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    Impact of pelvic floor muscle training on sphincter function and quality-of-life in patients who underwent low anterior resection: A comparative evaluation
    (Kare Publ, 2024) Ofluoglu, Cem Batuhan; Aydin, Isa Caner; Altuntas, Yunus Emre; Cetin, Kenan; Inan, Rahsan; Ilhan, Noyan; Mulkut, Firat
    OBJECTIVE: Our study aimed to determine the impact of pelvic floor muscle training (PFMT) on sphincter function and overall well-being in patients who underwent low anterior resection (LAR) and diverting ileostomy due to rectal cancer. For this purpose, anal electromyography (aEMG), low anterior resection syndrome (LARS) score, and the European Organization for Research and Treatment of Cancer quality-of-life questionnaires (EORTC-QLQ)-C30 (generic for cancer) and CR29 (specific to colorectal cancer) were used. The primary endpoint of our study is to determine the effect of PFMT on sphincter function by aEMG, the secondary endpoint is to evaluate the effect on quality-of-life using the LARS score, EORTC-QLQ-C30 and CR-29 questionnaires. METHODS: Conducted between January 2017 and April 2018 at a tertiary hospital's general surgery clinic, the study included 32 patients between the ages of 18 and 75 who underwent low anterior resection and diverting ileostomy surgery. The patients were divided into two: the Study Group (SG), which started PFMT after surgery, and the Control Group (CG), which was not subjected to additional exercises. Six months after closure of the diverting ileostomy, both groups were evaluated with aEMG, LARS scores, and EORTC-QLQ-C30 and CR-29. RESULTS: aEMG duration values were significantly lower in the SG (17.6 m/sec vs. 19.9 m/sec; p=0.001). Additionally, a significant decrease in SG, major LARS rates (12.5% vs. 62.5%; p=0.004) and LARS scores (23.1 vs. 30.0; p=0.003) was observed. While there was no significant difference between the groups in EORTC-QLQ C30, increased sexual interest and decreased fecal incontinence were observed in SG in EORTC-QLQ-CR29. CONCLUSION: PFMT significantly improves LARS scores, quality-of-life questionnaires and aEMG parameters, positioning PFMT as an accessible, non-invasive, easy-to-use first-line treatment option in the treatment of LARS.
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    SCOLICIDAL POTENCY OF BILE AGAINST ECHINOCOCCUS GRANULOSUS
    (Knowledgeworks Global Ltd-Kgl, 2025) Aydin, Isa Caner; Ilhan, Noyan; Seker, Ahmet; Ofluoglu, Cem Batuhan; Mulkut, Firat; Goret, Nuri Emrah; Cetin, Kenan
    Cysto-biliary fistulas are commonly diagnosed, either before or after surgical intervention, in patients with enlarged or advanced-stage hydatid cysts (HCs). Analysis of cystic contents in these patients shows that diminished scolex vitality is more common in patients with cysto-biliary fistulas. This study aims to demonstrate the scolicidal effects of bile on Echinococcus granulosus (EG) scolices at various bile concentrations and over specific periods. The time- and concentration-based scolicidal potency was analyzed in EG scolex samples obtained from HC patients. The integrity of the cyst wall and the scolicidal effect of the contents were evaluated using a vital staining technique with 0.1% eosin. Bile samples were collected from patients with cholelithiasis who were scheduled for surgery. Scolicidal efficacy of 100% was observed in all samples at the 1/4 bile concentration after 10 min and at the 1/8 concentration after 60 min. At a 1/16 concentration, scolicidal efficacy was 66% at 1 min, 89% at 10 min, 93% at 30 min, and 98% at 60 min. At a 1/32 bile concentration, scolicidal efficacy was 59% at 1 min, 68% at 10 min, 89% at 30 min, and 95% t 60 min. At a 1/64 concentration, the scolicidal efficacy was 53% at 1 min, 58% at 10 min, 77% at 30 min, and 93% at 60 min. After 1 hr, reasonable scolicidal efficacy was determined up to a 1/64 concentration; however, significant decreases in scolicidal efficacy were observed at 1/128 and 1/256 bile concentrations. Theoretically, bile, which is an endogenous secretion, can be used as a suitable and potent scolicidal agent. This study lays the groundwork for future in vivo clinical trials utilizing synthetic bile acids for scolicidal purposes or for studies evaluating the scolicidal effects of bile in patients who develop cysto-biliary fistulas.