Person: KILIÇARSLAN, HAKAN
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KILIÇARSLAN
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HAKAN
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Publication A cut-off value for the operation time and other risk factors in terms of the infection risk for flexible ureterorenoscopy(Wiley, 2020-12-01) Demir, Aslan; Celen, Sinan; Gunseren, Kadir Omur; GÜNSEREN, KADİR ÖMÜR; Cicek, Mehmet Cagatay; ÇİÇEK, MEHMET ÇAĞATAY; Kilicarslan, Hakan; KILIÇARSLAN, HAKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı.; 0000-0001-8673-3093; 0000-0002-0471-5404; AAO-8934-2021; ABC-9924-2020Objectives To investigate the operation time (OT) and ureteral access sheath (UAS) usage with the infection rates and to determine a cut-off value for OT.Methods We retrospectively analysed the data of the patients who underwent flexible ureterorenoscopy (FURS) for renal stones larger than 20 mm between 2010 and 2019. The investigated parameters were OT, UAS using, and infection status. The data were analysed by forming two groups according to whether the OT was less than 60 minutes and more, whether the UAS was used and whether an infection occurred. In addition, independent risk factors that may affect postoperative urinary infection development were also investigated by logistic regression analysis. And, a Receiver Operating Characteristic (ROC) curve analysis was applied to determine a cut-off value in OT terms, where infection rates increase more.Results A total of 575 patients were enrolled in the study. The rates of the usage of UAS and infection were greater statistically in the group for longer than 60 minutes. OT was longer statistically in the infection group than in the group without infection (94.1 +/- 14.2 and 68.01 +/- 23.1, for groups 1 and 2, respectively, P < .05, Table 2). OT was statistically longer in the UAS group than the unused one (79.3 +/- 24.4 and 66.7 +/- 22.4, for groups 1 and 2, respectively, P < .05, Table 3). ROC analyses revealed a cut-off point of 87.5 min for OT in terms of infection rate.Conclusion While the infection risk increases when OT exceeds 60 minutes, FURS can be safely performed up to 87.5 minutes with 89% sensitivity and 69% specificity infection risk.Publication Comparison of laparoscopic pyelolithotomy and retrograde intrarenal surgery in the management of large renal pelvic stones(Wiley, 2021-03-02) Çiçek, Mehmet Çağatay; Asi, Tariq; Günseren, Kadir Ömür; Kılıçarslan, Hakan; ÇİÇEK, MEHMET ÇAĞATAY; GÜNSEREN, KADİR ÖMÜR; KILIÇARSLAN, HAKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı; 0000-0002-0471-5404; 0000-0001-8673-3093; ABC-9924-2020; HGM-5995-2022; FGY-3115-2022Background To compare the clinical outcomes of laparoscopic pyelolithotomy (LP) and retrograde intrarenal surgery (RIRS) in the management of large renal pelvic stones.Patients and methods This study included patients who presented with a single renal pelvic stone sized >= 20 mm and who were treated primarily by LP or RIRS. The patients were grouped based on the surgical procedure they underwent. We retrospectively examined and compared the age, the longest axis, and the surface area of the stone, operation time, hospitalization time, complications, and stone-free rates of the two groups.Results Of the 156 patients included in the study, 44 had LP, and 112 had RIRS. Patients who received LP (13 males, 31 females) had a median age of 54 (18-79) years, while those who underwent RIRS (46 males, 66 females) had a median age of 54.5 (18-79). Patients who received LP were found to have larger median stone size (30 mm vs 24 mm, P = .003), longer operation time (100 minutes vs 70 minutes, P = .007), lower complication rate (2% vs 8.9%, P = .063), longer median hospital stay (3 days vs 1 day, P < .001) and better stone-free rate at the third month (90.9% vs 67.9%, P < .001).Conclusion LP is a safe and efficient procedure that could be used as an alternative to RIRS in managing large renal pelvic stones.Publication Which frequency is better for pediatric shock wave lithotripsy? Intermediate or low: A prospective randomized study(Springer, 2021-04-22) Kaygısız, Onur; Çiçek, Mehmet Çağatay; Mert, Ahmet; Akesen, Selcan; Sarandöl, Emre; Kılıçarslan, Hakan; KAYGISIZ, ONUR; ÇİÇEK, MEHMET ÇAĞATAY; AKESEN, SELCAN; SARANDÖL, EMRE; KILIÇARSLAN, HAKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Biyokimya Anabilim Dalı.; 0000-0002-9790-7295; 0000-0002-0471-5404; 0000-0003-4236-3646; 0000-0002-2593-7196; L-9439-2019; HGM-5995-2022; ELR-9087-2022; DXM-3644-2022; FGY-3115-2022Purpose Shock wave lithotripsy (SWL) is the first option in the treatment of pediatric kidney stones; however, optimal frequency is still uncertain. The aim of this study was to compare low frequency [60 shocks per minute (SWs/min)] and intermediate frequency [90 SWs/min] in terms of lithotripsy success, complications, cardiac arrhythmia, anesthesia time, secondary procedures, and efficiency quotient (EQ) in children. Methods Seventy-eight consecutive children who received SWL for radiopaque renal stones between July 2016 and January 2020 were randomly divided into two groups: Group 60 (SWL frequency: 60 SWs/min) and Group 90 (SWL frequency: 90 SWs/min). After exclusion (remaining 71 children), Group 60 (n = 38) and Group 90 (n = 33) were compared using univariate analysis. Results The median age of children (37 girls, 34 boys) was 5 (1-16) years. Patient demographics and stone features were similar between the groups. Success rate after the last SWL session was 81.6% (n = 31) for Group 60 and 87.9% (n = 29) for Group 90 (p = 0.527). Stone-free rate after the first, second, and third sessions was 42.1%, 18.4%, and 21.1% for Group 60 and 48.5%, 27.3%, and 12.1% for Group 90, respectively. Additional treatment rate was similar between the groups. In Group 60, the EQ was 57.83, and it was 64.07 in Group 90. Median total anesthesia time was significantly longer in Group 60 (74.5 min) than in Group 90 (32 min; p < 0.001). Conclusion Intermediate frequency and low-frequency pediatric SWL have similar success rates; however, intermediate-frequency SWL has a shorter anesthesia time.Publication 15 and 30 w holmium: Yag laser lithotriptor in ureteroscopic lithotripsy: Which one is more effective and safe?(Mary Ann Liebert, 2021-05-05) Kaygısız, Onur; Aydın, Yavuz Mert; Çicek, Mehmet Çağatay; Çelen, Sinan; Coşkun, Burhan; Kılıçarslan, Hakan; Kaygısız, Onur; KAYGISIZ, ONUR; Aydın, Yavuz Mert; AYDIN, YAVUZ MERT; Çicek, Mehmet Çağatay; ÇİÇEK, MEHMET ÇAĞATAY; Coşkun, Burhan; COŞKUN, BURHAN; Kılıçarslan, Hakan; KILIÇARSLAN, HAKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı.; 0000-0002-9790-7295; 0000-0002-6287-6767; 0000-0002-0471-5404; 0000-0002-8242-9921; JCO-5169-2023; AFP-3055-2022; L-9439-2019Background: Holmium:yttrium-aluminium-garnet (Ho:YAG) laser lithotripsy with ureteroscopy (URS) was a safe and successful treatment option for pediatric ureteral stones. We aimed to comparatively evaluate the outcomes of 15 and 30 W Ho:YAG laser lithotriptors in pediatric ureter stones.Materials and Methods: We retrospectively evaluated 55 children who underwent ureteroscopic laser lithotripsy to treat ureter stone size up to 15 mm between September 2009 and March 2020. Groups were formed according to the laser lithotriptor power 15 W (Group 15: n = 32), 30 W (Group 30: n = 23). The efficiency of laser lithotriptors was compared between the groups.Results: The age, gender, and stone characteristics (longest stone diameter, density, location and multiple stones) were similar between the groups. In the postop first month, stone-free status was achieved in all cases except one child in Group 15. The median operative time was significantly shorter in Group 30 (40 minutes) than in Group 15 (52.5 minutes) (P = .010). Clavien-Dindo class (CDC) 2 complications occurred in 2 children in both groups (P = .597). Although ureteric stenosis was observed in 1 patient in Group 15, no ureteric stenosis was seen in Group 30 during follow-up (median 16.1 months). Length of hospital stay (LoHS) and stone-free rates were similar between groups.Conclusion: URS with 15 and 30 W Ho:YAG laser lithotriptors is an effective treatment option for pediatric ureteral stones with a high success rate and low complication rates. In brief, 30 W Ho:YAG laser lithotriptors should be preferred over 15 W lithotriptors due to their shorter operative time with similar success rate.