follow up of 17 months, 48 patients (71.7%) were alive. Patients with peritoneal carcinomatosis showed significant poorer prognosis as shown by overall survival rate of 28.6%. Only serum CEA was significantly associated with lower disease free and overall survival (P = 0.002 and P = 0.001, respectively). Discussion and conclusion: Serum CEA is shown to be significantly associated with poor prognosis for gastric cancer patients. Serum level of CA19-9 and high peritoneal CEA levels are significant predictors for positive peritoneal washing cytology and the development of peritoneal carcinomatosis, respectively. Therefore, the possible impact of serum and peritoneal tumor markers especially on the staging and prognosis of gastric cancer remains to be clarified by future studies.

Introduction. Hydatidosis is a zoonotic infection and treatment is mandatory to avoid complications. Surgery remains the first choice in the treatment especially for CE2-CE3b cysts. Open or laparoscopic approaches are available. However, comparative studies are limited. Materials and Methods. Data of patients who underwent cystotomy/partial cystectomy for liver hydatidosis between January 2012 and September 2016 (n=77) were evaluated retrospectively. Recurrent cases and the patients with previous hepatobiliary surgery were excluded. 23 patients were operated upon laparoscopically and named as Group 1. 48 patients operated conventionally named as Group 2. Demographics, cyst characteristics, operative time, length of hospital stay, recurrences, and surgery related complications were evaluated. Results. Groups were similar in terms of demographics, cyst characteristics, and operative time. The length of hospital stay was 3.4 days in Group 1 and 4.7 days in Group 2 (p=0,007). The mean follow-up period was 17.8 months and 21.7 months, respectively (p=0.170). Overall complication rates were similar in two groups (p=0.764). Three conversion cases occurred (13%). One mortality was seen in Group 2. Four recurrences occurred in each group (17% versus 8.3%, respectively) (p=0.258). Conclusions. Laparoscopy is a safe and feasible approach for surgical treatment of liver hydatidosis. Recurrence may be prevented by selection of appropriate cases in which exposure of cysts does not pose an intraoperative difficulty.

Pilonidal sinus disease (PSD), most commonly seen in young men, is a chronic disease resulting from the pilosebaceous in the sacrococcygeal region. There is still no standardization in surgical treatment. In this study, the effectiveness, follow up outcomes and quality of life level were compared between Karydakis flap (KF) and Limberg flap (LF) operations. Among the patients who had undergone PSD surgery in our clinic between 2015 and 2016, those who could be reached and who received KF (n= 53) and LF (n= 51) operations were included into the study. Clinical data of these patients were retrospectively evaluated. Postoperative satisfaction levels of the patients were determined with Cardiff wound healing survey questions and visual analog scale. Mean operational time was 54 (44-75) minutes in the LF group and 45 (35-60) minutes in the KF group, and it was statistically significant (p= 0.001). Mean time to return to work was 14.3 (9-28) days in the LF group and 17.6 (10-30) days in the CF group and was statistically significant (p= 0.001). The rates of complications and recurrence were lower in the LF group although the difference was not statistically significant between the groups (p> 0.05). Mean psychosocial assessment score was 70.3 (57.5-88.7) in the KF group and 73.4 (53.5-87.5) in the LF group and the difference was statistically significant (p= 0.001). LF was a more reliable and preferable method compared to KF because of earlier return-to-work, lower rate of recurrence at long term follow up, and higher psychosocial satisfaction.