Browsing by Author "Binici, S."

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Application of the Hybrid Seton Technique in High, Complex Perianal Fistulas and One-Year Outcomes
(Yuzuncu Yil Universitesi Tip Fakultesi, 2025) Cikman, O.; Binici, S.
Introduction: Perianal fistulas are defined as abnormal, epithelialized connections in the anorectal region. In this study, we aimed to present the treatment outcomes of patients undergoing treatment with an elastic cutting seton (hybrid seton) for tran ssphincteric fistulas. Materials and Methods: A total of 92 cases diagnosed with high and complex anal fistulas in our hospital's general surgery clinic between 2023-2024 were included in the study. Patients had fistulas involving more than one-third of the sphincter muscles or transsphincteric fistulas in the anterior region. Demographic data, operation duration, treatment plans, visual analog scores, anal incontinence scores, recurrence rates, and complications were evaluated. Results: All patients presented with complaints of malodorous discharge, pain, swelling, and pruritus ani in the perianal region. During examination under anesthesia, the fistula tract was identified with a stylet, and the wrist portion of a size 8 glove was pla ced as a seton. The seton either fell off spontaneously or was removed with a fistulotomy within an average of 45 days. Over an average 12-month follow-up period, no recurrence or incontinence was observed in any of the cases. Conclusıon: The hybrid seton technique does not cause incontinence as it gradually cuts through sphincter tissue without causing acute damage. Additionally, the lack of seton revisions and quality-of-life deterioration in follow-up makes hybrid seton a preferred treatment option. © 2025, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Comparison of Hemorrhoid Electrotherapy with Direct Current and Ligasure Hemorrhoidectomy in the Treatment of Hemorrhoidal Disease
(Yuzuncu Yil Universitesi Tip Fakultesi, 2025) Aslan, F.; Oner, M.O.; Binici, S.; Beǧer, B.
Introduction: This study aims to compare LigaSure hemorrhoidectomy and direct current electrotherapy in the treatment of grade 2 and grade 3 internal hemorrhoids. Materıal and Methods: This retrospective study included patients with symptomatic grade 2 or 3 internal hemorrhoids unresponsive to medical treatment. In the galvanization group, hemorrhoidal columns were coagulated using electrotherapy with a current probe set between 2 mA and 16 mA. LigaSure hemorrhoidectomy was routinely performed as an open surgical procedure. Operative time, postoperative pain, length of hospitalization, and clinical stage were recorded. Patients were followed for 3 months to asses s healing, late complications, and recurrence. The patients' follow-ups were conducted via phone up to 2 years. Results: All patients underwent rectoscopy at the 3rd postoperative month. Patients with grade 2 or 3 hemorrhoids, as confirmed by endoscopy and physical examination, were classified as having a recurrence. The LigaSure method showed a sta tistically significant difference in recurrence rates. The mean operative time for the galvanization method was 26 minutes, and this difference was also statistically significant. Pain scores were significantly lower with direct current electrotherapy compared to other methods. Conclusion: Hemorrhoidal coagulation with galvanic electrotherapy reduces operative time and hospitalization duration. Additionally, the relapse rate and postoperative pain, as measured by VAS scores, are lower with this procedure compared to LigaSure hemorrhoidectomy. However, late complications and the intensity of late postoperative pain may be comparable between the two surgical methods. © 2025, Van Medical Journal. All rights reserved.