Comparison of Unilateral Fasciocutaneous V-Y Flap Technique with Cleft Lift Procedure in the Treatment of Recurrent Pilonidal Sinus Disease: A Retrospective Clinical Study.

BACKGROUND This study aimed to assess treatment outcomes of the cleft lift procedure and V-Y flap technique in the treatment of recurrent pilonidal sinus disease (PSD). MATERIAL AND METHODS A total of 51 patients who underwent cleft lift procedure and 43 patients who underwent fasciocutaneous V-Y flap technique were evaluated. The demographic characteristics, previous operations, duration of symptoms, perioperative complications, duration of operation and hospital stay, duration of draining of all patients, and recurrence of PSD were recorded. RESULTS The mean operation time was 35.61±5.254 min in the cleft lift group (CLG) and 57.42±7.327 min in the V-Y flap group (VYFG) (p=0.001). No wound dehiscence was found in the VYFG and 5 patients (9.8%) had wound dehiscence in the CLG (p=0.035). Draining time was 1.39±0.603 days in the CLG and 2.79±0.638 days in VYFG (p=0.001). The mean hospital stay was 1.75±0.523 days in the CLG and 3.77±1.02 days in the VYFG (p=0.001). Two patients (3.9%) in the CLG had recurrence and no recurrence was reported in the VYFG (p=0.189) in the given time interval. CONCLUSIONS Both methods in treatment of recurrent PSD can be preferred because of low complication and recurrence rates. Because no recurrence was found after the V-Y flap technique, it appears to be a preferable method despite some disadvantages.

Emergency Endoscopy and the Importance of Endoscopy Training in General Surgery Residency: A Survey-Based Study.

BACKGROUND Emergency endoscopy is a life-saving technique of great significance. The aim of our study was to draw attention to endoscopy training activities of general surgeons and their opinions on this issue. MATERIAL AND METHODS We asked general surgery specialists where they received their general surgery training, the institution where they currently worked, how many years they had been practicing, if they had endoscopy training during or after residency, if a gastroenterologist was available in their hospital, and whether they used endoscopy. We also asked some questions, including 'Should general surgeons perform emergency or elective endoscopy?', 'Is endoscopy training required in general surgery', and 'What is your opinion regarding this issue?', and we assessed the answers. RESULTS Of the 138 general surgeons undertaking surveys, 63% of participants received their general surgery training in university hospitals and 37% in training and research hospitals. The duration of practicing as a general surgeon was 5 years for 23.9%, 5-15 years for 38.4%, 15-20 years for 20.3%, and over 20 years for 17.4% of participants. The rate of receiving endoscopy training at residency was 51.4%, 25.4% did not have endoscopy training, and 23.2% had postgraduate training. All participants replied affirmatively to the question 'Should general surgeons perform emergency or elective endoscopy?'. CONCLUSIONS Although endoscopy has been widely used recently, gastroenterologists are not available in every hospital. Consequently, it is evident that endoscopy should be part of general surgery training.

Insulinoma-Induced Hypoglycemia in a Patient with Insulinoma after Gastrojejunostomy for Prepyloric Ulcer.

Hyperinsulinism due to dumping syndrome following gastric surgery is an uncommon condition. It is specified with hypoglycemic attacks. However, linking symptoms to dumping syndrome in each patient to whom gastric surgery was performed leads to inappropriate diagnosis and therapy. Insulinoma and other causes that give rise to hyperinsulinemia should not be ignored and these diagnoses should be excluded. In this paper, 71-year-old male patient who was followed up for 2 years with a false conclusion of dumping syndrome and operated on due to insulinoma diagnosed at endoscopic ultrasonography is presented in the light of the literature.