PROSPECTIVE EVALUATION OF SURGICAL MARGINS IN NON-MUSCLE INVASIVE BLADDER CANCER FOLLOWING PRIMARY TRANSURETHRAL RESECTION.

PURPOSE: Non-muscle invasive bladder cancers (NMIBC) constitute approximately 75% of bladder cancer cases. Primary transurethral resection (TUR) plays a pivotal role in both diagnosis and treatment. However, despite initial resection, tumors are often missed, leaving behind microscopic residual tumors. This study aims to prospectively investigate the surgical margins of tumors, which may serve as a potential source of residual tumors. MATERIALS AND METHODS: Seventy patients diagnosed with NMIBC who underwent primary TUR were enrolled in this study. Following initial resection, samples were collected from the normal-appearing mucosa extending 1 cm beyond the surgical margins. Lesions were categorized as 'healthy margins' for benign lesions, 'tumoral margins' for urothelial cancer, and 'dysplastic margins' for urothelial dysplasia. Clinical and pathological features of these groups were compared, and risk factors for detecting transitional cell carcinoma (TCC) in the normal-looking mucosa were analyzed. RESULTS: The tumoral margins group showed a significantly higher rate of T1 stage tumors compared to the healthy margins group, and a significantly higher rate of high-grade (HG) tumors compared to the dysplastic margins group. Moreover, the tumoral margins group had a significantly higher proportion of high-risk patients (85.7%) compared to the other groups, while the healthy margins group had a significantly higher proportion of low-risk patients (35.3%) compared to the tumoral margins group (0.0%). Additionally, the tumoral margins group demonstrated a significantly higher rate of carcinoma in situ (CIS) compared to the healthy margins group (35.7% vs. 5.9%). Detection of urothelial cancer at the margins was associated with T1 stage, HG stage, and the presence of CIS based on univariate analyses. CONCLUSION: To minimize residual tumors and prevent recurrence in patients undergoing primary TUR, we advocate for the resection of macroscopically visible tumors with nearly 2 cm of intact bladder tissue, thereby enhancing the quality of TUR.

Pediatric Craniofacial and Neck Burns.

This study aimed to determine the epidemiological features, risk factors, current management trends and prognosis associated with injury severity in paediatric craniofacial and neck burn injuries. In the study conducted between January 2016 and January 2022, the data of 204 paediatric patients with head and neck burns hospitalised in Gazi Yasargil Training and Research Hospital Burn Centre were scanned from medical records in a hospital computer. Of the total 204 patients, 114 (55.9%) were boys and 90 (44.1%) were girls. The age group most affected by burn trauma was the 1-4 age group at 55.4%. Scald burns were the most common cause in all age groups. Electrical, chemical and sunburns were rare causes. Among the patients, 97 (47.5%) developed acute conjunctivitis due to burns. Among the patients, 91 (44.6%) lived in rural areas and 113 (55.4%) in urban areas. The wound culture results of the patients were 24% positive, and the most common bacteria were Staphylococcus hominis (5.4%) and Staphylococcus aureus (4.9%). During follow-up, neck contracture developed in six (2.94%) patients with neck burns. Four (1.96%) patients died because of sepsis. The mean hospital stay was 5.49 ± 4.14 days. Craniofacial and neck burns in the paediatric population are complex and leave sequelae after burns, often requiring advanced care. Children are at risk for injury by liquid, kitchen and chemical products, which serve as common caustic injury mechanisms.

A rare type of burn : Nylon burns.

Objectives: In this study, it was aimed to examine nylon burns in paediatric patients and compare the results with other causes of hot object contact burns. Material and Methods: A 10-year retrospective study was conducted on 77 paediatric patients hospitalized for hot body burns at Gazi Yasargil Training and Research Hospital Burn Center. Results: Of those patients with hot body burns, 72.7% (n= 56) were males and 27.3% (n= 21) were females. Male-to-female ratio was 2.67:1. Mean age of the patients was 4.79 (min= 1, max= 16) years. There were 42 patients who applied to our hospital on the day of their burn, while four patients applied one day after the burn, one patient applied two days after the burn, 13 patients applied three days after the burn and 17 patients applied five days after the burn. Most burns (79.3%) were third-degree burns, whereas 19.5% were seconddegree and 1.2% were fourth-degree burns. The most common causes of hot body burns were hot nylon and hot stoves, followed by hot ash and hot irons. The number of nylon burns was the highest in the summer and the highest number of hot stove burns occurred in the winter. Nylon burns were most common in the three to eight age group and then gradually decreased. The highest burn rate was observed in nylon burns. Conclusion: The most common cause of all burns in the Turkish paediatric population is scalding. Although nylon burns are rare, they draw attention due to their higher burn degrees.

Diagnostic importance of serum C-reactive protein and procalcitonin in sepsis after burn.

INTRODUCTION: In this study, we investigated the usefulness of blood white blood cell (WBC), C-reactive protein (CRP) and Procalcitonin (PCT) levels with a clinical diagnosis of infection in patients with severe burns, with a bacterial culture (+) wound site, in patients with SIRS and sepsis. MATERIALS AND METHODS: In the study, 23 patients with (+) burn wound culture hospitalized in the intensive care unit of Gazi Yasargil Training and Research Hospital Burn Center burn between January 2016 and January 2021 were analyzed. While five of these patients were showing symptoms of SIRS. Sepsis was observed in five patients. RESULTS: From 23 patients, 18 (78.3%) were male, and 5 (21.7%) were female. The majority of our patients were lived in rural areas. The average age of patients was 1,061±17,273 years. The wound culture results of the 23 patients were (+), mostly due to Staphylococcus aureus in 21.7% (n=5) and Staphylococcus epidermidis in 21.7% (n=5). PCT and CRP results did not statistically differ in patients with sepsis, SIRS and (+) wound culture. CONCLUSION: The laboratory biomarkers WBC, CRP and PCT do not have a superior value in determining and monitoring infection processes in patients with serious burns.

Flame burns.

Flame burns lead to significant long-term morbidity and functional consequences. This study analyzed the mortality-related factors in patients with flame burns to compare with the existing literature. This retrospective descriptive study was carried out at the General Surgery Clinic, Gazi Yasargil Training and Research Hospital, Turkey, to include 131 patients admitted and treated with emergency surgery for flame burns between January 2016 and December 2019. Of the patients hospitalized for flame burn, 103 (78.6%) were male and 28 (21.4%) were female (M:F = 3.6) with a mean age of 25.3 ± 20.78 years. The 15-34 years age group was the most affected by flame burns. The most frequently affected body areas were the upper extremities and face (n = 68, 51.9%); conjunctivitis developed in 49 (37.4%) patients. The wound infection rate was 34.3%, and Staphylococcus epidermidis had the highest growth rate in wound culture results (24.4%). Flame burns were most common in winter and autumn. The majority of patients (n = 95, 72.5%) were treated with escharectomy and dressing, while grafting was performed in 36 (27.5%) patients. A total of 3 (2.2%) patients died-one died in a suicide attempt, one due to inhalation burn after flame burn, and another died due to sepsis. The average length of hospital stay was 8.0 ± 3.9 days. Flame burns are much more common in young men, causing deeper and wider burns and requiring greater surgical intervention. This leads to frequent wound infections and longer hospital stays.