Person: GÜNSEREN, KADİR ÖMÜR
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GÜNSEREN
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KADİR ÖMÜR
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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 Investigation of the tissue allele distribution of the deceased kidney donors between 2007 and 2017.(Lippincott Williams & Wilkins, 2019-11-01) Oflaz, Rafet; Elgin, Ersin; Yıldız, Abdülmecid; Oruç, Ayşegül; Akgür, Suat; Ünsal, Oktay; Karaca, Mert; Ersoy, Sahriye; Selimoğlu, Kerem; Arslan, İlknur; Karan, Elif; Çiçek, Mehmet Çağatay; Günseren, Kadir Ömür; Güllülü, Sümmeyye; Vuruşkan, Hakan; Oflaz, Rafet; Elgin, Ersin; Yıldız, Abdülmecid; ORUÇ, AYŞEGÜL; AKGÜR, SUAT; Ünsal, Oktay; KARACA, MERT; Ersoy, Sahriye; Selimoğlu, Kerem; Arslan, İlknur; Karan, Elif; ÇİÇEK, MEHMET ÇAĞATAY; GÜNSEREN, KADİR ÖMÜR; GÜLLÜLÜ, NAZMİYE SÜMEYYE; VURUŞKAN, HAKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Organ Nakli Merkezi.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İmmünoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kardiyoloji Anabilim Dalı.; 0000-0002-9509-5799; 0000-0002-0342-9692; 0000-0003-3635-7282; 0000-0002-3454-8483; 0000-0002-0471-5404; 0000-0001-6711-676X; AAG-7406-2021; AAH-4002-2021; DJU-5362-2022; DXA-2790-2022; EIF-8983-2022; JIX-1144-2023; JJY-8484-2023; AAG-7406-2021; EVS-9805-2022; CDS-3299-2022; CCH-8947-2022; FDB-4488-2022; HGM-5995-2022; EFH-9523-2022; CST-9838-2022; ITO-9188-2023Publication The effects of laparoscopic urologic surgery on cardiac functions: A pulse wave velocity study(Aves, 2020-07-01) Çiçek, Mehmet Çağatay; Kaynak, Yurdaer; Gunseren, Kadir Ömur; Kaygısız, Onur; Vuruşkan, Hakan; ÇİÇEK, MEHMET ÇAĞATAY; GÜNSEREN, KADİR ÖMÜR; KAYGISIZ, ONUR; VURUŞKAN, HAKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı.; 0000-0002-0471-5404; 0000-0001-8673-3093; 0000-0002-9790-7295; ABC-9924-2020; L-9439-2019; HGM-5995-2022 ; EFH-9523-2022Objective: The aim of this study is to evaluate the effects of laparoscopic urologic surgery on cardiac functions by the parameter pulse wave velocity (PWV), a noninvasive method.Material and methods: Between July 2012 and February 2013, a total of 47 patients were included in this prospective controlled study. Patients who have been scheduled for laparoscopic surgery (LS) (n=30) and open surgery (n=17) were enrolled in the study. Preoperative, perioperative, and postoperative cardiovascular parameters were measured by a PWV instrument, and the results were compared between laparoscopic (L) group and open (C) group.Results: In the L group, compared to preoperative values, perioperative systolic arterial pressure, diastolic arterial pressure, and mean arterial pressure increased considerably, by 2.6%, 7.9%, and 4.7%, respectively. This was in contrary to reductions in these parameters by 9.5%, 5.7%, and 10%, respectively, in the C group. For the I. group, cardiac output (CO) and cardiac index (CI) were increased in the perioperative period and decreased in the postoperative period. For the C group, there were no changes in measurements of perioperative and postoperative CO and CI. However, these changes in CO and CI were not significantly different between the L and C groups. Postoperative large artery elasticity index decreased in both groups. However, these changes did not represent significant difference between groups.Conclusion: Compared to open surgery, LS may cause increases in perioperative blood pressures. In addition, increased blood pressures may last even on the first postoperative day. These effects may be more important for patients with high cardiovascular risk.Publication Single center experience with laparoscopic adrenalectomy on a large clinical series: Lessons learned from 273 cases: A retrospective cohort study(Kuwait Medical Association, 2022-12) Çelen, Sinan; Günseren, Kadir Ömur; Vuruşkan, Hakan; Acımış, Nurhan Meydan; Kordan, Yakup; Yavaşcaoğlu, İsmet; GÜNSEREN, KADİR ÖMÜR; VURUŞKAN, HAKAN; YAVAŞCAOĞLU, İSMET; Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Bölümü; ITO-9188-2023; EFH-9523-2022; EIN-0828-2022Objectives: We aim to evaluate the risk of laparoscopic adrenalectomy (LA) for large adrenal tumors and the risk of learning curve.Design: Single centre, retrospective studySetting: Uludag University, Bursa, TurkeySubjects: A study in a large patient population (N=273) who underwent LA between 2006 and 2017.Interventions: The patients were divided into two study groups according to tumour size as estimated by pathologic specimen maximum diameter, Group A (less than 5cm) and group B (larger than 5cm). In addition, to evaluate learning curve of LA, the patients were divided into two groups according to time interval: the first period was 2006 to 2011, and the second period 2012-2017.Main outcome measures: To evaluate the risk of learning curve and tumour sizeResults: There was no statistical difference between the two groups for per-operative and postoperative complications according to tumour size <5 or >= 5 cm, and there was statistical difference between the two groups for operation time, length of hospital stay; but no statistical difference for postoperative complications according to time interval.Conclusion: LA in large adrenal masses (5 cm or larger) is not associated with longer operative time, increased blood loss and longer hospital stay, without affecting perioperative morbidity, Hence, the size of an adrenal mass should not be the only factor in determining whether LA or not. Besides, learning curve may affect outcomes of LA.Publication Effects of obesity on the perioperative results and continence status in laparoscopic radical prostatectomy(Galenos Yayıncılık, 2018-01-16) Kaygısız, Onur; Özmerdiven, Cağdaş Gökhun; Vuruşkan, Berna Aytaç; Coşkun, Burhan; Günseren, Kadir Ömür; Kordan, Yakup; Yavasçaoğlu, İsmet; Vuruşkan, Hakan; KAYGISIZ, ONUR; AYTAÇ VURUŞKAN, BERNA; COŞKUN, BURHAN; GÜNSEREN, KADİR ÖMÜR; VURUŞKAN, HAKAN; YAVAŞCAOĞLU, İSMET; Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; 0000-0002-9790-7295; AAH-9704-2021; ABC-9924-2020; AAH-9746-2021; AAM-9726-2020; JHZ-8017-2023; EFH-9523-2022Objective: To assess the effects of obesity on the surgical success and perioperative results and continence status in laparoscopic radical prostatectomy (LRP).Materials and Methods: The results of 300 consecutive patients undergoing LRP between April 2004 and January 2014 were analyzed retrospectively. Twenty patients were excluded from the study, thus, 280 patients remained. The patients were separated into 3 groups according to their body mass index. Based on this classification, group 1 (< 25 kg/m(2)) was normal, group 2 (25- 30 kg/m(2)) was overweight, and group 3 (> 30 kg/m(2)) was obese. The demographic data, intraoperative results, pathological results, and states of continence were compared among the groups.Results: There were 81 patients in group 1, 152 patients in group 2, and 47 patients in group 3. There were no significant differences when the groups were compared according to age and prostate specific antigen values. The intraoperative blood loss was high in group 3 only. Moreover, the estimated blood loss, transfusion, operative time, bilateral nerve- sparing rate, hospitalization days, and complication rate were similar between the groups. There were no significant differences when the pathological results were compared according to the positive surgical margins and Gleason scores. Although the continence rates in group 3 were significantly low 6 months after the operation (p< 0.05), the results were similar at 1 year (p= 0.738).Conclusion: LRP can be applied confidently in obese patients as well as normal and overweight patients.Publication Challenging risk factors for right and left laparoscopic adrenalectomy: A single centre experience with 272 cases(Brazilian Soc Urol, 2019-07-01) Kordan, Yakup; Günseren, Kadir Ömür; GÜNSEREN, KADİR ÖMÜR; Çiçek, Mehmet Cağatay; ÇİÇEK, MEHMET ÇAĞATAY; Vuruşkan, Hakan; VURUŞKAN, HAKAN; Yavaşçaoğlu, İsmet; YAVAŞCAOĞLU, İSMET; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı.; 0000-0001-8673-3093; 0000-0002-0471-5404; 0000-0002-9947-848X; ABC-9924-2020Purpose: This study aimed to compare perioperative and postoperative results of right and left laparoscopic adrenalectomy (LA), and to evaluate the impact of challenging factors on these outcomes.Materials and Methods: A total of 272 patient's medical records that underwent single side LA between October 2006 and September 2017 were retrospectively reviewed. The patients were divided into 2 groups according to operation side. Moreover, pheochromocytoma, metastatic masses and adrenal lesions >5cm in size were considered to be difficult adrenalectomy cases and the outcomes of these cases were compared between two groups.Results: 135 patients (49.6%) underwent right LA and 137 patients (50.4%) underwent left LA. Operation time, estimated blood loss (EBL) and hospitalization time were similar between the groups (p=0.415, p=0.242, p=0.741, respectively). Although EBL was higher on the right side than the left (p=0.038) in the first 20 cases, after this learning period has been completed, there was no significant difference between the groups. In patients with pheochromocytoma, metastatic mass and a mass >5cm in size, despite bleeding complications were clinically higher on the right side, this difference was not statistically significant.Conclusions: During the learning period of LA, EBL is higher on the right side. Due to the greater risk of bleeding complications on the right side even on the hands of experienced surgeons, extra care and preoperative planning are required in patients with pheochromocytoma, metastatic masses and masses >5cm in size.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 Monocyte-to-high-density lipoprotein cholesterol ratio is independently associated with all-cause mortality in deceased donor kidney transplant recipients(Başkent Üniversitesi, 2021-10-01) Çiçek, Mehmet Çagatay; Günseren, Kadir Omur; Aydın, Yavuz Mert; Yıldız, Abdulmecit; Elgin, Ersin; Ersoy, Alparslan; ÇİÇEK, MEHMET ÇAĞATAY; GÜNSEREN, KADİR ÖMÜR; AYDIN, YAVUZ MERT; YILDIZ, ABDULMECİT; Elgin, Ersin; ERSOY, ALPARSLAN; Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Bölümü; Uludağ Üniversitesi/Tıp Fakültesi/Transplantasyon Bölümü; Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Bölümü; 0000-0002-0471-5404; 0000-0001-8673-3093; 0000-0002-6287-6767; 0000-0002-9509-5799; ABC-9924-2020; AFP-3055-2022; HGM-5995-2022; HIG-9032-2022; DXA-2790-2022; CPX-5894-2022Objectives: The primary objective of this study was to evaluate the impact of monocyte-to-high-density lipoprotein cholesterol ratio on all-cause mortality in deceased donor kidney transplant recipients. Materials and Methods: This was a retrospective observational study in which all deceased donor kidney transplant recipients were included. Relevant data for analyses included clinical and demographic features, laboratory values, number of HLA matches, occurrence of delayed graft function, cold ischemia time, and survival status. Kaplan-Meier survival analysis and Cox proportional hazards analysis were performed to determine the effects of monocyte-tohigh-density lipoprotein cholesterol ratio on all-cause mortality. Results: Our study included 325 deceased donor kidney transplant recipients (43.1% females, mean age of 44.5 +/- 11.2 years). Median value of monocyte-tohigh-density lipoprotein cholesterol ratio was 14.0 (interquartile range, 9.94-21.03). The total median observation time was 227 weeks (range, 115-345 weeks). Twenty deaths (12.3%) occurred during the follow-up period in recipients with monocyte-to-highdensity lipoprotein cholesterol ratio below median value, whereas 47 deaths (29%) occurred in recipients with ratio above the median (P < .001). Log-rank test showed significantly higher mortality in the group with monocyte-to high density lipoprotein cholesterol ratio higher than median (P = .001). In the multivariate Cox model, delayed graft function, duration of dialysis, cold ischemia time, and monocyte-to-high-density lipoprotein cholesterol ratio group appeared as independent predictors of all-cause mortality. Conclusions: Monocyte-to-high-density lipoprotein cholesterol ratio before kidney transplant seems to affect survival independently in deceased donor kidney transplant recipients.Publication Evaluation of one year, five years and ten years life time of patients with kidney transplant: Single-center experience(Lippincott Williams & Wilkins, 2020-09-01) Elgin, Ersin; Aydın, Mehmet Fethullah; Ünsal, Oktay; Yıldız, Abdulmecid; Oruç, Ayşegül; Günseren, Kadir Ömur; Çiçek, Mehmet Çağatay; Budak, Ferah; Oral, H. Barbaros; Ersoy, Alparlan; Elgin, Ersin; Aydın, Mehmet Fethullah; Unsal, Oktay; Yıldız, Abdulmecid; ORUÇ, AYŞEGÜL; GÜNSEREN, KADİR ÖMÜR; ÇİÇEK, MEHMET ÇAĞATAY; BUDAK, FERAH; ORAL, HALUK BARBAROS; Ersoy, Alparlan; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Bursa Bölge Koordinasyon Merkezi.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İmmünoloji Anabilim Dalı.; 0000-0002-9509-5799; 0000-0002-5665-7402; 0000-0002-0342-9692; 0000-0001-7625-9148; 0000-0003-0463-6818; F-4657-2014; K-7285-2012; AAH-4002-2021; AAJ-8220-2020; IZP-9398-2023; DXA-2790-2022; JKA-8956-2023; JJY-8484-2023; EIF-8983-2022; JJO-6552-2023; CNT-9025-2022Publication Laparoscopic ureterolithotomy; an equally effective and a sensible alternative to flexible ureterorenoscopy in the management of large ureteral stones in terms of effectivity and cost(Iniestares, S.a., 2021-07-01) Demir, Aslan; Günseren, Kadir Ömür; GÜNSEREN, KADİR ÖMÜR; Çicek, Mehmet Çağatay; ÇİÇEK, MEHMET ÇAĞATAY; Yavasçaoğlu, İsmet; YAVAŞCAOĞLU, İSMET; Kılıçarslan, Hakan; KILIÇARSLAN, HAKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı.; 0000-0001-8673-3093; 0000-0002-0471-5404; 0000-0001-8673-3093; ABC-9924-2020; HGM-5995-2022; JIT-9412-2023; EIN-0828-2022OBJECTIVES: We aimed to understand whether laparoscopic ureterolithotomy (LU) is a good alternative to flexible ureterorenoscopic lithotripsy (FURS) by comparing these techniques concerning cost-effectiveness.METHODS: We analysed 79 patients with upper ureteral stones larger than 1.5 cm underwent FURS or LU concerning cost-effectiveness analysis. The data including age, body mass index (BMI), stone size, operation time, hospitalisation time, complications and stone-free rates of 15th day and 3rd months. We audited the costs of FURS and LU and compared them concerning cost-effectiveness.RESULTS: There was not any statistically significant difference between the two groups with regard to age, BMI, stone size, stone-free rates at the 3rd month, and complication rates, (p>0.05).The operation times were statistically lower in the FURS than in the LU (61.5 +/- 24.3 min and 140.9 +/- 49.1 min, respectively, p<0.05). The stone-free rate at the 15th day was lower in the FURS group than in the LU group (31 (81.6%) and 41 (100%), respectively, p<0.05) (Table I).However, this statistical difference disappears at 3 months (p>0.05). The mean costs of FURS and LU were $194.2 +/- 12.4 and $179.2 +/- 58.5, respectively (p<0.001).CONCLUSION: FURS is equally effective to LU in terms of stone-free rates. The cost of FURS is higher statistically than LU. FURS is shown as the first choice for the upper ureteral stones larger than 10 mm in size, if the laparoscopic experience is in high-level situations in that clinic, LU may be a suitable alternative to FURS, especially for challenging cases.