The Relationship between Pathological Features and 18 F-FDG PET/CT that Changed the Surgeon's Decision as Neoadjuvant Therapy in Breast Cancer.

Objective Patients diagnosed with breast cancer and decided to undergo surgical treatment can undergo neoadjuvant therapy following their 2-deoxy-2-[fluorine-18]fluoro-D-glucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) findings. The present study aims to determine the statistical significance of these patients whose treatment plan was changed and the reasons for the change in the plan. Materials and Methods The demographic features and treatment plans of 151 cases who were diagnosed with any stage of breast cancer were evaluated. These patients consist of those who admitted to Mersin University Hospital Breast Outpatient Clinic between January 2016 and December 2019. All of these patients aged between 41 and 85 years were examined with 18 F-FDG PET/CT after the decision for surgical treatment is made. The analysis included tumor pathology, side, type, subtype, size, and centricity in this study. Results About 18.5% ( n = 28) of patients' treatment plan was changed after 18 F-FDG PET/CT. They received neoadjuvant therapy. About 81.5% ( n = 123) of patients did not receive neoadjuvant therapy. Significant differences were observed between patients changed treatment plan and not changed concerning age, lymph node involvement, tumor size, centricity, and subtypes parameters. Conclusion Conventional imaging examinations are used in patients with breast cancer. These examinations may not be sufficient to determine advanced disease requiring neoadjuvant treatment. With 18 F-FDG PET/CT examination, these advanced stage patients are not overlooked. In our study, approximately one in five patients, treatment plan changed after 18 F-FDG PET/CT examination.

Current status of laparoscopic surgery usage in Türkiye: A middle-income country.

Objectives: This study aimed to determine the usage status of laparoscopic procedures in general surgical practice in Türkiye, which is a sample of middle-income countries. Material and Methods: The questionnaire was sent to general surgeons, gastrointestinal surgeons, and surgical oncologists who have completed their residency training and are actively working in university, public or private hospitals. Demographic data, laparoscopy training and the period of education, the rate of laparoscopy use, the type and volume of laparoscopic surgical procedures, their views on the advantages and disadvantages of laparoscopic surgery, and the reasons for preferring laparoscopy were determined with a 30-item questionnaire. Results: Two hundred and forty-four questionnaires from 55 different cities of Türkiye were evaluated. The responders were mainly males, younger surgeons (F/M= 11.1/88.9 % and 30-39 y/o), and graduated from the university hospital residence program (56.6%). Laparoscopic training was frequently taken during residency (77.5%) in the younger age group, while the elderly participants mostly received additional training after specialization (91.7%). Laparoscopic surgery was mostly not available in public hospitals for advanced procedures (p <0.0001) but was available for cholecystectomy and appendectomy operations (p= NS). However, participants working in university hospitals mostly stated that the laparoscopic approach was the first choice for advanced procedures. Conclusion: The results of this study showed that the surgeons working in MICs spent strong effort to use laparoscopy in daily practice, especially in university and high-volume hospitals. However, inappropriate education, cost of laparoscopic equipment, healthcare policies, and some cultural and social barriers might have negatively impacted the widespread use of laparoscopic surgery and its usage in daily practice in MICs such as Türkiye.

Oncoplastic Breast Surgery Techniques When Surgery is Essential for the Management of the Idiopatic Granulomatous Mastitis.

BACKGROUND: Immunosuppressive agents are the main treatment options for idiopathic granulomatous mastitis (IGM). However, in some patients, the remaining large pouch and seroma may cause recurrence and severe deformity. Oncoplastic breast surgery (OBS) techniques can be used when surgery is required. MATERIAL AND METHODS: In this study, surgical results of the patients histopathologically diagnosed with IGM who underwent any of the OBS techniques between 2016 and 2020 were evaluated. Patient characteristics, surgical indications, and technical details of the surgery were recorded. RESULTS: Eighteen patients who underwent wide excision combined with the OBS technique were included in the study. Surgery was performed owning to persistent disease (n = 12), recurrence (n = 3), and patient preference (n = 3). No major complications occurred after the OBS technique. None of the patients had recurrence at the surgical site. CONCLUSIONS: When surgery is indicated in patients with IGM, successful results can be obtained with acceptable complication rates by using the simplest and easiest applicable OBS techniques, including volume displacement technique.

Giant Abdominal Lipoma in Adult.

Lipomas arising from the omentum are extremely rare in adults. Omental lipomas are typically asymptomatic, but very large ones may cause nonspecific abdominal symptoms and discomfort. Rarely they can cause omental torsion and present with an acute abdomen. We report a 41-year-old female patient with a giant lipoma (40 × 26 × 8 cm and 11,520 g) who presented with mild abdominal discomfort. Workup included abdominal ultrasound (USG) and magnetic resonance imaging (MRI). Surgical resection was performed without complication. No recurrence was observed during 4-year follow-up.

Gut mucosa in the rats exposed temporary mechanical obstruction fed with probiotic.

BACKGROUND: Created a model in the rats, to prevent mucosal damage and related effects in the patients, who were operated due to mechanical obstruction. Some groups fed fodder with probiotics, some groups fed with standard fodder. It is objected that the damage of gut mucosa and related effects on how to expose the differences of the groups. METHODS: In this study, 48 female Wistar-albino type rats are separated into five groups randomly. In the first operation, rats' terminal ileum was tied up with silk except for the control group. Two groups 24, the other two groups 48 hours later operated again and terminal ileum obstructions were removed. During that time, each one of those 24 and 48 hours of obstructed groups were fed with probiotic. Twenty-four hours later, the control group and other groups were operated for the third time for sampling. Terminal ileum, liver, spleen, MLN (Mesenteric lymph node) and blood samples were taken. RESULTS: The research group, which was obstructed and fed with probiotics during 48 hours, was significantly observed in increased mucosa cell loss and mucosal edema. Bacterial translocation was found more common in groups without probiotics. Tissue GR (Glutathione reductase) and erythrocyte CAT (Catalase) were lower in the group of 24 hours obstructed and given probiotics. CONCLUSION: The findings suggest that the high rate of mucosal edemas in the groups that are fed with probiotics can be seen as damage, but we think that probiotics are consonant with the strength of the mucosal barrier. Thus, in the groups fed with probiotics, it is possible that bacterial translocation is seen less, and some antioxidative enzymes are found less. Further studies are needed to investigate the benefits of probiotics in patients operated for obstruction.

Contribution of an educational video to surgical education in laparoscopic appendectomy.

OBJECTIVE: With recent widespread advances in laparoscopy, providing education on this subject has become a significant challenge. The aim of this study was to determine the degree of contribution made by surgeons to laparoscopic education through an educational video. MATERIAL AND METHODS: A total of 40 volunteer general surgery residents and specialists participated in our study. Before watching the approximately six-minute educational video prepared for laparoscopic appendectomy, the participants were asked to fill out participant information forms and information measurement questionnaire forms. After the video, the participants were asked to fill out the information measurement questionnaire forms a second time; additionally, attitude evaluation forms and education evaluation questionnaire forms were presented to the participants for completion, and statistical analysis was performed. Furthermore, the total watching duration and the number of times the video was paused were recorded. RESULTS: A total of 40 surgeons participated in the study (75% residents and 25% specialists). When the results of the information determination questionnaire forms filled out by the resident and specialist groups before and after the video were compared, it was observed that the scores of both groups significantly increased after watching the video (p=0.001). A statistical significance was identified between the length of time the video was watched and the education evaluation form scores of the participants (p<0.01). It was observed that the longer the video was watched, the greater the increase in the education evaluation scores. The results of the attitude evaluation forms implied that the video could be produced more professionally. CONCLUSION: Although education is an inevitable requirement of laparoscopic surgery, many teaching methods are available. Awareness-enhancing videos prepared on this topic can be efficient in providing laparoscopic education.