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    Challenges in strategies for Amyand hernia in children: literature review with clinical illustrations
    (Springer Science and Business Media Deutschland GmbH, 2023) Klyuev, Sergey; Azizoğlu, Mustafa
    Introduction: Amyand hernia (AH) is a rare disease, so there are no standard strategies and there are many different aspects at each stage of its management. Based on our own experience, we encountered these differences even in a small number of cases and therefore sought to review the literature to highlight the diversity of approaches to this pathology. This review of the literature was not intended to describe the statistical findings found in the clinical case series, but rather to highlight the clinical and surgical difficulties of AH in children. Nevertheless, we conducted an introductory statistical study based on data from PubMed and Google Scholar to understand the global prevalence of AH. Materials and methods: The search for the key terms Amyand hernia, Amyand’s hernia, and “children” between 2003 and 2023 resulted in 52 PubMed and 548 Google Scholar articles. Results: After the exclusion of irrelevant studies, 101 articles were found. A total of 83 case reports describing 182 pediatric patients were used to understand the demographic distribution of this pathology. Given the impossibility of further comprehensive statistical analysis (due to heterogeneous data), a narrative design was used to describe the remaining aspects of AH management. Finally, three clinical cases demonstrated the mentioned aspects. Discussion: As a result of the search, conclusions were drawn about the main difficulties in the management of AH in children, which were discussed.
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    Platelet-rich Plasma as an Adjuvant Therapy to Crystallized Phenol in the Treatment of Pediatric Pilonidal Sinus Disease: A Prospective Randomized Controlled Trial
    (W B Saunders Co-Elsevier Inc, 2025) Azizoglu, Mustafa; Klyuev, Sergey; Kamci, Tahsin Onat; Okur, Mehmet Hanifi
    Objective: This study aims to evaluate the safety and efficacy of platelet-rich plasma (PRP) as an adjuvant to crystallized phenol (CP) in treating pediatric pilonidal sinus disease (PSD). Methods: A single-center randomized controlled trial was conducted at Istanbul Esenyurt Hospital. Eighty-seven patients aged 0-18 were randomly assigned to two groups: the CP group (n = 42) and the CP + PRP group (n = 45). Upon arrival at the clinic, patients began a regimen of manual shaving and, if necessary, laser epilation every 6-8 weeks. For those with pilonidal abscesses, incision, drainage, and antibiotics were given. The treatment area was sterilized and numbed with local anesthesia. Hair removal and curettage were performed, followed by the application of crystallized phenol. In CP + PRP group, PRP injections were also administered. The procedure concluded with wound dressing and thorough disinfection. The study was registered https://clinicaltrials.gov/ (NCT06324656). Results: The CP + PRP group demonstrated significantly shorter healing times (19.4 +/- 7.88 days) compared to the CP group (30.7 +/- 12.9 days) (p < 0.001). The cosmetic score was higher in the CP + PRP group (7.42 +/- 1.61) than in the CP group (6.11 +/- 1.88, p = 0.001). CP + PRP group had lower VAS scores at measured all-time points after applications (p < 0.05 for each). Complications were comparable between the groups, with no significant differences in bleeding, infections, or skin burns (p > 0.05 for each comparison). No difference was found between groups in terms of total complication rate (p = 0.398). The success rate was higher in CP + PRP group (98%; n = 44) compared to CP group (86%; n = 36) (p = 0.039). Recurrence rates were lower in CP + PRP group (2%; n = 1) than CP group (14%; n = 6) (p = 0.039). Conclusion: The autologous PRP injection in pediatric PSD is safe. The addition of PRP to CP treatment for pediatric PSD significantly improves healing time, cosmetic outcomes, and overall success rates without increasing complication rates. This combined approach offers a promising alternative for effective and efficient treatment of PSD in children. Type of the study: Randomized controlled trial. (c) 2024 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.