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Now showing 1 - 7 of 7
  • PublicationOpen Access
    Comparison of transperitoneal laparoscopic nephrectomy outcomes in atrophic and hydronephrotic kidneys
    (2015-12-01T00:00:00Z) GÜLPINAR, MURAT TOLGA; AKÇAY, MUZAFFER; SANCAK, EYÜP BURAK; Akbas, Alpaslan; Tepeler, Abdulkadir; REŞORLU, BERKAN; Armagan, Abdullah; AKÇAY, MUZAFFER
    Objective: To compare the results of transperitoneal laparoscopic nephrectomy in patients with atrophic and hydronephrotic kidneys. Material and methods: Clinical data were collected from 35 patients who had undergone laparoscopic nephrectomies for atrophic or hydronephrotic non-functioning kidneys between January 2010 and March 2014. Comparative analysis was carried out between the two groups examining demographic characteristics, imaging modalities, etiology, operative times, port numbers, conversion to open surgery, complications, pre- and post-operative hemoglobin and creatinine values, transfussion rates and length of hospital stays. Results: Laparoscopic nephrectomy was performed for atrophic kidneys in 20 (57%) patients and for hydronephrotic kidneys in 15 (42%) patients. In the atrophic group, 3 patients (15%) required transfusion because of bleeding but none of the patients required conversion to open surgery. In the hydronephrotic group one patient (6.6%) required transfusion and conversion to open surgery because of bleeding. Both of the groups were similar in terms of postoperative hospital stay but compared to the atrophic kidneys, hydronephrotic ones were associated with a longer total operative times (90.1 min vs. 73.6 min, p=0.03). Any serious complication (except for bleeding) and mortality were not encountered in both groups. Conclusion: Laparoscopic nephrectomy is a safe and effective minimally invasive technique that can be used in atrophic and hydronephrotic non-functioning kidneys.
  • PublicationOpen Access
    The relationship of neutrophil to lymphocyte ratio with testicular cancer
    (2020-01-01) İlktaç, Abdullah; Akbulut, Habib; Akçay, Muzaffer; Ersöz, Cevper; Doğan, Bayram; İLKTAÇ, ABDULLAH; DOĞAN, BAYRAM; ERSÖZ, CEVPER; AKÇAY, MUZAFFER; AKBULUT, HABİB
    Purpose: To assess the relationship between testicular germ cell tumors (TGCT) and neutrophil to lymphocyte ratio (NLR) and to determine whether this ratio can be used as a serum tumor marker. Material and Methods: Sixty-one patients with testicular germ cell tumors were included into the study. Patients were grouped as localized and non-localized. Histologically patients were categorized as seminoma and nonseminomatous germ cell tumors. Complete blood cell count was measured the day before surgery and at the postoperative 1st month. Preoperative and postoperative mean NLR values were compared. Results: Thirty-six patients (59%) had seminomas and 25 patients (41%) had nonseminomatous testicular cancer. Forty-fi ve patients (73.8%) had localized and 16 patients (26.2%) had non-localized testicular cancer. There was a statistically signifi cant difference between preoperative and postoperative mean NLR of the localized patients (p=0.001) but no such difference was detected for non-localized patients (p=0.576). Nineteen patients with localized seminomas had normal preoperative serum tumor markers. There was a signifi cant difference between preoperative and postoperative mean NLR in this group of patients (p=0.010). Twenty-six patients with localized tumors had preoperative increased serum tumor markers which normalized after orchiectomy. Mean NLR of these patients signifi cantly decreased from 3.10±2.13 to 1.62±0.59 postoperatively (p=0.010). Conclusions: NLR appears to be a useful marker for TGCT. It is successful in predicting localized and non-localized disease in early postoperative period.
  • PublicationOpen Access
    Comparison of Scoring Systems in Predicting Success of Percutaneous Nephrolithotomy
    Background: Scoring systems are useful to inform the patients about the success and complication rates of the operation prior the surgery. Aims: To determine the applicability of the popular scoring systems (Guy’s, stone size, tract length, obstruction, number of involved calices, and essence/stone density and Clinical Research Office of the Endourological Society) by means of examining preoperative data of patients treated with percutaneous nephrolithotomy. Study Design: Cross sectional study. Methods: We retrospectively reviewed files of the patients who had undergone percutaneous nephrolithotomy in our center between 2011 and 2015. Excluded from the study were patients aged <18 years, and those who were not assessed preoperatively with computed tomography. Preoperative computed tomography images of all patients were assessed by a single observer, and patients were graded based on three scoring system. Demographic data were analyzed along with perioperative data (operation, fluoroscopy, length of hospital stay, changes in hematocrit values, location, and number of access sites, stone-free and complication rates). Results: A total of 298 patients who had been treated with 300 procedures were enrolled into the study. Mean age, stone burden, number of stones, and density were 48.1±12.9 years, 663.5±442.8 mm2, 1.8±1.1 and 888.3±273 HU respectively. Scores of the cases based on Guy’s, stone size, tract length, obstruction, number of involved calices, and essence/stone density, and Clinical Research Office of the Endourological Society scoring system were calculated as 2, 7.6, and 222.1 points respectively. 81.6% of the patients were stonefree. Complications were detected in 30 (9.9%) patients. Based on receiver operating characteristic curve analysis a positive correlation was detected between success rate and scoring systems, i.e., Guy’s (p=<0.001, r=-0.309), stone size, tract length, obstruction, number of involved calices, and essence/stone density (p=<0.001, r=-0.295), and Clinical Research Office of the Endourological Society (p=<0.001, r=0.426). The Clinical Research Office of the Endourological Society scoring system had the highest predictive value. The sensitivity rates rates for Guy’s, Clinical Research Office of the Endourological Society and Stone scoring system were as 78.78%, 80% and 82.34% respectively. Conclusion: All of scoring systems predicted correctly the success of the percutaneous nephrolithotomy procedures. The Clinical Research Office of the Endourological Society scoring system had the highest predictive value. Keywords: Percutaneous nephrolitotomy, scoring methods, specificity and sensitivity, urinary calculi
  • PublicationOpen Access
    Effects of bipolar and monopolar transurethral resection of the prostate on urinary and erectile function: a prospective randomized comparative study
    (2013-01-01T00:00:00Z) Akman, Tolga; Binbay, Murat; Tekinarslan, Erdem; Tepeler, Abdulkadir; AKÇAY, MUZAFFER; Ozgor, Faruk; Ugurlu, Mesut; Muslumanoglu, Ahmet; AKÇAY, MUZAFFER
  • PublicationOpen Access
    The All-Seeing Needle Instead of the Veress Needle in Pediatric Urologic Laparoscopy
    (2013-11-01T00:00:00Z) Silay, Mesrur Selcuk; Tepeler, Abdulkadir; Sancaktutar, Ahmet Ali; Kilincaslan, Huseyin; ALTAY, BÜLENT; Erdem, Mehmet Remzi; Hatipoglu, Namik Kemal; AKÇAY, MUZAFFER; Akman, Tolga; Armagan, Abdullah; AKÇAY, MUZAFFER
    Purpose: To investigate the feasibility of the all-seeing needle for safe entry and creation of pneumoperitoneum in pediatric urologic laparoscopy. Patients and Methods: A total of 14 children underwent various transperitoneal urologic laparoscopic procedures. The all-seeing needle, which is 4.85F in diameter, was used for safe entry into the abdominal cavity at the site of the umblicus in all cases. The microoptic was integrated with the light system and connected via a zoom ocular enabling direct visualization of the layers between the skin and the peritoneal cavity. Once the intraperitoneal access was obtained, CO2 pneumoperitoneum was created from one port of the three-way connector attached to the proximal part of the needle. Then the laparoscopic trocars were placed under vision of the microoptical system. Results: Mean age of the children was 4.52.9 years. In all children, the all-seeing needle was safely introduced into the abdominal cavity under direct vision. Then, CO2 pneumoperitoneum was succesfully performed. The mean time for optical puncture was calculated as 1.1 +/- 0.8 minutes. No complication was encountered during the introduction of the needle, creation of the pneumoperitoneum, and placement of the trocars. Conclusions: The all-seeing needle appears to be beneficial in safe entry and for creating pneumoperitoneum in laparoscopic pediatric urology cases. It eliminates the disadvantages of the Veress needle, which is blunt insertion, and may possibly prevent complications.
  • PublicationOpen Access
    General Overview of Renal Cell Carcinoma with the Evaluation of our cases
    Objective: Renal cell carcinoma (RCC) is the 14th most common tumor in the world. In 2010, the protocol for the examination of kidney specimens with invasive carcinoma of renal tubular origin was updated. The aim of our study was to review 1-year RCC patients of our hospital according to the new protocol, classification, and staging systems with respect to their morphological and immunohistochemical features.. Methods: The medical records of 54 RCC patients between July 2012 and July 2013 were retrospectively reviewed. They were classified according to the WHO 2004 classification system and newly defined subtypes. The following variables were determined in each case: age, sex, histological subtype, stage, and Fuhrman nuclear grade. Results: In our study, 30 (55.6%) men and 24 (44.4%) women were diagnosed with RCC out of 54 patients. The median age was 56 years. In total, 21 patients had (55.2%) right-and 17 had (44.74%) left-sided tumors. Thirty-eight (70.3%) clear cell, 6 (11.1%) papillary, 7 (12.96%) chromophobe, 1 (1.85%) multilocular, 1 (1.85%) unclassified, and 1 (1.85%) tubulocystic RCC were seen. According to primary tumor, 33 (61.1%) pT1, 10 (18.51%) pT2, 9 (16.66%) pT3, and 2 (3.70%) pT4 patients were reported. Chromophobe RCCs were excluded from the Fuhrman grading (G) system; of the remaining 2 (4.17%) were G1, 30 (62.5%) were G2, 13 (27.08%) were G3, and 3 (6.25%) were G4 tumors. Conclusion: Although RCC constitutes the majority of renal tumors, different subtypes are also encountered. In our study, clear cell RCCs were the most common type of tumors consistent with the literature. The remarkable point was that chromophobe RCCs were more frequent in our study. Because of infrequency, more examples are required to distinguish newly defined subtypes.
  • PublicationOpen Access
    Current Minimal Invasive Surgery Treatment For Kidney Stones: Bezmialem Experience
    (2016-08-01T00:00:00Z) AKÇAY, MUZAFFER; Tepeler, Abdulkadir; TOSUN, MUHAMMED; Basibuyuk, Ismail; Elbir, Fatih; KARDAŞ, SİNA; Akman, Tolga; Armagan, Abdullah; Tasci, Ali Ihsan; AKÇAY, MUZAFFER; TOSUN, MUHAMMED; KARDAŞ, SİNA
    Objective: We aimed to present the outcomes of patients with symptomatic kidney stones treated with percutaneous nephrolithotomy (PNL) or retrograde intrarenal surgery (RIRS). Methods: The medical records of patients with symptomatic renal calculi treated with PNL or RIRS between November 2010 and May 2015 were obtained. Demographic characteristics such as age; sex; BMI; stone size and location; and perioperative data including operation, fluoroscopy, and hospitalization time; and success and complication rates were assessed. Results: Standard (n:336), mini-PNL (n:51), ultramini-PNL (n:37) and microperc (n:47) were performed for 471 renal units. RIRS was the treatment method for 290 renal unites. In the PNL group, the mean patient age was 44.5 (1-83) years and BMI was 26.9 kg/m2. The mean stone size was 27.6 mm. In the RIRS group, the mean age and BMI were 47.1 (1-86) years and 25.1 kg/m2, respectively. The mean operation, fluoroscopy, and hospitalization times were 70.0 (20-240) min, 45.1 (17-610) s, and 2.4 (1-20) days, respectively, in the PNL group. On the other hand, the mean operation, fluoroscopy, and hospitalization times were 62.5 (40-180) min, 29.8 (0-96) s, and 26.4 (12-120) h, respectively, in the RIRS group. Whine stone free status was achieved in 88% in the PNL group; this rate was lower (80%) in the RIRS group. Conclusion: Both PNL and RIRS are efficient minimally invasive methods with low morbidity and high success rates for the treatment of symptomatic kidney stone disease.