Purpose: A significant number of the protective stomas temporarily applied in order to reduce the effects of anastomosis complications after rectal cancer surgery cannot be closed and become permanent. In this study, the causes that can lead to a permanent stoma were investigated.Materials and Methods: Patients who underwent elective surgery with low anterior resection and protective ileostomy due to rectal cancer were included in the study. Patients whose stoma could not be closed within one year were evaluated as permanent stoma.Results: 66 patients were included in the study. The mean closing time for the stomas were found as 5, 6 +2,5 (1-12)months. The stomas of twelve (18.2%) of the patients could not be closed and became permanent. The presence of metastatic disease at the time of diagnosis, the proximity of the anastomosis to the anal entry, coloanal anastomosis, and the final pathology showing stage IIIC were found to be risk factors for permanent stoma.Conclusion: Some of the stomas applied temporarily due to surgical treatment of rectal cancer became permanent. Before the index operation, the patient and their relatives should be informed that in the presence of certain risk factors, these stomas may not be closed and become permanent.
1 January 2020 in Annals of Surgical Treatment and Research
Background: Periductal mastitis (PM) is a rare disease characterized by chronic inflammation of the terminal mammary ducts. Complete removal of terminal lactiferous ducts with Hadfield procedure is a previously defined technique in treatment but carries various complications risks. This study aims to evaluate the effectiveness of modified techniques in the treatment of PM. Methods: Twenty women who underwent surgery due to PM between January 2012 and December 2019 were retrospectively analyzed. Types of PM were determined. All patients were operated on with three different incisions [Hadfield’s operation with periareolar incision (n:11), periareolar combined radial incision (n:7), and round block incision (n:2)]. Results: The mean age was 37.5 ± 6.5 years (range: 24–49). Sixty percent of patients had type 3 PM. In Hadfield’s procedure, NAC retraction (n:2), seroma (n:1), and hematoma (n:1) were seen. In the periareolar incision combined radial incision group only one patient had complications (seroma) and none in the round block method. Follow-up was 12 ± 1.5 months and disease relapse occurred in two patients in the Hadfield group. Patients who underwent round block were more satisfied with the appearance of the nipple. Conclusions: In the treatment of PM, the main principle of surgical treatment is the excision of the affected canal with a clear margin. Apart from the classical Hadfield procedure, the round block method and periareolar combined radial incision techniques can be performed in the treatment of PM.
Purpose: The aim of this study is aimed to demonstrate the changes in the tumor diameter and expressions of vascular endothelial growth factor (VEGF), estrogen receptor (ER), progesterone receptor (PR), Ki-67, and Cerb-B2 status after neoadjuvant chemotherapy in the patients with locally advanced breast cancer.Materials and Methods: Sixty-nine patients who diagnosed with locally advanced breast cancer and treated with were prospectively evaluated. The tumor diameter and VEGF, Ki-67, ER, PR, and Cerb-B2 expressions tested by immunohistochemistry (IHC) were evaluated before and after neoadjuvant chemotherapy.Results: There was a statistically significant reduction in the tumor diameter and in the expression of VEGF, Ki-67, ER, PR, and Cerb-B2 after neoadjuvant chemotherapy. Conclusion: The significant reduction in VEGF expression suggests that the tumor angiogenesis and its metastatic ability may be reduced by neoadjuvant chemotherapy. The significant change in the Ki-67 proliferation index may suggest the reduced proliferative activity of malignant cells with neoadjuvant chemotherapy.