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    Is the increase in the number of pilonidal sinus surgery normal?
    (Aves, 2010) Karahan, Omer; Eryilmaz, Mehmet Ali; Torun, Veli; Sevinc, Baris; Koksal, Hande; Aksoy, Faruk; Ay, Serdan
    Purpose: We have noticed the increase in pilonidal sinus operations (PSO) and performed this study to determine the extent of this change and if there is a difference between the number of pilonidal sinus surgery and outpatient and inpatient numbers. Material and Method: We scanned PSO, which was performed in three hospitals [medical faculty hospital (MFH), education and research hospital (ERH) and state hospital (SH)] in the same city, in the last 10 years between 1999 and 2008. We have determined the yearly distribution of cases, total number of operations performed, number of general surgery operations (GSO) at the same period and changes in staff of general surgery clinics. We reviewed the number of outpatients, inpatients and the middle group surgical procedures containing PSO as well, performed at the whole city and the country in the last 10 years. Results: The number of PSO was 234 and the number of GSO was 7.728 at MFHs in the first 5 years. These numbers were 259 and 10.384 in the second period, respectively. The increase was 11% for PSO and 72% for GSO. The increase in PSO was lower than GSO. In ERH there were 506 PSOs in the first 5 years and 760 PSOs in the second 5 years. The number of GSO had increased from 11.563 to 11.452 in the second 5 years. There was a 1% decrease in the number of GSOs, whereas the number of PSOs increased by 50% (p<0.001). The number of PSOs performed in SHs increased from 353 to 1.224, by 247%. Also, the number of GSO increased from 10.215 to 15.595, by 53%. The increase in the number of PSOs in two hospitals (ERH and SH) was statistically significant (p<0.001). The number of PSOs was 246 in 2005 and it became 1.341 in 2008, with an increase of 439% at the whole city. Considering Turkey, the number of PSOs performed was 12.415 in 2005 and it increased to 54.633 (340%) in 2008. Conclusion: There is a rapid increase in the number of PSOs performed at the state hospitals in Konya and all around Turkey. Absolute reasons for this increase should be investigated and preventive measures should be taken.
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    Papillary thyroid carcinoma after radioactive iodine treatment for toxic thyroid nodule: Case report
    (Marmara Univ, Fac Medicine, 2018) Sevinc, Baris; Karahan, Omer; Duran, Cevdet; Cayci, Mustafa; Ay, Serden
    Radioactive iodine (RAI) treatment is recommended as the first choice for toxic thyroid nodules by American Thyroid Association (ATA). Here, we present our second case of papillary thyroid carcinoma after RAI therapy. A fifty five-year-old woman received RAI therapy for toxic thyroid nodule in the right lobe in 2005. Pre-treatment fine needle aspiration biopsy (FNAB) revealed benign cytology. She was euthyroid after the therapy. However, 8 years after the treatment she had 15 mm thyroid nodule in the same location. This time, FNAB result was suspected for papillary thyroid carcinoma. The patient underwent bilateral total thyroidectomy and the histopathological evaluation revealed papillary thyroid carcinoma in the nodule. This is the second case with papillary carcinoma after RAI therapy. Papillary carcinoma developed after the RAI therapy. In conclusion, all cases should be closely followed up after RAI therapy for carcinoma development.
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    Randomized prospective comparison of midline and off-midline closure techniques in pilonidal sinus surgery
    (Mosby-Elsevier, 2016) Sevinc, Baris; Karahan, Omer; Okus, Ahmet; Ay, Serden; Aksoy, Nergis; Simsek, Gurcan
    Background. Pilonidal sinus is a chronic inflammatory disorder of the intergluteal sulcus. The disorder often negatively affects patients' quality of life, and there are numerous possible methods of operative treatment for pilonidal sinus. The aim of our study was to compare the results of 3 different operative procedures (tension-free primary closure, Limberg flap, and Karydakis technique) used in the treatment of pilonidal disease. Methods. The study was conducted via a prospective randomized design. The patients were randomized into 3 groups via a closed envelope method. Patients were included in the study after admission to our clinic with pilonidal sinus disease and operative treatment already were planned. The 2 main outcomes of the study were early complications from the methods used and later recurrences of the disease. Results. A total of 150 patients were included in the study, and the groups were similar in terms of age, sex, and American Society of Anesthesiologists scores. The median follow-up time of the study was 24.2 months (range, 18.5-34.27) postsurgery. The recurrence rates were 6% for both the Limberg and Karydakis groups and 4% for the tension-free primary closure group. Therefore, there was no substantial difference in the recurrence rates. Conclusion. The search for an ideal treatment modality for pilonidal sinus disease is still ongoing. The main conclusion of our study is that a tension-free healing side is much more important than a midline suture line. Also, tension-free primary closure is as effective as a flap procedure, and it is also easier to perform.