Browsing by Author "Yeni, Sezgin"
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Publication Is laparoscopic adrenalectomy for pheochromocytoma safe and effective in geriatric patients?(Wiley, 2021-06-12) Günseren, Kadir Ömur; Çiçek, Mehmet Çağatay; Bolat, Deniz; Yeni, Sezgin; Vuruşkan, Hakan; Gül, Özen Öz; Yavaşcaoğlu, İsmet; GÜNSEREN, KADİR ÖMÜR; ÇİÇEK, MEHMET ÇAĞATAY; VURUŞKAN, HAKAN; ÖZ GÜL, ÖZEN; YAVAŞCAOĞLU, İSMET; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Anabilim Dalı.; 0000-0001-8673-3093; 0000-0002-0471-5404; 0000-0002-1332-4165; ABC-9924-2020; HGM-5995-2022 ; GFT-1275-2022; EFH-9523-2022; GBT-4320-2022; EIN-0828-2022Objectives The study aimed to assess the haemodynamic changes of laparoscopic adrenalectomy (LA) in geriatric patients with pheochromocytoma (PHEO). To the best of our knowledge, this is the first study to evaluate the haemodynamic outcomes of LA in this patient population.Methods Data of 350 patients who underwent single-side transperitoneal LA between 2000 and 2020 were reviewed retrospectively. Patients with a histopathological diagnosis of PHEO were included in the study and classified into two groups according to their ages at the date of surgery. Patients older than 65 years were accepted as elderly according to the World Health Organisation (WHO) recommendations.Results A total of 54 patients underwent LA for PHEO. Fifteen patients were enrolled in the elderly and 39 in the young groups. There were no significant differences in terms of the operation site (0.564), tumour size (0.878), perioperative results such as mean anaesthesia; operation times, blood loss and haemodynamic changes. There were no significant differences in mean hospitalisation and intensive care unit times. One patient in both groups had grade 1 complication according to Clavien Dindo classification (prolonged ileus, managed with medical treatment and transfusion during surgery, respectively).Conclusion Young and elderly patients had similar outcomes in terms of haemodynamic changes that occurred with LA. LA in elderly patients with PHEO is as safe and effective as in younger patients.Item Preoperatif dönemde takılan JJ stentin retrograd intrarenal cerrahi sırasında renal pelvis basıncına etkisi(Bursa Uludağ Üniversitesi, 2022) Yeni, Sezgin; Kaygısız, Onur; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı.Amaç: Retrograd intrarenal cerrahi (RIRS) sırasında böbrek içinde basınç artışını gösteren çalışmalar olmakla birlikte preoperatif JJ stent takılmasının intrapelvik basınç üzerine etkisini gösteren çalışma yoktur. Biz bu çalışmada işlem öncesi JJ stent uygulamasının ve işlem sırasında üretral stent uygulamasının RIRS sırasında renal pelvis basıncına etkisini araştırdık. Gereç-Yöntem: Bu çalışmada 02.09.2019 ile 30.10.2021 tarihleri arasında kliniğimizde RIRS yapılmış toplam 85 hastanın verileri retrospektif olarak incelendi. Dışlama kriterleri sağlandıktan sonra 42 hasta çalışmada kaldı. Preoperatif JJ stent takılmış 21 hasta Grup 1’i oluştururken preoperatif JJ stent takılmamış 21 hasta Grup 2’yi oluşturdu. RIRS sırasında basınç verileri milimetre civa (mmHg) cinsinden üreter kataterinin distal ucu basınç dönüştürücü ile anestezi monitörüne bağlanarak ölçülmüş ve kaydedilmiş. Gruplar demografik, taş özellikleri, perioperatif sonuçlar ve basınç değerleri açısından karşılaştırıldı. İntrapelvik en yüksek basınç ve ortalama basıncı etkileyen faktörleri tespit etmek için multivaryant analiz yapıldı. Bulgular: Gruplar arasında yaş, cinsiyet, vücut kitle indeksi (VKİ), taraf, taş boyutu, taş lokalizasyonu, taş dansitesi açısından fark yoktu. Grup 2’de preoperatif hidronefroz SFU Grade 2-3 oranı Grup 1’e göre daha yüksek bulundu (p=0,045). İntrapelvik basınç karşılaştırmasında Grup 1’de tüm basınçlar Grup 2’ye göre daha düşük saptandı. Ortanca kontrol pelvis basıncı (Pc) Grup 1’de 7 mmHg (6-9 mmHg) iken Grup 2’de 9 mmHg (6-12 mmHg) idi (p<0,001). En yüksek pelvis basıncı (Ph) Grup 1’de 78±18,2 mmHg iken, Grup 2’de 110±23,9 mmHg idi (p<0,001). Ortanca en düşük pelvis basıncı (Pl) Grup 1’de 29 mmHg (19-54 mmHg) iken Grup 2’de 42 mmHg (17-65 mmHg) idi (p=0,001). Ortanca pelvis basıncı (Port) Grup 1’de 41 mmHg (28-70 mmHg) iken Grup 2’de 69 mmHg (35-96 mmHg) idi (p<0,001). Dolu mesanede ortalama pelvis basıncı (Pbf) Grup 1’de 46,7±10,9 mmHg iken Grup 2’de 70±16,9 mmHg idi (p<0,001). Boş mesanede ortalama pelvis basıncı (Pbe) Grup 1’de 40,2±12 mmHg iken Grup 2’de 61,3±14,7 mmHg idi (p<0,001). Üretral katater takılması ile ortanca pelvis basınç düşüşü (Pdec) Grup 1’de 8 mmHg (2-22 mmHg) iken Grup 2’de 8 mmHg (1-28 mmHg) idi ve gruplar iv arasında fark izlenmedi (p=0,909). Multivaryant analizde intrapelvik basıncın düşük olmasında JJ stentin ve Grade 0-1 hidronefroz varlığı bağımsız bir prediktif faktör olarak gösterildi. Sonuç: Sonuçlar değerlendirildiğinde, RIRS öncesi takılan JJ stentin yaptığı üreter dilatasyonu sayesinde perioperatif renal pelvis basıncını azalttığı gösterildi. Ayrıca işlem sırasında üretral katater ile mesane drenajının yapılması da perioperatif renal pelvis basıncını azalttığı gösterildi.Publication Ureteral wall thickness at the stone site: A critical predictor of success and complications in children undergoing semi-rigid ureteroscopy(Elsevier, 2021-10-07) Kırlı, Elif Altınay; Bülbül, Emre; Kaygısız, Onur; Yeni, Sezgin; Can, Günay; Tutar, Onur; Onal, Bülent; KAYGISIZ, ONUR; YENİ, SEZGİN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı.; 0000-0001-5143-6507; 0000-0002-9790-7295; L-9439-2019 ; GFT-1275-2022IntroductionWe retrospectively assessed the role of ureteral wall thickness (UWT) at the ureteral stone site in predicting the stone-free status and the complication rates in children undergoing semi-rigid ureterorenoscopy (URS).Patients and methodsThe children who underwent URS and had undergone non-contrast abdominal computerized tomography before the URS were included in the study. The following protocol was used to determine the outcome. Immediately before removing the stent, all children were evaluated by ultrasound (US) and plain film (KUB) for residual stones in the upper urinary tract and after removing the double J stent, the presence of stone fragments in the ureter was checked with URS. The children were considered stone-free if no residual fragments were identified in radiologic imaging and the evaluation of the ureter by URS. The case was accepted as a failure if any fragments were seen on immediate US, KUB, and/or during URS just after the stent removal. The patients who could not complete the standard primary URS procedure due to stone-related reasons (patients for whom we could not pass the safety guidewire behind the stone and/or the procedure was terminated due to pyuria during the procedure) were also accepted as a failure. The possible factors related to the patient, stone, ureter, and the operation that could affect the outcome and the complications following the URS were evaluated.ResultsThe children's median age was six years (1-17 years). Among the 89 children included in the study, 69 (78%) were stone-free, and 20 (22%) presented residual stone after the first URS session. The ROC analysis revealed that a UWT value of 4.5 mm (sensitivity 60%, specificity 92%) was the optimal cut-off value predictive of the URS outcome. The regression analysis revealed UWT >4.5 mm (p = 0.006) and multiple stone presentation (p = 0.005) as independent risk factors for residual stone. Complications were detected in 15 (17%) children. Thick ureteral wall (p = 0.012) and longer operative time (p = 0.016) were defined as the independent risk factors for complications.DiscussionIncreased UWT is associated with the adverse outcomes of URS due to tissue hypertrophy, edema, and mucosal bleeding may cause difficulty in removing the stone. The thick ureteral wall might increase the risk of complications due to the necessity of manipulating the instruments or the involuntary forceful use of instruments while removing the stone.ConclusionUWT was the only independent variable affecting both increased failure and complication rates in children undergoing URS.Publication Ureteral wall thickness at the stone site: A critical predictor of success and complications in children undergoing semi-rigid ureteroscopy(Elsevier, 2021-06-01) Bülbül, E.; Kırlı, Elif Altınay; Kaygısız, Onur; Yeni, Sezgin; Can, Günay; Tutar, Onur; Onal, Bülent ; KAYGISIZ, ONUR; YENİ, SEZGİN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı.; 0000-0002-9790-7295; GFT-1275-2022; L-9439-2019Publication Ureterorenoscopic lithotripsy for pediatric kidney stones using holmium: Yttrium-aluminum-garnet laser devices: 15 W vs 30 W(Mary Ann Liebert, Inc, 2022-03-07) KAYGISIZ, ONUR; ÇİÇEK, MEHMET ÇAĞATAY; YENİ, SEZGİN; Yeni, Sezgin; Çicek, Mehmet Çağatay; Coşkun, Burhan; COŞKUN, BURHAN; Kılıçarslan, Hakan; KILIÇARSLAN, HAKAN; Turan, Levent; TURAN, LEVENT; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı.; 0000-0002-9790-7295; 0000-0001-5143-6507; 0000-0002-0471-5404; 0000-0002-8242-9921; L-9439-2019; AAH-9704-2021; JCO-5169-2023Introduction: We aimed to compare the effectiveness of 15- and 30-W holmium: yttrium-aluminum-garnet (Ho:YAG) laser devices used in the treatment of pediatric kidney stones.Methods: Eighty-six consecutive pediatric patients who underwent retrograde intrarenal surgery (RIRS) between February 2010 and August 2020 were enrolled in the study. After exclusion criteria were applied, the data of 79 children were evaluated retrospectively. Patients were divided into two groups according to the laser device power of 15 W (Group 15: N = 30) and 30 W (Group 30: N = 49). The groups were compared according to demographic characteristics, stone feature, and clinical efficacy.Results: The age, gender, height, weight, and stone characteristics were similar between the groups. The mean operation time was shorter in Group 30. The stone-free rate after the first RIRS session (SF1) was 66.7% in Group 15 and 83.3% in Group 30. The SF1 for 20-mm or larger kidney stones was found to be 0% in Group 15 and 62.5% in Group 30. However, there was no statistically significant difference between the two groups in terms of stone-free rate.Conclusions: In pediatric kidney stone treatment, 30-W Ho:YAG laser devices should be preferred as they shorten the operation time compared with 15-W devices and provide the final stone-free status with fewer procedures, especially in large kidney stones.