INTRODUCTION: The objective of this study was to evaluate the endoscopy results of patients with gastric wall thickening detected in the upper gastrointestinal tract based on computed tomography imaging performed to investigate different complaints.
METHODS: The results of patients who were referred between October 2009 and March 2015 after computed tomography imaging demonstrated upper gastrointestinal system wall thickening and who underwent endoscopy were reviewed retrospectively. Patient data of age, gender, the location of the thickening detected with radiological imaging, hemoglobin values, endoscopy findings, and diagnosis were analyzed.
RESULTS: A total 171 patients underwent gastroscopy for upper gastrointestinal wall thickening. Forty-three (25.1%) of the patients were diagnosed with stomach cancer, 87 (50.8%) with gastritis, 8 (4.6%) had a hiatal hernia, 7 (40.09%) had a gastric polyp, and 20 (11.6%) had a gastric ulcer. Six patients (3.5%) had normal results. Patients with gastritis had a mean hemoglobin level of 12.6 g/dL compared with 10.09 g/dL in those with stomach cancer (p<0.001). Patients with an ulcer had a mean hemoglobin level of 10.8 g/dL compared with 12.6 g/dL in patients with gastritis (p<0.001). Among the patients with wall thickening in the upper gastrointestinal system and malignancy, 83.7% were over 50 years of age and 51% had a hemoglobin level below 10 g/dL.
DISCUSSION AND CONCLUSION: Wall thickening detected in the gastrointestinal system with radiological imaging may be a sign of malignancy, especially in patients who are over 50 years of age and have a hemoglobin level below 10 g/dL.

INTRODUCTION: Evaluations of laparoscopic appendectomy (LA) and open appendectomy (OA) as surgical treatment for acute appendicitis (AA) have yielded varying results. This assessment of the results observed at a single institution and some of the literature findings is provided as a contribution to the discussion about the superiority of different techniques in different patient groups.
METHODS: The patient charts and electronic data of 1587 patients who underwent an OA or LA procedure between June 2014 and August 2018 were retrospectively reviewed. Patients younger than 18 years of age and patients with any pathology other than AA were excluded from the study. A total of 1423 patients, 877 males (61.6%) and 546 females (38.4%), were included in the study. Patients who underwent OA were classified as Group I (n=771, 54.2%) and patients who underwent LA comprised Group II (n=652, 45.8%).
RESULTS: The mean age of the patients was 32.27±11.85 years, the mean duration of the operation was 59.77±20.24 minutes, the mean length of follow-up was 24.46±13.70 months, and the mean length of hospital stay was 1.61±1.14 days. The mean duration of the procedure was shorter in the OA group (58.8±20.9 minutes) compared with the LA group (60.88±19.38 minutes) (p=0.002). The percentage of female patients was higher in the LA group (42.94%) than in the OA group (34.50%) (p=0.001). The wound site infection rate was higher in the OA group (9.9%) compared with the LA group (9.05%). The rate of complications requiring hospitalization was higher after OA (3.5%) compared with LA (2.3%), and the rate of complications requiring re-operation was also higher with OA (1.03%) compared with LA (0.3%). However, the difference in all parameters was statistically insignificant.
DISCUSSION AND CONCLUSION: Both OA and LA are safe methods to treat AA. The rate of postoperative complications and the length of an OA operation have been decreasing progressively over the years; however, a preference for LA has been increasing over time. As for gallbladder operations, LA is likely to be the gold standard in AA treatment.

INTRODUCTION: The aim of this study was to compare the handmade sailor’s knot method with the intracorporeal knot method used to close the appendix stump.
METHODS: The files of 47 patients who were operated on for acute appendicitis between January 2017 and January 2019 were analyzed retrospectively. The patient records were analyzed in terms of age, gender, type of laparoscopic surgery, length of hospital stay, and postoperative complications. The patients were divided into 2 groups: patients ligated with the sailor’s knot method and a prepared loop (Group 1) and intracorporeally ligated patients (Group 2).
RESULTS: Of the 47 patients included in the study, 24 were male (51%) and 23 were female (49%). In Group 1, 15 (55.5%) patients were male and 12 (44.5%) patients were female. In Group 2, there were 9 (45%) male patients and 11 (55%) female patients. The mean length of hospitalization of the patients in Group 1 was 3±1.68 days, while it was 2.95±1.13 days in Group 2. The duration of surgery was 73.70±31.76 minutes in Group 1, while it was 70.75±27.25 minutes in Group 2. There was no statistically significant difference between the 2 groups in terms of the length of hospitalization or the duration of surgery.
DISCUSSION AND CONCLUSION: A handmade sailor’ knot is an easy, reliable, and cost-effective method to close the appendix stump in patients undergoing laparoscopic appendectomy. The technique can be used safely when intracorporeal knot-tying or suturing cannot be performed.

INTRODUCTION: The objective of this study was to investigate the results of the first 48 patients who underwent total laparoscopic transperitoneal donor nephrectomy at a single institution and to present the impact of the kidney extraction site on ischemia time.
METHODS: The study included patients who underwent kidney donor surgery between February 2017 and December 2018. Evaluation of the kidney transplantation candidates was performed by the kidney transplantation council. A total of 4 trocars were used for a right-side nephrectomy, and 3 trocars were used for a left-side nephrectomy. The kidneys were extracted through a suprapubic incision in the first 18 cases and through the inguinal region in the last 30 cases. A comparison was made of the demographic characteristics and the intraoperative and postoperative results of the 2 groups.
RESULTS: Of the study patients, 30 were female and 18 were male, with a mean age of 48.0±9.6 years (range: 30–71 years). All of the patients underwent a total laparoscopic transperitoneal donor nephrectomy. Four patients underwent a right-side nephrectomy and 44 underwent a left-side nephrectomy. There was no case of conversion to open surgery. The mean operative time was 251.4±72.4 minutes (range: 127–420 minutes). In the first 18 cases, the organ was extracted through a suprapubic incision and the ischemia time was 318±140 seconds (range: 150–720 seconds). In the last 30 cases, the organ was extracted through an inguinal incision and the mean ischemia time was 151.5±55.1 seconds (range: 80–265 seconds). The mean length of hospital stay was 5.4±1.1 days (range: 3-10 days).
DISCUSSION AND CONCLUSION: The application of minimally invasive surgery in healthy individuals undergoing donor nephrectomy leads to better physical, psychological, and social outcomes. Surgical experience and the choice of extraction site can shorten the warm ischemia time significantly. Extraction through the inguinal region is recommended, as it provides for a faster removal and shortens the warm ischemia time. Laparoscopic donor nephrectomy can be used safely in centers with experience performing advanced laparoscopy.

INTRODUCTION: Peptic ulcer perforation requires urgent surgical intervention, but there is no consensus on a preference for open or laparoscopic surgery. The aim of this study was to compare the results of laparoscopic and open methods of surgery for patients with a peptic ulcer perforation.
METHODS: The data of 52 patients who underwent surgery for peptic ulcer perforation at 4 hospitals were investigated retrospectively. The patients were divided into 2 groups according to the surgical technique applied: open surgery or laparoscopic. Both techniques used an omental patch to repair the perforation. Patient age, gender, preoperative blood white blood cell count, blood amylase level, duration of symptoms before admission to the hospital, length of operation, number of drains, quantity of intra-abdominal free fluid observed during the operation, quantity of fluid used for irrigation, patient abdominal operation history, and complications were noted and analyzed.

RESULTS: Thirty-seven of the patients underwent open surgery and 15 underwent laparoscopic surgery (mean age: 37.73±16.85 years; female/male 3/49). There was no significant difference in the parameters between the groups. No mortality was observed in any of the patients. Wound infection developed in 2 patients who were operated on using the open technique. Only 1 case of laparoscopic surgery (6.66%) was converted to open surgery.
DISCUSSION AND CONCLUSION: Laparoscopic repair of a peptic ulcer perforation demonstrated results that were similar to open surgery and helps to reduce complications such as wound infection. It may be especially valuable in early-onset cases and younger patients.

A splenic artery aneurysm is the third most frequent intraabdominal aneurysm, accounting for 60% of all visceral artery aneurysms. There is a rupture rate of 2% with an associated mortality rate of 36%. Treatment of splenic artery aneurysm may include laparotomy, laparoscopy, or endovascular techniques. Excellent results have been reported with laparoscopic techniques recently. Presently described is a case of symptomatic, non-ruptured proximal and middle segment splenic artery aneurysm treated with laparoscopic surgery. A 27-year-old female patient applied to the general surgery polyclinic complaining of abdominal pain and dyspepsia. After evaluating all of the clinical findings, a diagnosis of splenic artery aneurysm was made and a laparoscopic splenectomy and aneurysmectomy were performed. The patient was discharged on postoperative day 8. During the postoperative follow-up period, she recovered very well with no clinical problem.

Although foreign bodies located in the esophagus are not frequently encountered, it is a problem that can cause serious morbidity and mortality, especially if a perforation has occurred. Flexible endoscopy is the preferred therapeutic option for removing foreign bodies in cases of perforation due to its high success rate and low risk of complications. Presently described is the case of a 65-year-old female who was admitted to the hospital with an impacted esophageal foreign body, which was revealed to be a meat bone that had perforated the esophageal wall, accompanied by a paraesophageal abscess formation. Flexible endoscopy was performed in the operating room under general anesthesia and the esophageal foreign body was gently removed with rat tooth forceps and a snare. Purulent abscess fluid was drained from the esophageal perforation site and aspirated through the endoscope. The perforation site in the esophageal mucosa was about 1 centimeter in size and was closed with an endoscopic hemoclip. Perforation due to esophageal foreign bodies may lead to clinical conditions with serious mortality and morbidity. Endoscopic procedures performed by an experienced endoscopist may be appropriate in selected cases and avoid a major surgical operation.

Laparoscopic gallbladder-preserving surgery (LGPS) was developed in recent years to avoid the potential complications of laparoscopic cholecystectomy when there is a functional gallbladder. This is the first case report of LGPS in 2 adult patients in Turkey: Two patients, 40 and 53 years old, each with a single gallstone. Gallbladder function was evaluated preoperatively using ultrasonography. The gallstones were 12 mm and 20 mm in diameter. LGPS was performed using 3 trocars in one case and 2 in the other. No severe postoperative complications, such as bile leakage or hemorrhage, were observed. No recurrence was observed at 14 months after the operation. In conclusion, LGPS is feasible technique for selected cholelithiasis patients with a functional gallbladder. Randomized controlled trials are required for broad adoption of this technique.