SUMMARY INTRODUCTION: Obesity is a growing public health problem associated with many comorbid diseases. The aim of this study was to evaluate the relationship between body mass index and complications of thyroidectomy. METHODS: Patients who underwent total thyroidectomy between January 2015 and December 2018 were enrolled. Patients were divided into two groups, i.e., BMI <25 (group A) and BMI≥ 25 (group B). Demographics, operative time, and complications were retrospectively reviewed. RESULTS: The study included 145 patients (66 in Group A and 79 in Group B). There was no significant difference between the two groups in terms of age (p=0.330) and gender (p=0.055). No surgical site infection and bleeding complications were observed in any patients. The mean operative time was 148.4 minutes (90-235) in Group A and 153.4 minutes (85-285) in Group B (p=0.399). Transient hypocalcemia was observed in 25 (37.9%) patients in group A, and 23 (29.1%) patients in Group B (p = 0.291). Permanent hypocalcemia was not observed in any patient in group A, and in 2 patients in Group B (2.5%) (p = 0.501). Transient recurrent nerve palsy was observed in 1 (1.5%) patient in Group A and in 3 (3.8%) patients in Group B (p=0.626). None of the patients had permanent recurrent nerve palsy. Parathyroid autotransplantation was performed on 1 patient (1.5%) in group A and on 7 (8.9%) patients in Group B (p=0.055). CONCLUSION: We think there is no relationship between a high BMI and thyroidectomy complications, and surgery can also be performed safely in this patient group.

Spontaneous perforation of the nonspecific small bowel ulcer is a rarely seen condition that causes acute abdomen and mostly diagnosed perioperatively. A 72-year old female patient was admitted to emergency service with abdominal pain. Her physical examination was compatible with acute abdomen and peritonitis. Abdomen computerized tomography showed free air under the right diaphragm. She was operated with a presumptive diagnosis of gastrointestinal perforation. An isolated jejunal perforation on the opposite side of the mesentery was found perioperatively. A biopsy was taken, and the perforation was repaired with primary sutures. The patient died in the intensive care unit due to pulmonary complications on the fifth postoperative day. Although the biopsy was taken from the superficial tissue, it was consistent with an ulcer. Nonspecific jejunal ulcer perforations can be life-threatening because of the delayed diagnosis. Especially in elderly patients, it should be kept in mind as a cause of acute abdomen.

Aim:Prolonged stay in intensive care unit is associated with a high risk of mortality. Predictability of it is important to reduce mortality. The aim of this study is to determine the factors affecting prolonged stay in secondary general surgery intensive care unit.Materials and Methods: Between January 2014 and October 2017, 68 patients with prolonged stay undergoing general surgery ICU follow-up in the postoperative period after the general surgical procedure and the same number of randomly selected patients with similar characteristics were compared in two groupsResults:The median age of the patients with prolonged stay was 69,00 (22,50) and the median age of the patients in the control group was 59,00 (14,75) (p < 0,001).In prolonged stay group, 59 patients underwent abdominal emergency surgery, and 9 patients underwent abdominal elective surgery. The number of patients undergoing abdominal emergency procedures in the control group was 23, and the number of patients undergoing abdominal elective procedure was 45 ( p=0,001). Fourty eight of the patients in the prolonged stay group had mortality, 7 of the patients in the control group had mortality (p=0,001). As a result of multivariate analysis; in the prolonged stay group, emergency abdominal surgical procedure rate (p <0.001) (Odds ratio:12.983), age (p = 0.006) (Odds ratio:0.96) and mortality rate (p <0.001) (Odds ratio: 20,91) was found to be statistically significant.Conclusion: . Emergency abdominal surgical procedure, age and high mortality rate are associated with prolonged stay.