Person: GÜRPINAR, ARİF NURİ
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GÜRPINAR
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ARİF NURİ
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Publication Double purse -string suturing: An easy plication technique in thoracoscopic repair of diaphragmatic eventration(W B Saunders Co-elsevier Inc, 2020-05-01) Parlak, Ayşe; PARLAK, AYŞE; Gürpınar, Arif Nuri; GÜRPINAR, ARİF NURİ; Doğruyol, Hasan; Bursa Uludağ Üniversitesi/Tıp Fakültesi; 0000-0001-7686-2561; AAH-6766-2021; AAI-3658-2021Objective: The aim of this study was to describe a new double purse-string suturing plication method that was developed to minimize difficulties experienced in thoracoscopic plication in pediatric patients.Methods: We retrospectively analyzed the data of patients that underwent diaphragmatic eventration repair with new technique developed in our clinic. In this technique, we perform diaphragm plication with continuous double layer purse-string suturing. A third suturing may be necessary in case of wide eventrations. Thoracic drainage catheter is inserted into the thorax on a routine basis.Results: Thoracoscopic plication was performed using the double purse-string suturing technique on 16 cases that presented with diaphragmatic eventration between April 2012 and December 2018. The patients' mean age was 2.2 years (6 months-17 years). The main causes of admission were recurrent respiratory system infections (n: 14), respiratory distress with effort (n: 4), ventilator dependence (n: 1), and gastrointestinal complaints such as nutritional problems (n: 1). Diaphragmatic eventration was incidentally detected in 1 patient. No complications were observed during the postoperative period, except for 1 patient that developed pneumothorax. The mean duration of hospital stay was 4.9 days (2-7 days), except for 1 patient who had ventilator dependence and congenital myopathy. The mean descending distance of the diaphragm was 2.3 intercostal spaces at postoperative first month. The clinical outcomes were satisfactory and all patients experienced symptom improvements.Conclusions: Diaphragm plication with double purse-string suturing method enables symmetrical stretching of the diaphragmatic muscles. Therefore, the diaphragmatic surface and costophrenic sinium are protected and remain functional. The advantages of this new double purse-string suturing method are easy application and durability. We believe that this method can become a preferred thoracoscopic plication technique for treatment of diaphragmatic eventration.Publication Lung functions during long term follow-up after pleural empyema treatment in children(Galenos Yayıncılık, 2009-12-01) Kırkpınar, Ayhan; Canıtez, Yakup; Çelebi, Solmaz; Sapan, Nihat; Hacımustafaoğlu, Mustafa; Gürpınar, Arif; Kırkpınar, Ayhan; CANITEZ, YAKUP; ÇELEBİ, SOLMAZ; SAPAN, NİHAT; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; GÜRPINAR, ARİF NURİ; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Cerrahisi Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı Hastalıkları Anabilim Dalı.; 0000-0003-4646-660X; CXY-2332-2022; CJQ-2060-2022; JHN-1091-2023; FUI-8766-2022; CTG-5805-2022; ISV-9154-2023Introduction: Studies on lung functions at the long term follow-up of pleural empyema treatment in children are limited. The aim of this study was to evaluate the long term pulmonary function test results in childhood empyema cases treated with antibiotic (AB) or AB+tube thoracostomy (TT) or AB+TT+fibrinolytics (FT).Materials and Method: In this study, 45 cases (1 to 13 years old) treated for empyema were included. The age, gender, clinical characteristics, radiological findings and laboratory results at baseline and during the follow-up periods and the treatment modalities (AB or AB+TT or AB+TT+FT) were evaluated. Pulmonary function tests were performed at the end of the follow-up periods.Results: The mean ages at baseline and at the end of follow-up period of 30.4 +/- 13.5 (6-54) months were 6.3 +/- 3.3 (1-13) years and 9.3 +/- 3.4 (4-17) years, respectively. Stages of the disease at admission was acute exudative (stage 1) in 14 (31.1%) cases, fibrinopurulent (stage 2) in 19 (42.2%) and chronic organizing (stage 3) in 12 (26.7%). Twenty one cases (46.7%) were treated with AB, 8 (17.8%) with AB+TT and 16 (35.5%) with AB+TT+FT. Chest roentgenograms showed abnormal findings in 15 cases (33.3%) at the 3rd month, in 3 cases (6.6%) at the 6th month and none at the 12th month. Pulmonary function tests were available in 25 children. The mean follow-up period of these cases was 32.7 +/- 11.9 months after the empyema treatment. Three cases (12%) with a shorter mean follow-up (8.3 +/- 3.3 months) had minimal restrictive patterns. Six of 25 (24%) cases having pulmonary function tests were classified as stage 1, 12 (48%) as stage 2, and 7 (28%) as stage 3 empyema at admission. Of 25 cases having pulmonary function tests, 12 (48%) were treated with AB, 4 (16%) with AB+TT and 9 (36%) with AB+TT+FT. Mean VC, FVC, FEV1/FVC, FEV1, FEF25-75% and PEF values did not significantly differ according to stages and treatment modalities (p>0.05).Conclusion: It was seen that after the treatment of empyema, remarkable improvements were seen in chest roentgenographic findings between 3rd and 6th months and in general, pulmonary function tests revealed normal results in long term. Our results suggest that lung functions are not significantly compromised at long term after empyema treatment.Publication Clinical clues(Aves Yayincilik, Ibrahim Kara, 2012-09-01) Gurpinar, Arif; GÜRPINAR, ARİF NURİ; Yazici, Zeynep; YAZICI, ZEYNEP; Celebi, Solmaz; ÇELEBİ, SOLMAZ; Hacimustafaoglu, Mustafa; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Cerrahi Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0003-4646-660X; AAI-2303-2021Publication Our lobectomy experience(Galenos Yayincilik, 2010-12-01) Mercan, Mehmet Hilmi; Gürpınar, Arif; GÜRPINAR, ARİF NURİ; Şengün, Ayse; Doğruyol, HasanIntroduction: Lobectomy is a compulsory operation performed due to congenital or acquired reasons in which, minimum lung tissue loss and the prevention of residual lung function is targeted. Patients who had lobectomy in our clinic were retrospectively evaluated for indications of their lobectomies and postoperative follow up.Materials and Method: Our clinic records were retrospectively investigated for lobectomy operations and with their etiologies. The pneumonectomy and segmented lobectomy operations were excluded from this study. Principally, etiologic factors were divided in 2 groups; congenital and acquired deformities.Results: Twenty seven patients (16 males and 11 females) were included and their ages ranged from 2 days to 17 years. The number of patients with congenital disease was 14 and their mean age for operation was 3 months. The number of patients who had acquired etiology was 13 and their mean age for operation was 6 years. The congenital causes were lobar emphysema (n: 7), congenital cystic adenomatoid malformation (n: 4) and pulmonary sequestration (n: 3). The acquired causes werepost pneumonic deformities (n: 12) and traumatic bronchus rupture (n: 1). While patients who were operated due to congenital reasons were completely cured, the follow up of 2 patients with acquired reasons (one with Kartagener's syndrome and one with tuberculosis) is still continuing in assistance with pediatric infectious disease team.Conclusion: The results of lobectomy are better for congenital causes. The patients having acquired causes for lobectomy need longer follow- up times and their results vary depending on primary disease.Publication Right lung agenesis; isolated and with accompanied anomalies(Galenos Yayincilik, 2013-12-01) Canitez, Yakup; ÇEKİÇ, ŞÜKRÜ; CANITEZ, YAKUP; GÜRPINAR, ARİF NURİ; Gürpınar, Arif; Sapan, Nihat; SAPAN, NİHAT; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; 0000-0002-9574-1842; L-1933-2017Right lung agenesis is a rare anomaly that can be isolated or accompanied by system anomalies such as cardiac, skeletal or urinary systems. Case 1, a four-month-old girl, was brought because of respiratory distress. Patient had polydactyly, syndactyly of right thumb, right mandibular hypoplasia and low-set dysmorphic ears. Lung x-ray and thorax computerized tomography (CT) were consistent with right pulmonary agenesis and butterfly vertebra was evident in the 7th thoracic level. Thoracic CT angiography revealed narrowing of the left main bronchus and esophagus due to compression of aorta, left pulmonary artery and right atrium. In bronchoscopy, narrowing due to compression at the carina level was seen and right main bronchus was not seen. In abdominal ultrasonography, right kidney placement anomaly (pelvic ectopia) was present and renal scintigraphy revealed fusion in both kidneys. With these findings, it was found that right pulmonary agenesis was accompanied by ipsilateral radial ray anomaly, renal anomaly, vertebral anomaly and hemifacial microsomia. Case 2, a fifteen-year-old male patient, was diagnosed as pulmonary agenesis via chest x-ray, pulmonary CT and bronchoscopy after a wheezing episode when he was 2 months old. Patient had no complaint except for exhaustion that is aggravated by exercise during last year. In physical examination, he had a mild scoliosis toward right, respiratory sounds were diminished on right hemithorax and heart sounds were heard on right side. Chest x-ray and thoracic CT were consistent with right lung agenesis. No abnormality was found in echocardiography and abdominal ultrasonography was normal. Accompanied cardiovascular anomalies, distortions of intrathoracic structures and recurrent infections are main factors that affect mortality and morbidity. Here, two cases with right lung agenesis, isolated and accompanied by multiple anomalies, were presented.Publication X-ray-evaluation(Aves Yayincilik, Ibrahim Kara, 2012-12-01) Hacımustafaoğlu, Mustafa; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; Çelebi, Solmaz; ÇELEBİ, SOLMAZ; Gürpınar, Arif; GÜRPINAR, ARİF NURİ; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Cerrahisi Anabilim Dalı.; 0000-0003-4646-660XPublication X - ray - evaluation(Aves Yayincilik, Ibrahim Kara, 2009-09-01) Hacımustafaoğlu, Mustafa; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; Gürpınar, Arif; GÜRPINAR, ARİF NURİ; Doğruyol, Hasan; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; 0000-0003-4646-660XPublication Congenital diaphragmatic hernia: Ten-year single center results(Galenos Yayıncılık, 2017-12-01) Dorum, Bayram Ali; Çakır, Salih Çağrı; Yakut, Uğur; Özkan, Hilal; Gürpınar, Arif Nuri; Köksal, Nilgün; Dorum, Bayram Ali; ÇAKIR, SALİH ÇAĞRI; Yakut, Uğur; ÖZKAN, HİLAL; GÜRPINAR, ARİF NURİ; Köksal, Nilgün; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Neonatol Bilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Cerrahisi Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; 0000-0002-2823-8454; 0000-0001-5761-4757; A-5375-2017; HJZ-4508-2023; JSF-7437-2023; JRA-9088-2023; JIJ-4901-2023; JGS-7600-2023Introduction: Congenital diaphragmatic hernia (CDH) is a rare abnormality with high mortality and long-term comorbid conditions. Our aim, in this paper, was to describe demographics and birth characteristics, treatment, and outcomes of consecutive patients with CDH treated at our institution.Methods: The present study represents a retrospective cohort study of neonates with CDH who were treated at Uludag University Medical Faculty, Neonatal intensive care unit, Bursa. We identified the medical records of all patients with CDH who were admitted for treatment to our neonatal intensive care unit from January 2007 to December 2016. We reviewed the medical, surgical records, demographics and birth characteristics. We also recorded presence of pulmonary hypertension, whether or not the liver and, stomach also herniated into the thorax, other associated congenital malformations, and type of mechanical ventilation.Results: Forty patients were included in this study. The overall mortality was 67.5% (27/40). Survival for those who had surgical correction of CDH was 61% (13/21). Low birth weight, low gestational age, low APGAR scores and, high oxygen need at baseline was found to be associated with mortality, in patients with CDH. Among survivors, the median duration of hospitalization was 23 (14-35) days. Chronic gastrointestinal, pulmonary disorders and, failure to thrive were the most comorbid conditions after discharge.Discussion And Conclusion: KDH still has high mortality and morbidity. The birth of patients with prenatal diagnosis at appropriate centers will increase their chances of successful intervention.Publication Laparoscopic repair of morgagni hernia in children(Mary Ann Liebert, Inc, 2022-02-11) Parlak, Ayşe; PARLAK, AYŞE; Gürpinar, Arif Nuri; GÜRPINAR, ARİF NURİ; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; 0000-0001-7686-2561; AAI-3658-2021; AAH-6766-2021Background: This study aims to review laparoscopic repair techniques of Morgagni hernias at a tertiary referral center.Methods: This retrospective study includes pediatric patients who underwent laparoscopic repair of Morgagni hernia between March 2004 and March 2021. The patients' demographics, presenting symptoms, operative approach, and postoperative outcomes were recorded.Results: Fourteen patients underwent laparoscopic repair of Morgagni hernia. The mean age at the time of operation was 24.7 months. Defect closing techniques were intracorporeal knot tying (n: 2), extracorporeal knot tying, and subcutaneous knot placement (n: 10), combination with intracorporeal continuous suturing and several extracorporeal intermittent sutures (n: 2). Different approaches were used during removal of the needle from the insertion point in the extracorporeal knot tying: intracorporeally, using a laparoscopic needle holder (n: 6), with an 18-gauge injector tip (n: 1), and extracorporeally with suture passer forceps (n: 3). In the intracorporeal knot tying technique, the mean operation time was 127 minutes (range 90-180 minutes). In the extracorporeal knot tying technique, the mean operation time was 75 minutes (range 30-180 minutes). The mean operation time in the technique that used suture passer forceps for removing the needle from the same point of insertion was 40 minutes. There was no intraoperative complication.Conclusions: In the laparoscopic repair of Morgagni hernia, full-thickness anterior abdominal wall repair with interrupted sutures that are tied extracorporeally in the subcutaneous tissue by separated minor skin incisions is the easy approach. Using suture passer forceps during removal of the needle facilitates this technique and shortens the operation time.