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    Assessment of demographic, clinical and histopathological features of patients who underwent appendectomy due to a presumed diagnosis of acute appendicitis
    (Turkish Assoc Trauma Emergency Surgery, 2021) Akbulut, Sami; Bahce, Zeynep Sener; Oztas, Tulin; Gumus, Serdar; Sogutcu, Nilgun; Sakarya, Hamdi; Gok, Ali Fuat Kaan
    BACKGROUND: To compare the clinical, biochemical, and histopathological features of patients who underwent appendectomy due to a presumed diagnosis of acute appendicitis (AAp). METHODS: The demographic, biochemical and histopathological data of 8206 patients who underwent appendectomy for AAp between January 2006 and March 2014 were retrospectively analyzed in this study. Patients were compared regarding the following characteristics: disruption by season (autumn vs. winter vs. spring vs. summer), working days (weekdays vs. weekends), histopathological findings (AAp vs. normal appendix [NAp]) and histopathological subgroup (non-perforated AAp vs. perforated AAp vs. NAp). RESULTS: Of the 8206 patients aged between 16 and 89 years, 4763 (58.0%) were male. Appendectomy distribution by season was as follows: autumn (n=1959; 23.9%), winter (n=2062; 25.1%), spring (n=2061; 25.1%) and summer (n=2124, 25.9%). NAp rates were higher in summer than those in other seasons. White blood cell (WBC) and neutrophil levels were significantly higher in autumn and winter compared with those in other seasons. In total, 6120 (74.6%) appendectomies occurred on weekdays and 2086 (25.4%) on weekends. WBC and neutrophil levels were significantly higher on weekends than those on weekdays. Appendectomy distribution by histopathological groups as follows: AAp (n=7414; 90.3%) and NAp (n=792; 9.7%). Appendectomy distribution by histopathological subgroups was as follows: non-perforated AAp (n=6966; 84.9%), perforated AAp (n=448; 5.5%), and NAp (n=792; 9.7%). WBC, neutrophil, and TBil levels in the non-perforated and perforated AAp groups were significantly higher than in the NAp group. While most of the patients with perforated AAp (62.1%) and non-perforated AAp (59.6%) were males, most of the patients with NAp (58.1%) were females. CONCLUSION: This study suggests that a relationship exists between demographic features, histopathological findings of appendectomy specimens, seasons, days of the week, and working days in patients undergoing appendectomy.
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    Giant Acrochordon Arising from the Thigh
    (Coll Physicians & Surgeons Pakistan, 2015) Bahce, Zeynep Sener; Akbulut, Sami; Sogutcu, Nilgun; Oztas, Tulin
    Acrochordons commonly develop from skin on the neck and axillar region, but may be found on any region of body. Although some predisposing factors have been implicated, the definite etiology has yet to be determined. We report the case of a 46-year female patient who presented with a large mass lesion on the inner aspect of the thigh. She stated that the swelling had emerged some 20 years ago and had progressively grown since then. Magnetic resonance imaging revealed a solid lesion with no anatomic relationship with musculoskeletal structures. Taking into account the basal width of the lesion, spinal anesthesia was administered and the lesion was excised with an intact surgical border of approximately 1 cm. The resulting defect was primarily closed. A histopathologic examination led to the diagnosis of an acrochordon with a size of 20 x 14 cm. To the best of our knowledge, this is the largest acrochordon lesion with the widest base reported in the literature.
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    Relationship between clinical and histopathological features of patients undergoing cholecystectomy
    (Termedia Publishing House Ltd, 2020) Akbulut, Sami; Yagmur, Yusuf; Sakarya, Hamdi; Bahce, Zeynep Sener; Gumus, Serdar; Sogutcu, Nilgun
    Introduction: Cholelithiasis is most common disease of the gallbladder and cholecystectomy is the one of the most performed surgical procedure worldwide. Aim: To assess the relationship between the demographic, biochemical, and histopathological variables of patients who underwent cholecystectomy. Material and methods: Demographic, biochemical, and histopathological data of 5077 patients undergoing cholecystectomy were compared in terms of two different aspects: open cholecystectomy (OC group; n = 2090) versus laparoscopic cholecystectomy (LC group; n = 2987), and an elective group (n = 4814) versus an emergency group (n = 263). Results: A total of 5077 patients aged between 13 and 97 years were included in the study. Aspartate aminotransferase (AST) levels, alanine aminotransferase (ALT) levels, mean platelet volume, and prevalence of acute/chronic cholecystitis were significantly higher in the LC group than in the OC group. On the other hand, age, direct bilirubin level, thrombocyte count, and prevalence of gallbladder cancer/gangrenous cholecystitis were significantly higher in the OC group than in the LC group. Levels of AST, ALT, white blood cells, neutrophils, and some prevalence of acute/chronic active cholecystitis were higher in the emergency group than in the elective group. On the other hand, the lymphocyte count and prevalence of chronic cholecystitis/hyperplastic polyps were higher in the elective group than in the emergency group. Histopathological analysis identified 32 patients with malignant gallbladder cancer as follows: adenocarcinoma (n = 21), mucinous adenocarcinoma (n = 3), papillary adenocarcinoma (n = 3), adenosquamous carcinoma (n = 1), clear cell adenocarcinoma (n = 2), squamous carcinoma (n = 1), and hepatocellular carcinoma metastasis (n = 1). Conclusions: Even when the appearance of gallbladder specimens is normal, histopathological assessment allows for early diagnosis of many unusual findings such as gallbladder cancer.