Ersin Turan

Phenol is widely used as a minimally invasive treatment for pilonidal sinus disease (PSD); however, its clinical application is characterized by substantia

Aim: Pilonidal sinus disease (PSD) primarily affects young adults; rapid recovery is essential and yet lacks a standardized treatment approach. While excisional techniques delay recovery, minimally invasive options like laser ablation and phenol application are gaining interest, yet comparative long‐term evidence is scarce. This study compared short‐ and long‐term outcomes of laser versus phenol treatment in PSD. Method: In this multicentre retrospective cohort study (Nov. 2017–Sep. 2024), patients treated with laser or phenol were included. 1:3 propensity score matching using the nearest neighbour algorithm was performed based on age, gender, prior surgical history and year of operation. Categorical variables were analysed using chi‐squared or Fisher's exact tests, whereas continuous variables were compared using Student's t ‐test or Mann–Whitney U test depending on distribution normality. Results: Out of 897 eligible patients, 644 were included (median age: 26 years, body mass index [BMI]: 26.2 kg/m ² , male‐to‐female ratio: 4:1). The number of sinuses/pits was 2–3 in both groups. Operating time was significantly longer in the laser group. Complications occurred in 6.8% of laser patients, whereas none were reported in the phenol group. Pain scores were higher in the laser group (2 [1–3] vs. 1 [0–2]). Median follow‐up was 45 months (laser) and 40 months (phenol). Return to daily activities was delayed in the laser group, whereas complete healing was slower in the phenol group. Readmission, recurrence and recovery rates were comparable (85%–86%). Conclusion: Both treatments demonstrated low complication and recurrence rates with high recovery rates. Laser favoured faster healing and fewer sessions, whereas phenol allowed for shorter procedures and earlier return to daily life.

Aim: Although laparoscopic cholecystectomy (LC) is considered minimally invasive, it can cause moderate to severe pain in the postoperative period. This study investigates the effects of modified thoracoabdominal nerve block with perichondrial approach (M-TAPA) on postoperative analgesia after LC. Material and Methods: The patients were divided into two groups: Group M (patients who received the M-TAPA block) and Group C (control group patients who did not receive the block). The primary outcome measures were the pain scores at 0, 2, 4, 8, 12, and 24 hours postoperatively. The secondary outcome measures included the total amount of rescue analgesic consumed, the time to first rescue analgesia, the occurrence of complications (nausea, and vomiting), and patient satisfaction. Results: When the change over time of the numerical rating scale (NRS) scores at 24 hours postoperative was evaluated for both rest and movement, the time*group interaction was statistically significant for NRS scores during both rest and movement (p

Benign anorektal hastalıklar, tanı ve tedavi yöntemlerinin çoğunun ofis ortamında uygulanabilmesi nedeniyle genel cerrahi polikliniklerindeki hasta popülasyonunun önemli bir kısmını oluşturmaktadır. Günümüz Türkiye’sinde polikliniklerde bakılan hasta sayısının yoğunluğu göz önüne alındığında, bir genel cerrah polikliniklerde önemli sayıda hemoroidal hasta ile karşılaşmaktadır.

Objective Patient comfort is an important factor affecting the outcome and success of inguinal hernia repairs. Mesh usage significantly decreases recurrence rate however, the problems due to mesh usage negatively affects the patient comfort. Desarda repair using the body's own tissues has gained importance because it is more physiological and has low recurrence rates. In this study, we aimed to compare Desarda and Lichtenstein repairs in terms of chronic pain and recurrence. Material and Method Patients who were operated on at Konya Training and Research Hospital between October 2010 and February 2014 were included in the study. Randomization was done using the closed envelope method. Desarda repair was performed in the first group (D), and Lichtenstein repair was performed in the second group (L). Both techniques were applied as originally described. 3 questionnaires were used in the assessment of chronic pain. All three questionairres were filled before the operation, after first and third year from the operation. Results 162 people participated in the research. There were 80 people in the Desarda group and 82 in the Lichtenstein group. The median follow up time was 122 (96-145) months. There were 2 cases with recurrence in each groups. Preoperative pain levels were similar. The pain incidence, severity and limited activity were similar in the first and third years. The mean operation time was significantly lower in D group than L group (44.5±3.7 min and 56.7±2.97 min respectively). Complication rates were similar in both groups. Conclusion Desarda technique can safely used for hernia repair with its similar recurrance, complications and chronic pain rates with the most commonly used Lichtenstein technique. Moreover, it is advantageous with physiological closure of myopectineal orifice, being easy to perform, not containing foreign material and being cost-effective.

Amaç:Covid-19 salgınında, hastaların hastaneye başvuruları kontaminasyon endişeleri nedeniyle ertelendi. Çalışmamız pandemi sürecinde akut apandisit (AA) nedeniyle tedavi gören hastalarda hastaneye yatış süresi, komplike AA oranı ve komplikasyon oranlarını belirlemeyi ve bunları pandemi olmayan dönemle karşılaştırmayı amaçladı. Gereç ve Yöntemler:Pandemi döneminde (11.03.2020 - 01.06.2020) ve pandemi olmayan dönemde (11.03.2019-01.06.2019) apandisit nedeniyle tedavi edilen 159 hastanın verileri geriye dönük olarak incelendi. Başvuru süresi, komplike AA oranı, inflamatuar belirteçler, hastanede kalış süresi, postoperatif komplikasyonlar ve dren kullanımı ile ilgili veriler analiz edildi. Bulgular: Ortalama hastaneye başvuru süresi grup 1'de 1,37 ± 1,53 gün, grup 2'de 2,54 ± 2,18 gündü (p

Objective: Postoperative recurrent pilonidal sinus disease is troublesome, and its treatment is a challenge. In this study, it was aimed to present the long-term efficacy of crystallized phenol treatment on postoperative recurrent pilonidal sinus disease through our results collected within the last 20 years. Material and Methods: Two hundred and twenty-seven patients who had been previously operated on and suffered from recurrent pilonidal sinus disease were enrolled. The operation was applied in our outpatient clinic under local anesthesia. Demographic data of the patients, number of crystallized phenol treatment, duration of follow-up and recurrence numbers were prospectively recorded. Treatment success and factors affecting recurrence were examined. Results: Our success rate was found as 71.5%. This success rate belongs to the group of patients who never quit treatment and complied with the treatment. The patients were followed up for a mean 45.8 months. Of the post-crystallized phenol treatment recurrences, 72.4% took place within the first five years, while 97.4% did so within the first 10 years. Mean number of crystallized phenol applications was 2.6. The longer the duration of the disease before treatment, the more recurrence was observed after treatment (p= 0.02). There was no correlation between the number of previous operations and recurrence after treatment. As the number of sinus openings increased, so did the number of applications (p= 0.001). Conclusion: Crystallized phenol treatment yields promising long-term results in recurrent pilonidal sinus disease as well and may be recommended as the first choice in recurrent pilonidal sinus disease treatment since it is an effective non-operative treatment modality.

Objectives: The etiology of pilonidal sinus disease is still controversial. Acquired theory in its etiology has become more popular nowadays. The aim of this study was to investigate the effects of dominant hand use on sinus features and sinus direction. Methods: Eight hundred and sixty-five patients with diagnosis of primer pilonidal sinus disease were included. Data on patients’ ages, BMI, over-sitting histories, duration of disease, dominant hand use histories, the condition of their sinuses at the time of presentation, the number of sinus openings, sinus directions, and sinus extension directions were collected. Relationship was evaluated between dominant hand use and sinus direction or sinus extension direction. Results: There was no statistically significant difference between the patients’ ages, sexes, BMI figures, the durations of disease and over- sitting history and dominant hand use. While the sinus directions of patients who had shorter duration of disease were towards the midline, it was seen that as the duration of disease increased the sinus extensions were oriented any side (p = 0.01). There was, however, a significant relationship between the sinus extension direction and dominant hand use. It was observed that the sinus extension direction of the patients who dominantly used their right hands was towards the left, while the sinus extension direction of the patients with dominant left hands was towards the right (p = 0.04, RR:2.05). Conclusions: The fact that sinus extension directions can change against factors affecting body positions proves to be another factor which shows that pilonidal sinus disease is an acquired disease.

Objective: This study aimed to better demonstrate the long-term outcomes and effectiveness of crystallized phenol treatment by presenting our twenty years experience. Method: One thousand and twenty-six patients who have primer pilonidal sinus were enrolled. The operation was applied outpatient clinic under local anestesia. Recurrence rate, application number, healing time and factors affecting them were analysed. Result: The success rate was 84.3%. The mean number of crystallized phenol treatment applications was 2.1 and the mean recovery time was 8.9 weeks. The rate of recurrence was higher in patients with a long disease duration prior to initiating treatment (p = 0.04). The rate of recurrence was higher in patients with a higher number of opening and crystallized phenol treatment application, those with longer application time, and those with a positive family history (respectively p = 0.01, p = 0.002, p = 0.008). Conclusion: Long-term outcomes are also very successful in the treatment of pilonidal disease with crystallized phenol treatment. We believe that crystallized phenol treatment should be the first choice in the treatment of pilonidal disease because it is inexpensive, can be applied as an outpatient treatment, is a non-invasive procedure, has results comparable to surgical procedures, and does not cause loss of work and strength.

Postoperative intraabdominal adhesions still maintain their currency as serious causes of morbidity and mortality. This study aimed at evaluating the role of platelet-rich plasma (PRP) in the prevention of intraabdominal adhesions. A total of 16 healthy rabbits were used within the scope of the study. The animals were allocated into two groups as Group 1 (control group) and Group 2 (study group). In all subjects, cecal abrasion was formed by laparotomy. In the study group, platelet rich plasma was administered intraabdominally. At the end of the study, the adhesions were evaluated by Nair’s Score. Total adhesion score in Group 1 was 8, while the mean score was 1. On the other hand, total adhesion score in Group 2 was 12, while the mean score was 1.5. There was no statistical difference between both groups by total adhesion score and mean fibrosis score. However, mean scores for inflammatory cell infiltration and angiogenesis were higher in Group 2 and the differences were statistically significant (p= 0.021). We were not able to report the positive results of PRP; however, we believe that we shed an important light for future studies which might be conducted using the combination of different methods.