Journal of Clinical Trials and Experimental Investigations

Functional ovarian cysts in childhood: A single-center experience in diagnostic and therapeutic practices

2025-08-15T12:19:23+03:00

Objective: We aimed to evaluate the follow-up protocols of pediatric patients diagnosed with functional (developmental) ovarian cysts in our hospital and to compare our approach with findings in the literature.

Materials and methods: Medical records of 12,012 pediatric surgery outpatients from January 2018 to December 2023 were reviewed based on ICD-10 codes. Patient complaints, clinical history, laboratory and imaging findings, follow-up strategies, and treatment methods were analyzed.

Results: Among 3917 female patients, 17 were diagnosed with functional ovarian cysts, representing a prevalence of 0.15%. The mean age was 12.7 years. Seven patients were diagnosed incidentally, seven presented with abdominal pain, one with abdominal distention, one with a breast lesion, and one with menstrual irregularity. Hormonal tests (Follicular stimulating hormone (FSH), Luteinizing hormone (LH), estradiol, progesterone, prolactin) were fully performed in seven patients, partially in three, and not performed in seven. Thirteen patients had ovarian cysts; the mean diameter was 32.2 mm in the left ovary and 43.0 mm in the right ovary. Three patients had bilateral cysts. No medical treatment was given. Surgery was performed in four patients—one via laparotomy for a 20 cm cyst, and three via laparoscopy. One patient declined surgery. Eight patients were followed for an average of 1.5 years, with no additional interventions required.

Conclusion: Our pediatric surgery clinic has followed the classic algorithm for ovarian cysts. The most remarkable finding is that ultrasound results differ conspicuously in different centers. Our findings could be an appendix to the issue in the country.

Investigation of perfusionists' level of knowledge on the use of temporary epicardial pacemaker in adult cardiac surgery

2025-07-12T00:35:57+03:00

Objective: The aim of this study was to evaluate the level of knowledge of perfusionists regarding the use of temporary epicardial pacemakers in adult cardiac surgery and the adequacy of their training on this subject.

Materials and methods: This cross-sectional descriptive study was conducted using an online survey among 147 perfusionists. Data were analysed using descriptive and inferential statistics.

Results: Only 8.8% of the participants had received training on the temporary epicardial pacemaker and none of them considered it sufficient. The highest knowledge was related to sinus bradycardia and indications for complete AV block. Knowledge about complications was moderate.

Conclusion: Although the role of perfusionists in temporary epicardial pacemaker applications is important, the lack of clarification of these responsibilities by institutional protocols leads to uncertainties in practice. It is necessary to establish standardised training and written guidelines for perfusionists in order to maintain the use of temporary epicardial pacemakers in a safe and effective manner.

Colorectal polyp risk in the context of gastric pathology: The roles of intestinal metaplasia and Helicobacter Pylori

2025-07-07T21:11:09+03:00

Objective: The role of Helicobacter pylori (H. pylori) infection and intestinal metaplasia (IM) in colorectal neoplasia remains unclear. While H. pylori is a recognized cause of upper gastrointestinal disease, its effect on the colorectum is controversial. IM, often arising from chronic gastritis, may reflect systemic mucosal changes with potential relevance to colorectal pathology. Our aim was to investigate the association between H. pylori, IM, and colorectal polyp development.

Materials and methods: In this retrospective cross-sectional study, 626 patients who underwent both upper gastrointestinal endoscopy and colonoscopy were evaluated. Gastric biopsies were examined histologically for H. pylori and IM, and colorectal polyps were assessed for size, location, and histology. Logistic regression was used to identify factors associated with polyp presence.

Results: Colorectal polyps were found in 29.1% of patients, most being tubular adenomas <1 cm. H. pylori infection was not associated with polyps (p=0.979), whereas IM was strongly associated (44.6% vs. 22.8%, p<0.001) and remained significant in multivariate analysis (OR=2.29, 95% CI: 1.60–3.28, p<0.001).

Conclusion: IM is significantly associated with colorectal polyp presence and may serve as a marker to prioritize colonoscopic screening, particularly in intermediate-risk populations. Further prospective studies are warranted to confirm these findings and explore underlying mechanisms.

Predictors of peritoneal lavage use in pediatric open appendectomy: A retrospective study

2025-07-24T19:06:08+03:00

Objective: This study aims to identify the clinical and diagnostic parameters influencing the decision to perform peritoneal lavage during pediatric open appendectomy.

Materials and methods: The files of patients who underwent open appendectomy due to acute appendicitis were retrospectively scanned. The patients were divided into two groups based on whether peritoneal lavage was performed. Age, gender, accompanying symptoms, physical examination findings, hemoglobin, leukocyte, C-reactive protein (CRP), abdominal ultrasonography (USG), abdominal tomography (CT) findings, intraoperative findings, and hospital stay duration of the groups were recorded.

Results: The mean age and hemoglobin values of the peritoneal lavage group were statistically significantly lower than those without lavage (p<0.05). Fever, vomiting, nausea, diarrhea, rebound, and CRP were higher in the lavage group (p<0.05). Leukocyte count and symptom onset time were statistically significantly lower in the no-lavage group (p<0.05). A statistically significant negative correlation existed between age, hemoglobin, CRP levels, and peritoneal lavage. There was a statistically significant and positive relationship with other parameters (p<0.05). According to the results of binary logistic analysis, CT and hemoglobin parameters were also substantial in multivariate analysis (p<0.05).

Conclusion: While many factors affect the decision to perform peritoneal lavage in univariate analysis, CT findings and hemoglobin levels are significant parameters in multivariate analysis.

Comparison of LIFT and cutting seton methods in the treatment of high transsphincteric anal fistulas

2025-07-06T12:35:01+03:00

Objective: Many treatment modalities have been recommended for high transsphincteric anal fistulas, but none have been proven to be ideal. This study aims to compare the ligation of intersphincteric fistula tract (LIFT) and cutting seton methods in the treatment of high transsphincteric anal fistulas.

Materials and methods: This study was conducted in the general surgery department of Health Sciences University Gazi Yaşargil Training and Research Hospital. Retrospective data of patients who underwent surgery for perianal fistula in our clinic were reviewed. Patients diagnosed with high transsphincteric anal fistulas were included in the study. According to the treatment method, patients were categorized into two groups: LIFT (Group 1) and cutting seton (Group 2). The groups were compared in terms of recovery time, recurrence rate, postoperative pain, and incontinence.

Results: There were a total of 60 patients in the study, with 30 patients in each group. The mean recovery time was significantly shorter in Group 1. At the end of 1-year follow-up, successful results were obtained in 21 (70%) patients in Group 1 and in 24 (80%) patients in Group 2 (p=0.371). While there was no significant difference between the groups in the visual analog scale evaluation in the preoperative period (p=0.398), there were significantly higher pain scores in Group 2. There was no difference between the two groups in the Wexner score at preoperative, postoperative 4th and 12th weeks.

Conclusion: Both LIFT and cutting seton procedures exhibit similar long-term healing, recurrence, and continence preservation rates in patients with high transsphincteric anal fistulas. However, LIFT has the advantage of less postoperative pain and shorter recovery time.

The major problem for perfusionists during cardiopulmonary bypass: Vent aspirator not sucking! solutions

2025-09-23T22:54:32+03:00

Objective: The objective of this study is to investigate the frequency, causes and solutions of the problem of ‘vent aspirator not sucking’ encountered during cardiopulmonary bypass (CPB) and to evaluate its relationship with professional experience, institutional environment and educational status.

Materials and methods: A descriptive cross-sectional study was conducted through an online survey of 186 actively practicing perfusionists across Turkey. A 17-item structured questionnaire was used to collect data on demographics, vent usage habits, problem frequency, perceived causes, interventions, and training background. Data were analyzed using descriptive statistics, chi-square tests, and multivariate logistic regression.

Results: Approximately 65% of participants reported experiencing the vent problem occasionally or frequently, with the rewarming phase being the most common stage of occurrence (45.7%). The most frequently cited causes included incorrect cannula positioning (72.6%) and vacuum system issues (59.1%). Less experienced perfusionists and those working in private hospitals or high-volume centers reported significantly more problems. Receiving specific training on vent management reduced the risk by 45% (OR = 0.55, p = 0.035), yet 58.1% of perfusionists indicated insufficient training. Moreover, only 18.3% reported having standard protocols in their institutions.

Conclusion: The “vent aspirator not sucking” issue is a widespread and multifactorial technical problem during CPB, significantly affected by experience, institutional factors, and training. Addressing this challenge requires the development of standardized procedures, structured education programs, and increased awareness of alternative venting strategies to improve patient safety and surgical outcomes.

Contemporary application and prospects of mesenchymal stem cell therapies in gynecology and gynecologic oncology

2025-09-29T16:00:41+03:00

Dear Editor,

Mesenchymal stem cells (MSCs) have garnered increasing interest because to their multidirectional differentiation potential, , immunomodulatory capabilities, and self-renewal capacity. Being able to comprehend the multi-omics molecular background of stem cells has the potential to offer us with important information on the treatment of diseases, including gynecological disorders, as well as the synthesis of healthy cells for use in regenerative medicine. Due to the fact that they encourage immunoregulatory, anti-inflammatory, anti-apoptotic, and anti-oxidative activities, MSCs have been proven to possess paracrine capabilities. This gives them the status of agents that are tolerant of the immune system. In addition, they possess both pain-relieving and angiogenic actions.

Postoperative pancreatic fistula after pancreatic cancer surgery: Past and present of ISGPS classification

2025-09-18T14:33:29+03:00

To the Editor,

Postoperative pancreatic fistula (POPF) is a frequent and consequential complication after cancer-related pancreatic resections. Even in high-volume centers, reported incidence after pancreatoduodenectomy ranges from ~5% to 30%, and distal pancreatectomy historically reaches 30–40% in some series. POPF prolongs hospitalization and drives secondary problems—abscess, sepsis, hemorrhage, and delayed gastric emptying—despite overall perioperative mortality falling below 5% in specialized units. Although Grade C events are uncommon (<5%), they carry a grave prognosis, with postoperative mortality reported up to 20–30% when organ failure or erosive bleeding occurs.