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Article Importance of Alkaline Phosphatase as a Predictor of Transient Hypoparathyroidism After Parathyroidectomy(Springernature, 2025) Gulen, Merter; Emral, Ahmet Cihangir; Sariyildiz, Gulcin TurkmenBackgroundThere are insufficient studies that have investigated the relationship between temporary hypoparathyroidism (hypoPTH) and the preoperative serum alkaline phosphatase (ALP) level in patients with no renal function disorder who have undergone isolated parathyroidectomy. The aim of this study was to determine whether or not the preoperative serum ALP level could be a marker which could predict the development of postoperative temporary hypoPTH. MethodsThis cross-sectional study included 158 patients aged > 18 years who were diagnosed with primary hyperparathyroidism (PHPT) between 2017 and 2022. The demographic data of the patients were retrieved from the hospital records. The patients were separated into two groups according to the serum calcium level after the parathyroidectomy, as the normal group and the temporary hypoPTH group. The determinants of temporary hypoPTH developing after parathyroidectomy in PHPT patients were investigated using multivariate logistic regression analysis. ResultsTemporary hypoPTH was determined in 25.3% of patients. The mean age and 25-O-HD level were determined to be lower in the patients who developed temporary hypoPTH compared to those who did not. The preoperative serum ALP, parathormone, and 24-h urine calcium levels were determined to be higher in the cases that developed temporary hypoPTH. As a result of the regression analysis, only the serum ALP level was determined to be an independent risk factor predicting the development of temporary hypoPTH (p: 0.005, OR: 1.021). In the ROC analysis, when a cutoff value of 119.5 pg/mL was taken for ALP, it was determined to have 73% sensitivity and 72% specificity for the prediction of the development of temporary hypoPTH. ConclusionsThe most appropriate treatment for symptomatic PHPT patients selected with positive imaging is minimally invasive parathyroidectomy. The most important postoperative complications are hypocalcemia and hypoPTH. The preoperative serum ALP level may be helpful in determining patients at risk of developing temporary hypoPTH following parathyroidectomy.Article Citation - WoS: 4Citation - Scopus: 5Evaluating Efficacy and Outcomes: Comparison of Laser Treatment and Crystallized Phenol in Pilonidal Sinus Disease(Frontiers Media Sa, 2025) Emral, Ahmet Cihangir; Gulen, Merter; Ege, BahadirObjective The aim of this study is to comprehensively evaluate the efficacy of laser ablation and crystallized phenol application in the treatment of pilonidal sinus disease, focusing on treatment success, recurrence rates, complications, and the patients' return to normal life.Material and method Data from patients treated for pilonidal sinus disease with laser ablation and crystallized phenol application at our clinic between January 2020 and September 2023 were retrospectively reviewed. Preoperative data including pit counts, disease stage, preoperative pilonidal abscess history, disease duration (week), treatment success, recurrence/persistent disease, postoperative complications, healing time (days), and visual analogue scale (VAS) scores on postoperative days 1 and 7, as well as return to normal life (days), were analyzed.Results A total of 121 patients were included in the study, with 51 receiving laser ablation and 70 receiving crystallized phenol application. The postoperative outcomes revealed that the wound healing period and postoperative VAS values were statistically significantly better in the laser ablation group.Conclusion Wound healing was faster and postoperative pain was less in the laser group compared to the phenol group. According to this study, both methods can successfully treat the disease in selected cases.Article Citation - WoS: 1Citation - Scopus: 2Incidental Detection of Ectopic Liver Tissue During Elective Cholecystectomy: a Case Report(Frontiers Media Sa, 2025) Emral, Ahmet CihangirIntroduction Ectopic liver tissue (ELT) is a rare embryological anomaly most commonly found in the abdominal region, particularly on the gallbladder. It is generally asymptomatic and is often discovered incidentally during surgery or autopsy. Although histologically similar to the main liver, ELT should be excised due to the potential risk of malignancy.Case presentation This study presents a case of incidental ELT discovered during elective cholecystectomy in a 34-year-old female patient. Preoperative imaging revealed multiple gallstones, and during laparoscopic exploration, an ectopic liver tissue lesion was found on the gallbladder fundus. The lesion, measuring 10 x 5 mm, was excised en bloc with the gallbladder and sent for pathological examination, which showed no malignancy.Discussion The rarity and asymptomatic nature of ELT make it difficult to diagnose preoperatively, but its association with malignant transformation warrants careful management. In cases of suspected malignancy, further surgical approaches such as extended surgical margins and regional lymph node dissection should be considered.Conclusion This case underscores the importance of early detection and excision of ectopic liver tissue due to its potential for malignant transformation.Article Citation - WoS: 2Citation - Scopus: 1Evaluation of Laser Ablation for Recurrent Pilonidal Sinus Disease: Treatment Success, Recurrence Rates, and Patient Outcomes(Springer London Ltd, 2025) Emral, Ahmet Cihangir; Yazici, Sinan EfePurposePilonidal sinus disease (PD) is a chronic, recurrent inflammatory condition primarily affecting the sacrococcygeal region, often resulting in discomfort, abscess formation, and recurrent disease. Various surgical interventions, including laser ablation, have been employed to treat recurrent PD. This study evaluates the efficacy of laser ablation in patients with recurrent PD, focusing on treatment success, recurrence rates, complications, and recovery outcomes.MethodsA retrospective analysis of 37 patients with recurrent pilonidal sinus disease treated with laser ablation between January 2022 and January 2025 was conducted. Preoperative data, postoperative complications, healing time, Visual Analog Scale values, and return to normal activities were collected.ResultsThe results showed that 70.3% of patients achieved complete healing without recurrence, while 21.6% experienced recurrence within a mean follow-up of 9.6 months. Five patients (13.5%) developed superficial infections, which were managed with local dressing. The median time for wound healing was 35 days, and patients returned to normal activities in an median of 1 day. Persistent disease was observed in 8 patients (21.6%), of whom 5 patients (62.5%) achieved full epithelialization after retreatment with laser ablation.ConclusionThe ease of application, avoidance of hospitalization, minimal postoperative care, and rapid return to daily activities make laser treatment a safe and effective therapeutic option for patients with recurrent pilonidal disease, supported by favorable outcomes and low morbidity.Article Which Technique Is Preferable for Grade 2-3 Hemorrhoidal Disease: Laser Vs. Rubber Band Ligation ? A Retrospective Study(Springernature, 2025) Emral, Ahmet Cihangir; Gulen, Merter; Ege, BahadirBackground The aim of this study is to compare the short and long-term results (postoperative pain, complications, return to daily life, recurrence) between patients who underwent laser hemorrhoidoplasty (LH) and rubber band ligation (RBL) due to grade 2-3 hemorrhoidal disease. Methods The results of patients who underwent LH and RBL between June 2020 and June 2023 for grade 2-3 hemorrhoidal disease were evaluated retrospectively. The patient information was examined in terms of operation time, postoperative 1st, 7th and 14th day visual analog scale (VAS) values, the amount of analgesic used in the first 7 postoperative days, return to normal life (days), recurrence within 1 year and other complications (postoperative bleeding, thrombosis, urinary retention, infection/abscess, anal stenosis, deterioration in continence). Results A total of 260 patients were included in the study, 166 of whom underwent RBL and 94 LH. Operation time, VAS values, postoperative 7-day analgesic use (mg), worsening of incontinence, time to return to normal life (days), complications and recurrence within 1 year evaluated. LH has statistically significant lower postoperative 1st day pain and less analgesic use (mg) than RBL (p < 0.001). Conclus & imath;ons LH and RBL both offer effective treatment options for grade 2-3 hemorrhoidal disease, with comparable recurrence rates and time to return to normal life. However, LH is associated with significantly less postoperative pain and analgesic use on the first postoperative day, potentially enhancing patient satisfaction.
