Ahmet Rencuzogullari

Purpose: This study aimed to investigate the potential role of dyslipidemia in the pathogenesis of hemorrhoidal disease (HD) and to explore the underlying mechanisms.Materials and Methods: In this prospective study, 200 patients presenting with benign anorectal complaints between February-March 2025 were enrolled. One hundred patients diagnosed with hemorrhoidal disease (HD group) and 100 patients with other benign anorectal conditions (control group) underwent fasting lipid profile assessment. The HD group was classified according to Goligher’s classification, and the relationship between hemorrhoidal grade and lipid levels was analyzed.Results: Compared with the control group, the HD group exhibited significantly higher levels of LDL (123.7 ± 41.7 vs. 103.9 ± 48.4 mg/dL), triglycerides (173.0 ± 126.1 vs. 141.8 ± 74.5 mg/dL), and total cholesterol (198.2 ± 53.9 vs. 171.7 ± 60.3 mg/dL). HDL levels correlated inversely with hemorrhoidal grade, being highest in Grade I and lowest in Grade IV disease.Conclusion: Our findings suggest an association between hemorrhoidal disease and dyslipidemia. Because this was an observational study, causality cannot be established; further studies are needed to determine whether lipid management affects the risk or severity of hemorrhoidal disease.

Aim: The aim of this study was to adapt and validate the Cryptoglandular Anal Fistula Quality of Life (AF-QoL) scale for Turkish-speaking patients, providing a disease-specific, patient-reported outcome measure (PROM) to assess quality of life (QoL) in cryptoglandular anal fistula. Methods: A prospective, multicenter, cross-sectional study was conducted across seven tertiary centers in Türkiye. The 22-item AF-QoL scale, originally validated in English, was translated and culturally adapted into Turkish following Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines, including expert consensus and a pilot study ( n = 10). A total of 220 Turkish-speaking adults with cryptoglandular anal fistula completed the scale. Structural validity was evaluated using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Internal consistency was assessed using Cronbach’s alpha, and item–total correlations. Test–retest reliability was evaluated in a clinically stable subgroup of patients. Results: EFA confirmed a six-domain structure, comprising psychological impact, everyday activities, unpredictability/disease control, seton-related issues, social limitations, and discharge/discomfort, explaining 69.2% of the total variance. CFA demonstrated an acceptable overall model fit ( χ ² / df = 1.94, root mean square error of approximation [RMSEA] = 0.048, Comparative Fit Index [CFI] = 0.945, standardized root mean square residual [SRMR] = 0.035). The Turkish AF-QoL demonstrated high internal consistency (Cronbach’s α = 0.828), satisfactory item–total correlations ( r = 0.32–0.76), and good test–retest reliability (intraclass correlation coefficient = 0.74), indicating temporal stability. Conclusions: The Turkish version of the AF-QoL demonstrates satisfactory reliability and structural validity for use in Turkish patients with cryptoglandular anal fistula. This cross-cultural validation provides a disease-specific PROM suitable for clinical and research applications. Further studies assessing additional measurement properties, including structural validity, measurement error, and responsiveness, are warranted. Clinical trial registration: This study was not a clinical trial and thus was not registered in a clinical trial registry.

The aim of our study is to evaluate the effects of glutamine, partially hydrolyzed guar gum and combined glutamine and partially hydrolyzed guar gum form in rats with experimental radiation enteritis by histopathological, immunohistochemical and biochemical measurements. 64 Wistar albino rats with an average weight of 220–280 g were used in the study. 1st group only took water, 2nd group only took glutamine, 3rd group only took partially hydrolyzed guar gum, 4th group took partially hydrolyzed guar gum with glutamine, 5th group took only radiotherapy, 6th group took radiotherapy with glutamine, 7th group took radiotherapy with partially hydrolyzed guar gum and 8th group took radiotherapy, glutamine and guar gum. Partially hydrolyzed guar gum was given with radiotherapy, and glutamine and guar gum were given together with radiotherapy in the 8th group. All rats were weighed on the first, seventh and tenth days. On the tenth day, the rats were sacrificed and their clinical status, biochemical, histopathological and immunohistochemical parameters in the terminal ileum were evaluated. Differences between groups were compared statistically. All groups were compared in terms of crypt length, villus height, crypt abscess, congestion, intraepithelial lymphoid infiltration, stool consistency, myeloperoxidase, malondialdehyde, caspase-3% and tumor necrosis factor alpha mean, and statistical significance was observed (p < 0.05). Weight% difference in rats was statistically significant between groups (p < 0.05). Interleukin-10 values were not statistically significant between groups (p > 0.05). In paired comparisons, there was a statistically significant difference between the control group and the group with radiation enteritis in terms of biochemical, histopathological, immunohistochemical and clinical parameters (p < 0.05). There was no statistically significant difference between the 5th group and 6th group, 7th group and 8th groups in terms of biochemical, histopathological, immunohistochemical and clinical parameters (p > 0,05). The result suggest that glutamine, partially hydrolyzed guar gum and combination therapy may not have a protective effect on radiation enteritis.

Background: This study aimed to investigate the causes of failure after the ileal pouch‐anal anastomosis (IPAA) procedure for ulcerative colitis (UC) and to determine the independent risk factors affecting their quality of life.Methods: This multi‐center cohort study included all UC patients who underwent IPAA at nine referral centers in Türkiye from 2010 to 2018. Centers were categorized as high‐volume (≥10 cases/year) or low‐volume (P = 0.002), biologic use (OR = 13.45, P = 0.033), chronic pouchitis (OR = 14.31, P = 0.013), postoperative blood transfusion (OR = 7.04, P = 0.048), and low annual case volume (OR = 30.86, P = 0.047). CGQL and Oresland scores averaged 0.77 ± 0.1 and 6.3 ± 1.1, respectively. Factors negatively impacting QoL included two‐staged procedures, small bowel obstruction, venous thromboembolism, chronic pouchitis, increased frequency of bowel movements, and low annual case volume.Conclusions: IPAA surgery in UC patients in Türkiye demonstrates acceptable rates of complications and pouch failure, with high patient satisfaction in terms of QoL and functional outcomes. Optimizing long‐term results requires enhanced surgical expertise and coordinated multidisciplinary management strategies.

Purpose To investigate the performance of computed tomography (CT) in the local staging of colon cancer in different segments, with emphasis on parameters that have been found to be significant for rectal cancer, namely, extramural venous invasion (EMVI) and tumor deposits (TDs). Methods CT and pathology data from 137 patients were independently reviewed by radiology and pathology teams. The performance of CT in categorizing a given patient into good, versus poor prognostic groups was assessed for each segment, as well as the presence of lymph nodes (LNs), TDs and EMVIs. Discordant cases were re-evaluated to determine potential sources of error. Elastic stain was applied for EMVI discordance. Results The T staging accuracy was 80.2%. For T stage stratification, CT performed slightly better in the left colon, and the lowest accuracy was in the transverse colon. Under-staging was more common (in 12.4%), and most of the mis-staged cases were in sigmoid colon. According to the first comprehensive correlative analysis, the sensitivity, specificity, and accuracy of CT for detecting TDs were found to be 57.9%, 92.4%, 87.6%, respectively. These figures were 44.7%, 72.7%, and 63.5% for LN, and 58.5%, 82.1% and 73% for EMVI. The detection rate was better for multifocal EMVI. The detection rate was also comparable (although substantially underestimated) for LNs, with the half of the LNs missed by CT being < 5 mm. Four patients that were classified as TD by CT, disclosed to be LNs by pathology. Correlative analysis led to refinement of the pathology criteria, with subsequent modifications of the initial reports in 13 (9.5%) patients. Conclusion Overall, CT performed well in the evaluation of colon cancer, as did TD and EMVI. It is advisable to include these parameters in CT-based staging. Radiologists should be aware of the pitfalls that occur more commonly in different segments.

This study aimed to reveal the incidence, clinicopathological, and oncological outcomes of appendiceal neoplasms.