Turkish Journal of Surgery最新文献

{"title":"Non-standardized surgery lateral internal sphincterotomy: Is there a consensus?","authors":"Neriman Şengül, Buse Balcı, Hatice Maras, Cihangir Akyol","doi":"10.47717/turkjsurg.2025.2025-4-18","DOIUrl":"https://doi.org/10.47717/turkjsurg.2025.2025-4-18","url":null,"abstract":"<p><strong>Objective: </strong>Lateral internal sphincterotomy (LIS) is considered the gold standard surgical treatment for chronic anal fissures. However, substantial variation exists in the surgical techniques applied. This study aims to evaluate practice differences among surgeons performing LIS and to assess whether a consensus has been established.</p><p><strong>Material and methods: </strong>An anonymous online survey was conducted to assess surgeons' technical approaches to LIS. Data were collected using a 24-question survey targeting surgeons from various countries.</p><p><strong>Results: </strong>A total of 207 surgeons (131 from Türkiye, 76 from other countries) responded. The majority were male (73.3%) and between 40 and 64 years of age (64.7%). Most participants (70%) had more than 10 years of surgical experience, and 55% were affiliated with academic centers. The open technique was preferred by 73.6% of respondents, while 21.4% opted for the closed method. Partial sphincterotomy was favored by 66%, followed by complete (21%) and tailored (12%) approaches. Substantial heterogeneity was noted in bowel preparation, patient positioning, incision type, and management of skin tags or hypertrophied papillae. Only 6% reported routine use of anorectal manometry. Variations were more prominent across countries than between demographic groups. The principal finding of the study is the lack of a standardized approach to LIS across international surgical communities.</p><p><strong>Conclusion: </strong>There is no standardized approach to LIS among surgeons. Surgical technique preferences vary significantly and appear to be influenced more by geographic practice location than by individual surgeon characteristics such as age, gender, or experience.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of quality of life in primary hyperparathyroidism patients: Pre- and post-parathyroidectomy outcomes in an Indian cohort.","authors":"Manish Rohilla, Cherring Tandup, Divya Dahiya, Arunanshu Behera, Sanjay Kumar Bhadada, Manish Thakur, Sree Vani Paladugu","doi":"10.47717/turkjsurg.2025.6811","DOIUrl":"https://doi.org/10.47717/turkjsurg.2025.6811","url":null,"abstract":"<p><strong>Objective: </strong>Primary hyperparathyroidism (PHPT) is a common endocrine condition that causes hypercalcemia and other symptoms due to improper parathyroid hormone (PTH) secretion. With fatigue, bone pain, and neuropsychiatric difficulties, the disorder drastically lowers quality of life (QoL). This study uses Pasieka's parathyroid symptoms score to evaluate parathyroidectomy's impact on Indian PHPT patients' QoL.</p><p><strong>Material and methods: </strong>This 18-month prospective observational study was conducted at an Indian academic tertiary care facility. Parathyroidectomy was performed on 42 PHPT patients. Pasieka's parathyroid symptoms questionnaire and baseline clinical and biochemical parameters were completed preoperatively and three months postoperatively. The questionnaire uses a linear analog scale to assess 13 symptoms, including weariness, bone pain, mood issues, and cognitive issues.</p><p><strong>Results: </strong>Preoperatively, patients demonstrated markedly increased calcium and PTH levels. Post-parathyroidectomy, notable enhancements were noted across various QoL dimensions. Significant reductions in bone pain, joint pain, weariness, and muscle weakness were seen (p<0.001). Neuropsychiatric symptoms, such as irritability and mood fluctuations, shown considerable improvement (p<0.001). Cognitive symptoms, including amnesia, exhibited some improvement, although dermatological symptoms such as itching and polydipsia were mitigated.</p><p><strong>Conclusion: </strong>PHPT patients benefit greatly after parathyroidectomy in both physical and mental ways. In order to reduce the systemic effects of PHPT, surgery must be performed quickly. Parathyroidectomy improves patient well-being.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Right colic artery pseudoaneurysm in a patient with rheumatoid arthritis: a case report.","authors":"Sriparna Biswas, Bijit Saha, Rohith Kodali","doi":"10.47717/turkjsurg.2025.6793","DOIUrl":"https://doi.org/10.47717/turkjsurg.2025.6793","url":null,"abstract":"<p><p>To describe the clinical presentation, diagnosis, and endovascular treatment of a right colic artery (RCA) pseudoaneurysm in a patient with rheumatoid arthritis, highlighting its rarity as a complication of rheumatoid vasculitis. A woman in her early 50s with rheumatoid arthritis presented with a three-day history of epigastric pain, vomiting, and melena. Examination revealed anemia, purpuric rashes, and mild abdominal tenderness. Computed tomography (CT) angiography identified an RCA pseudoaneurysm. Following resuscitation and blood transfusion, selective superior mesenteric artery angiography and transarterial coil embolization were performed. The procedure was successful, leading to symptom resolution. RCA pseudoaneurysms are rare, usually resulting from trauma or pancreatitis, but can also arise from rheumatoid vasculitis. This is the first reported case of a RCA pseudoaneurysm due to rheumatoid arthritis. CT angiography is the preferred diagnostic tool, and coil embolization is an effective treatment for hemodynamically stable patients.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Children are not just small adults: Comment on \"Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) for pediatric mesenchymal hamartoma: A case report\" by Caballes et De Lara.","authors":"Juri Fuchs","doi":"10.47717/turkjsurg.2025.2025-3-17","DOIUrl":"https://doi.org/10.47717/turkjsurg.2025.2025-3-17","url":null,"abstract":"","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microbiome, mechanics, and morphology: Rethinking the etiopathogenesis of pilonidal sinus disease.","authors":"Semra Demirli Atıcı","doi":"10.47717/turkjsurg.2025.2025-5-2","DOIUrl":"https://doi.org/10.47717/turkjsurg.2025.2025-5-2","url":null,"abstract":"","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of enhanced view-totally extraperitoneal technique and totally extraperitoneal technique in S1 scrotal hernia repair.","authors":"Abdullah Hilmi Yılmaz, Mehmet Eşref Ulutaş","doi":"10.47717/turkjsurg.2025.6669","DOIUrl":"10.47717/turkjsurg.2025.6669","url":null,"abstract":"<p><strong>Objective: </strong>The treatment of scrotal hernias may vary according to the surgeon's experience. Although open anterior approaches are mostly preferred, specialized hernia surgeons prefer laparoscopic approaches. The study evaluated the safety and efficacy of the laparoscopic enhanced view-totally extraperitoneal (eTEP) technique and the laparoscopic totally extraperitoneal (TEP) technique in treating scrotal hernias.</p><p><strong>Material and methods: </strong>The retrospective cohort study compared patients with unilateral scrotal hernia who underwent eTEP or TEP from November 2022 to October 2023. The two groups were compared in demographic characteristics and operative and postoperative data. The main result of this study was the recurrence rate.</p><p><strong>Results: </strong>A study analyzed 54 patients: 30 underwent the eTEP technique, and 24 underwent the TEP technique. No significant difference was observed between the groups regarding recurrence rates, incidence of chronic pain, time of the surgical procedure, length of stay, time taken to resume daily activities, pneumoperitoneum occurrence, and complications, particularly hematoma and seroma formation. Patients were followed up for an average of 19 months (±5.2).</p><p><strong>Conclusion: </strong>The comparison of the eTEP technique to traditional TEP for scrotal hernia repair has not demonstrated any conclusive evidence of the superiority of eTEP. The outcomes associated with the eTEP technique were found to be comparable to those of TEP, with an average follow-up period of 19 months. Similar to TEP, the eTEP technique demonstrates both safety and feasibility in the management of scrotal hernias. Furthermore, it is necessary for prospective randomized studies to compare these two techniques directly, specifically in the realm of scrotal hernia repair.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":"147-153"},"PeriodicalIF":0.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The double burden: Family, career, and gender discrimination in surgery.","authors":"Semra Demirli Atıcı","doi":"10.47717/turkjsurg.2025.2025-3-14","DOIUrl":"10.47717/turkjsurg.2025.2025-3-14","url":null,"abstract":"","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"41 2","pages":"212-213"},"PeriodicalIF":0.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive score for conversion in laparoscopic cholecystectomy - a prospective study.","authors":"Shravan Teja V, Ramya Ramakrishnan, Jai Prakash Srinivasan","doi":"10.47717/turkjsurg.2025.6690","DOIUrl":"10.47717/turkjsurg.2025.6690","url":null,"abstract":"<p><strong>Objective: </strong>2-15% of laparoscopic cholecystectomy gets converted to an open procedure due to various factors. The aim of this study was to identify pre-operative risk factors that could predict the conversion of laparoscopic cholecystectomy to open surgery. Pre-operative prediction would help in reducing the morbidity.</p><p><strong>Material and methods: </strong>Adult patients undergoing elective laparoscopic cholecystectomy at a tertiary institute were included in the study. The parameters analysed were age, gender, body mass index, total count, liver function test, gall bladder size and wall thickness, impacted stone in Hartmann's pouch and common bile duct (CBD) diameter on ultrasonography. Intra-operative findings and the total number of conversions to open surgery were documented. Statistical analysis was done using SPSS 16.0 Inc., IBM system. A univariate regression analysis was used to find the significant risk factors followed by multivariate linear regression.</p><p><strong>Results: </strong>Twenty-one of the 222 (9.5%) patients who underwent laparoscopic cholecystectomy, were converted to open cholecystectomy. Six variables were found significant on univariate analysis: Age, sex, total count, gallbladder wall thickness and size and diameter of the CBD. On logistic regression analysis, gall bladder wall thickness and size were found to be significant, and were used in the scoring system, wherein 1 point was given to each variable. The predicted risk of conversion was 0.5%, 1.8% and 7.2% for a score of zero, one and two respectively.</p><p><strong>Conclusion: </strong>The most significant factors predicting conversion of laparoscopic cholecystectomy to open surgery were gall bladder size and wall thickness. This prediction can be used to minimize the time to conversion and reduce the morbidity.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":"141-146"},"PeriodicalIF":0.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the effects of epidermal growth factor mesenchymal stem cell and silver sulfadiazine on burn stasis zone.","authors":"Ömer Kürklü, Sinan Soylu","doi":"10.47717/turkjsurg.2025.6684","DOIUrl":"10.47717/turkjsurg.2025.6684","url":null,"abstract":"<p><strong>Objective: </strong>This study investigates the effects of adipose tissue-derived mesenchymal stem cell (MSC), human recombinant epidermal growth factor (EGF) and silver sulfadiazine (SSD) on wound healing in the burn stasis zone by applying the comb burn model in rats.</p><p><strong>Material and methods: </strong>A comb burn model was used for the burns and 32 Wistar albino female rats were randomly divided into four groups (control, SSD, SSD+MSC, SSD+EGF). On the 1^st day and the 21^st day, the total burn area on the 1^st day and the healed, healing, and non-healing burn area on the 21^st day were calculated with the Image-J program. At the end of the 21^st day, the pathology samples taken after euthanasia were scored semiquantitatively in terms of epithelization, inflammatory cell density, fibroblast density, collagen amount, and angiogenesis after hematoxylin-eosin staining.</p><p><strong>Results: </strong>Histopathological analysis demonstrated that epithelialization scores were highest in the MSC (3.88±0.35, p<0.001) and EGF (3.63±0.52) groups, while the control group had the lowest values (1.50±0.53). Inflammatory cell density was significantly lower in the MSC (1.50±0.53, p<0.001) and EGF (1.88±0.64) groups than in the control group (3.75±0.46). Similarly, fibroblast density was lowest in the MSC (1.38±0.52, p<0.001) and EGF (1.75±0.71) groups, while the control group had the highest values (3.63±0.52). Collagen fibril density was significantly increased in the MSC (3.88±0.35, p<0.001) and EGF (3.50±0.53) groups compared to the control (1.63±0.74). Angiogenesis was highest in the EGF group (3.75±0.46, p<0.001), followed by the MSC group (3.00±0.53), while the control group had the lowest values (1.25±0.46). These results suggest that MSC and EGF play a significant role in wound healing, with MSC demonstrating superior epithelialization and EGF exhibiting the greatest angiogenic effect. Photo-analytical measurements showed that on day 1, burn area sizes were similar among all groups (p>0.05). By day 21, the healing burn area was significantly smaller in the MSC (3.19±0.98 cm², p<0.001) and EGF (4.33±0.48 cm²) groups compared to the control (8.43±2.35 cm²). The non-healing area was smallest in the EGF group (0.67±0.49 cm²), followed by the MSC (1.06±0.49 cm², p<0.001) and SSD (1.91±0.75 cm²) groups, whereas the control group had the largest non-healing area (7.29±2.20 cm²). These findings suggest that MSC was the most effective treatment for promoting wound healing, followed by EGF and SSD.</p><p><strong>Conclusion: </strong>We determined that both histologically and photo analytically, MSC and EGF provided faster wound healing in the burn stasis zone EGF gave better results than all groups in preventing necrosis.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":"135-140"},"PeriodicalIF":0.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the perspectives and challenges of general surgery residents in Türkiye: Insights from a survey on surgical training.","authors":"Hamza Göktuğ Kıvratma, Burak Yavuz, Mustafa Can Çağ, Erhan Tükel, Emre Onat, Güliz Avşar, Burak Atar, Kamil Öztürk, Sabiha Nur Özmen, Buse Yıldırım, Yiğit Türk, Ahmet Deniz Uçar, Güldeniz Karadeniz Çakmak, Ahmet Serdar Karaca","doi":"10.47717/turkjsurg.2025.6783","DOIUrl":"10.47717/turkjsurg.2025.6783","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the perspectives of general surgery residents in Türkiye regarding the conditions and methods of their training, as well as the methods and circumstances under which their training is conducted.</p><p><strong>Material and methods: </strong>The study involved 426 resident physicians undergoing training in general surgery at various institutions, including university hospitals, education and research hospitals, and foundation university hospitals, from January to March 2024. A web-based survey was distributed to the residents via email, containing 18 multiple-choice questions. The results were analyzed using the SPSS statistical software.</p><p><strong>Results: </strong>The study revealed that 21.36% of the resident physicians had been in training for 0 to 1 year, while 20.19% had been in training for 2 to 3 years. A significant portion, 62.44%, was receiving their training in education and research hospitals, 36.38% in university hospitals, and only 1.17% in foundation university hospitals. In terms of training adequacy, 48.36% of the residents felt they did not receive enough practical training, and 81.22% believed they lacked sufficient theoretical training. Furthermore, 66.10% reported insufficient support for conducting academic research, and only 47.65% were aware of the core training program. Regarding work hours, 35.45% of residents were on duty every other day, 7.28% worked more than eight shifts per month, and 68.08% reported working 60 hours or more per week. Additionally, 91.31% of the residents deemed their salaries inadequate, and 71.36% experienced delays in receiving their on-call pay. Notably, only 55.63% expressed satisfaction with their experience as general surgery residents.</p><p><strong>Conclusion: </strong>The findings of this research indicate that there is a lack of standardization in general surgery specialization training in Türkiye. The report reveals that both theoretical and practical training are insufficiently provided and not delivered in a systematic manner. Additionally, general surgery residents expressed low levels of satisfaction with the training they receive. It is evident that improvements are necessary in several areas concerning the training and working conditions of resident physicians.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":"121-129"},"PeriodicalIF":0.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}