RESUMO
Purpose@#The aim of this study was to evaluate the effect of neuromonitoring on the number of lymph nodes (LNs) removed when applied during neck dissection. @*Methods@#A total of 166 patients receiving neck dissection due to papillary thyroid cancer were separated into 2 groups (monitoring group, n = 76; non-monitoring group, n = 90). @*Results@#The number of LNs dissected was observed to be statistically significantly higher in the monitoring group (P = 0.001), and the difference between the groups in the number of positive LNs was significant (P = 0.031). There was seen to be a negative relationship between the number of positive LNs dissected and recurrence (r = –0.404, P = 0.005). @*Conclusion@#Intraoperative neuromonitoring during neck dissection makes a positive contribution to the prevention of the development of recurrence by increasing the number of LNs excised and the number of metastatic LNs.
RESUMO
To investigate the factors associated with patients with Fournier's gangrene, and to clarify the effect of diabetes mellitus [DM] as a comorbid disease on morbidity and mortality of patients with Fournier's gangrene. Twenty-six Fournier's gangrene patients who were admitted to the Emergency Department of Ankara Numune Teaching and Research Hospital, Ankara, Turkey from 1997 to 2003 were examined retrospectively. The mean age of the patients was 52.8 years. There were 8 female [30.8%] and 18 male [69.2%] patients. The etiological causes were as follows: diseases of the perianal region, history of operations, trauma and injections. Major comorbid disease states were diabetes mellitus [DM] and hypertension. The lesions in Fournier's gangrene were most commonly located in the perineum and genital region. Female patients with diabetes mellitus had significantly unusual extensive involvement, especially abdominal wall involvement. The most frequently isolated pathogen was Escherichia coli, while staphylococcal infection was most commonly seen in the presence of DM. Colostomy was performed on 53.8% of the patients, and cystostomy on 7.6% of the patients. Average time of staying at the hospital was 25 days with a mortality rate of 34.6%. Patients with DM had high mortality rates and stayed longer at the hospital than the non-diabetic patients. In addition to early diagnosis, early and aggressive debridement and administration of multiple wide spectrum antibiotics chosen for the causative agent are the golden standard for decreasing the mortality and morbidity. Diabetes mellitus has been found to be an important factor to increase mortality rates of patients with Fournier's gangrene