Purpose: Pilonidal sinus disease (PD) is a chronic, recurrent inflammatory condition primarily affecting the sacrococcygeal region, often resulting in discomfort, abscess formation, and recurrent disease. Various surgical interventions, including laser ablation, have been employed to treat recurrent PD. This study evaluates the efficacy of laser ablation in patients with recurrent PD, focusing on treatment success, recurrence rates, complications, and recovery outcomes. Methods: A retrospective analysis of 37 patients with recurrent pilonidal sinus disease treated with laser ablation between January 2022 and January 2025 was conducted. Preoperative data, postoperative complications, healing time, Visual Analog Scale values, and return to normal activities were collected. Results: The results showed that 70.3% of patients achieved complete healing without recurrence, while 21.6% experienced recurrence within a mean follow-up of 9.6 months. Five patients (13.5%) developed superficial infections, which were managed with local dressing. The median time for wound healing was 35 days, and patients returned to normal activities in an median of 1 day. Persistent disease was observed in 8 patients (21.6%), of whom 5 patients (62.5%) achieved full epithelialization after retreatment with laser ablation. Conclusion: The ease of application, avoidance of hospitalization, minimal postoperative care, and rapid return to daily activities make laser treatment a safe and effective therapeutic option for patients with recurrent pilonidal disease, supported by favorable outcomes and low morbidity.

BACKGROUND:Enterocutaneous fistula is an abnormal communication between the gastrointestinal tract and skin. One-third of enterocutaneous fistulas disappear spontaneously, but the rest of them require surgical treatment. CASE REPORT:We describe the case of a 34-year-old woman with enterocutaneous fistula that she had had for year. She had previously undergone 2 unsuccessful operations, and the fistula recurred twice. Distal subtotal gastrectomy and Billroth 2 reconstruction were performed. In the pathological examination, the distal gastrectomy specimen revealed foci of ulceration. Well-circumscribed non-necrotizing granulomas were occasionally encountered beneath the ulcers. CONCLUSIONS:Failure of treatment in recurrent fistula management has a variety of reasons. Our clinical experience shows that granulomatous gastritis can be a complicating factor in treatment of recurrent enterocutaneous fistula.

BACKGROUND Liver transplant (LT) recipients have an increased risk for the development of postoperative atrial fibrillation (POAF). POAF has been associated with serious long-term outcomes such as thromboembolic events, stroke, heart failure, and even graft instability. MATERIAL AND METHODS We assessed potential clinical, biochemical, and ECG predictors of POAF in LT recipients between 2012 and 2024.The patients were divided into 2 groups: POAF and non-POAF (34.5%, n: 38 and 65.4, n: 72, respectively). RESULTS Basal characteristics and comorbidities of the 2 groups were similar. Patients in the POAF group had significantly higher heart rates (81.16±18.62 bpm vs 65.11±12.47 bpm, P<0.01) and longer maximal P-wave durations (169.47±20.41ms vs 145.06±33.99 ms, P<0.01). Maximal P-wave duration, PR interval, P-wave peak time in lead II (PWPT-II), QRS duration, and QTc interval were also significantly longer in the POAF group compared to the non-POAF group. With these consistent findings, we may consider that changes or abnormalities in P-wave indices are significant indicators of atrial conduction delay, even before the development of LA enlargement. CONCLUSIONS Our results are valuable in providing the prediction of POAF, which may be associated with major adverse outcomes such as mortality in LT recipients, using a simple and inexpensive tool like ECG. Such risks can be minimized by strategies such as optimization of beta-blocker therapy, fluid and electrolyte balance, and intraoperative temperature regulation.

BACKGROUND Living donor liver transplantation (LDLT) has been shown to be safe in the curative treatment of liver cirrhosis. Portal flow modulation techniques, such as splenic artery ligation (SAL), have been used to avoid complications like small-for-size syndrome (SFSS). However, the effects of SAL on portal flow, splenic function, and hematologic outcomes remain underexplored. MATERIAL AND METHODS This retrospective study analyzed 60 LDLT recipients treated at a single center from January 2023 to December 2024. Thirty patients underwent SAL (SAL+) while 30 did not undergo SAL (SAL-). Data on demographic and clinical characteristics, portal flow dynamics, spleen volume, hematologic parameters, and postoperative complications were collected and analyzed using IBM SPSS 20.0. Statistical significance was set at P<0.05. RESULTS SAL significantly reduced portal flow from 3148±989 mL/min to 1949±830 mL/min (P<0.001), optimizing the portal flow/graft weight ratio. SAL also decreased splenic volume by 21% and alleviated thrombocytopenia, with postoperative platelet counts increasing 3.8-fold compared to preoperative levels (P<0.001). There were fewer complications in the SAL+ group, with significant reductions in biliary complications and improved graft function. No severe ischemic splenic changes or thromboembolic events were observed in the SAL+ group. CONCLUSIONS SAL is an effective strategy for portal flow modulation in LDLT, significantly reducing portal flow to optimal levels and improving hematologic outcomes. By preserving splenic function and minimizing complications, SAL is a safe and beneficial approach to managing SFSS and improving graft performance in LDLT patients.