Trephine Colostomy: Minimally Invasive Stoma Technique.

Aims: Stoma is an important part of surgical management of numerous malignant or benign anorectal diseases and anorectal injuries. This can be performed without recourse to laparatomy. This study was aimed to assess the outcome of trephine to loop sigmoid colostomy creation. Study Design: The retrospective study included 18 patients who underwent trephine colostomy due to various conditions including Fournier’s gangrene, inoperable anorectal cancer, recto-vaginal fistula, fecal incontinence, and rectal injury. Place and Duration of Study: Izmir Katip Celebi University Ataturk Training and Research Hospital, Department of Surgery between January 2005 and January 2015. Methodology: The retrospective study included 18 patients who underwent trephine colostomy. Demographic characteristics, primary pathology for colostomy decision, length of hospital stay, anesthesia technique, and early period surgical complications at 3 months were recorded. Results: Patients comprised 11 males and 7 women with a mean age of 53±5 years. The indications for stoma formation were Fournier’s gangrene in 8 cases, inoperable anorectal cancer in 3 cases, high recto-vaginal fistula in 2 cases, fecal incontinence in 3 cases and rectal injury in 2 cases. Regional anesthesia was performed in 12 and general anesthesia in 6 cases. Only one patient (5.6%) had stricture of the stoma. There were no other complications and no additional morbidity and mortality related to TS technique. Conclusion: Trephine stoma is a relatively simple, safe and rapid procedure and an effective alternative to colostomy formation without laparotomy indications.

Thick-needle vacuum-assisted biopsy technique for inflammatory breast carcinoma diagnosis

PURPOSE: Inflammatory breast carcinoma (IBC) is a rare clinicopathological cancer type with unique clinical features and a poor prognosis. In this disease, there is generally no palpable mass in the breast. IBC can be mistakenly diagnosed as mastitis and patients may receive a delayed diagnosis and treatment, since these two disorders cause similar pathological appearences on the breast. Clinical suspicion of the disease followed by histopathological observation of occluded dermal lympthatics by tumor emboli leads to definitive diagnosis of IBC. METHODS: Here, we report our experiences in diagnosing IBC using Thick-Needle Aspiration Biopsy (TNAB). RESULTS: Eight patients having clinically suspected IBC, received TNAB. IBC was definitively diagnosed upon observation in histopathological examination of occluded dermal lymphatics by tumor emboli since TNAB allowed adequate tissue sampling. CONCLUSION: In this study, we showed that IBC can be reliably diagnosed using TNAB.

OBJETIVO: O carcinoma inflamatório da mama (CIM) é um raro tipo histopatológico do câncer mamário, com características clínicas especiais e prognóstico reservado. Nesta doença, geralmente não se palpa nódulos mamários. O CIM pode equivocadamente ser diagnosticado como mastite e gerando um retardo no diagnóstico e tratamento, visto que ambas as doenças tem apresentação semelhante. A suspeita clínica da doença seguida da observação histopatológica de embolia tumoral com oclusão dos linfáticos da derme conduz ao diagnóstico definitivo de CIM. MÉTODOS: Relata-se o procedimento no diagnóstico de CIM utilizando a biópsia de aspiração por agulha de grosso calibre (BAAGC). RESULTADOS: Oito pacientes com suspeita clínica CIM foram submetidos a BAAGC. Todos os casos receberam diagnóstico definitivo de CIM após caracterização histopatológica da biópsia. BAAGC permitiu a amostragem adequada do tecido. CONCLUSÃO: O CIM pode ser diagnosticado utilizando BAAGC.