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    Does mesh utilization in femoral hernia repair affect recurrence?
    (2020) Acar, Nihan; Acar, Turan; Gungor, Feyyaz; Er, Ahmet; Atahan, Kemal; Haciyanli, Mehmet
    Aim: The mechanism of how femoral hernias (FH) develop is not clear. As a result of increased intra-abdominal pressure, preperitoneal fat tissue passes through the femoral ring and also drags the pelvic peritoneum.Femoral hernias are more common in women and also approximately 60% occur on the right, 30% on the left side and 10% are bilateral. The chief complaints of the patients are swelling and pain in the groin. Most cases require emergency operation due to incanceration or strangulation. Hernia repair can be performed with or without mesh, and with open or laparoscopic techniques.In this retrospective study, we aimed to compare the recurrence rates in patients who underwent FH repair with and without mesh.Material and Methods: This is a retrospective study of 48 patients who underwent surgery due to FH in our clinic between January 2012 and October 2017. The patients were divided into two groups according to mesh utilization: Hernia repair with mesh (Group 1) and hernia repair without mesh (Group 2).Results: A total of 48 patients with FH were operated (35 females, 13 males). The mean age of the patients was 64.6 ± 18.3 years and, 31 patients (64.5%) had right-sided and 17 patients (35.5%) had left-sided hernia.When the groups were compared, there was a statistically significant difference in terms of comorbidity, length of hospital stay and morbidity. There was no significant difference in recurrence (recurrence rates: 6.3%, 6.3%, respectively).Conclusion: Currently, mesh and non-mesh repairs are commonly used for the treatment of FH. This study showed that absence of mesh in FH repair did not affect recurrence.
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    The predictive value of laboratory factors in evaluating the necessity of surgical treatment in Crohn’s disease
    (2020) Gur, Emine Ozlem; Haciyanli, Selda; Saritas Yuksel, Elif; Cekic, Cem; Dilek, Osman Nuri; Haciyanli, Mehmet
    Aim: The primary treatment of Crohn’s disease (CD) is medical but approximately 70% of all patients with CD undergo surgical intervention throughout their lives. We aimed to determine which parameters can guide decision making before surgical treatment and to determine the effectiveness of the Glasgow prognostic index (GPI) and prognostic nutritional index (PNI) in predicting the necessity of surgery.Material and Methods: Patients who underwent surgery or medical treatment for CD were matched for age and sex. Group 1: operated patients; Group 2: received medical treatment. Hemogram and biochemistry test results were recorded. Platelet to neutrophil ratio (PNR), Neutrophil to lymphocyte ratio (NLR), and Lymphocyte to monocyte ratio (LMR) were calculated. Patients who had both a serum elevation of CRP (>1.0 mg/dL) and hypoalbuminemia (3.5 g/dL) were allocated a GPI of 2. Patients with only one of the abnormal values were allocated a GPI of 1, and patients who had neither were allocated a GPI 0. Parameters compared statistically between groups. The value p0.05 was accepted significant.Results: Of the 104 patients 51 were in Group 1 and 53 were in Group 2. The number of patients with a GPI value of 3 was significantly higher in Group 1 than in Group 2 (p 0.05), as were NLR, protein, albumin, neutrophil, platelet, and CRP levels (p 0.05). The multivariate analysis revealed that albumin and GPI values were independent variables in predicting the likelihood of receiving an operation in CD. Conclusion: In conclusion, evaluating the necessity of surgical treatment during follow-up for CD, neutrophil, NLR, CRP, albumin, platelet, PNI, and GPI, can be used. If the GPI value is 2 in a patient with CD under follow-up whose albumin levels are low, then surgical treatment should be considered.