Person: TOSUN, MUHAMMED
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Publication Open Access Flexible ureterorenoscopy results: analysis of 279 cases(2015-09-01T00:00:00Z) Elbir, Fatih; Basibuyuk, Ismail; Topaktas, Ramazan; KARDAŞ, SİNA; TOSUN, MUHAMMED; Tepeler, Abdulkadir; Armagan, Abdullah; KARDAŞ, SİNA; TOSUN, MUHAMMEDObjective: In this study, the outcomes of 279 cases in whom we performed retrograde intrarenal surgery (RIRS) were evaluated retrospectively. Material and methods: RIRS was performed on 279 cases with the aid of access sheath of guidewire between March 2011 and February 2015. All patients were operated in the standard lithotomy position. A hydrophilic guidewire was inserted with the aid of rigid ureterorenoscopy and we checked whether there were any residual ureteral stones and other pathologies. Fluoroscopy was used routinely in all cases. Stone fragments smaller than 3 mm were left off but those bigger than 3 mm were removed by grasper after stone fragmentation. Controls of the patients were assessed by plain films (KUB), urinary tract ultrasonography (US) and/or computed tomography (CT) 1 month after the operation. Success rate of the procedure was defined as the stone-free status or presence of residual fragments less than 3 mm. Results: 152 of the patients were male and 127 were female. The median ages of the male and female patients were 47.7 (1-86) ve 45.9 (3-79) years respectively. The median stone size was 13.5 mm (8-25). Preoperatively 34 (12.1%) patients had double-J ureteral stent. 19 (6.8%) patients were operated while they were still receiving antithrombotic and antiplatelet therapy Solitary kidney was present in 24 patients while the remaining patients had kyphoscoliosis (n=3), rotation anomaly (n=6), pelvic kidney (n=2), double collecting system (n=3), and horseshoe kidney (n=6). In 264 patients access sheath was used, in 15 patients operation was performed with the help of the guidewire. Double-J stents were inserted to 14 patients because of ureteral stricture and they underwent operation after 2 weeks later. Renal stones of 219 patients among all cases were fragmented completely and the patients were discharged as stone free (SF). Our success rate (SF or presence of clinically insignificant residual [CIRF]) was 78.4%. Stone size (p=0.029), stone number (p=0.01), stone location (p=0.023) had significant influence on the stone-free rate after RIRS The mean operation and floroscopy time was 62.5 min. (40-180) and 29.8 sec (4-96), respectively. The mean hospitalization time was 26.4 hours (12-72). Double J stents were placed to 253 patients for more stone burden and ureteral edema. Any complication was not observed for all cases except perioperative developed infection for two patients. Conclusion: With advances in laser technology and flexible ureterorenoscopy, kidney stones can be treated with lower morbidity and high success rates. Keywords: Flexible ureterorenoscopy; kidney stone; retrograde intrarenal surgery.Publication Metadata only Comparison of flexible ureterorenoscopy and micropercutaneous nephrolithotomy in the treatment for moderately size lower-pole stones(2015-11-01T00:00:00Z) Armagan, Abdullah; Karatag, Tuna; Buldu, Ibrahim; TOSUN, MUHAMMED; Basibuyuk, Ismail; Istanbulluoglu, Mustafa Okan; Tepeler, Abdulkadir; TOSUN, MUHAMMEDTo present a retrospective comparative clinical study of micropercutaneous nephrolithotomy (microperc) versus flexible ureterorenoscopy (F-URS) in treatment of moderate-size lower-pole stones (LPSs).Publication Metadata only Comparison of Scoring Systems in Pediatric Mini-Percutaneous Nephrolithotomy(2016-07-01T00:00:00Z) Utangac, Mehmet Mazhar; Tepeler, Abdulkadir; Daggulli, Mansur; Tosun, Muhammed; Dede, Onur; Armagan, Abdullah; TOSUN, MUHAMMEDOBJECTIVE To apply urolithiasis scoring systems to the pediatric miniperc procedure and to compare their predictive capability for postoperative outcomes.Publication Metadata only The role of ultra-mini percutaneous nephrolithotomy in the treatment of kidney stones(2016-12-01T00:00:00Z) Tepeler, Abdulkadir; Basibuyuk, Ismail; TOSUN, MUHAMMED; Armagan, Abdullah; TOSUN, MUHAMMEDObjective: In our study we aimed to evaluate outcomes of ultra-mini-percutaneous nephrolithotomy (UMP) performed for the treatment of kidney stones.Publication Metadata only Is micro-percutaneous nephrolithotomy surgery technically feasible and efficient under spinal anesthesia?(2015-06-01T00:00:00Z) Karatag, Tuna; Tepeler, Abdulkadir; Buldu, Ibrahim; AKÇAY, MUZAFFER; TOSUN, MUHAMMED; Istanbulluoglu, Mustafa Okan; Armagan, Abdullah; AKÇAY, MUZAFFER; TOSUN, MUHAMMEDThe objective of the study was to present the clinical and operative effects of two types of anesthesia on micro-percutaneous nephrolithotomy (-microperc-). We retrospectively reviewed 116 patients who underwent microperc between August 2011 and September 2013. Patients were sorted into one of the two groups according to the type of anesthesia received: general (Group 1, n:53) or spinal (Group 2, n:63). Perioperative variables (age, stone size, location) and outcomes (operation time, success, complication rate) were evaluated and compared. Although there was a statistically significant difference in the mean age of patients (30.3 +/- A 22.1 vs. 45.8 +/- A 14.6, respectively, p < 0.001), mean body mass indexes were similar (p = 0.689). There was no substantial difference in terms of sizes and localizations of stones in the two groups (p = 0.970 and p = 0.795). While a significant difference was found in comparison of operative times (59.62 +/- A 32.56 vs. 40.98 +/- A 26.45 min, p < 0.001), there was no statistically significant difference in mean fluoroscopy times (124.92 +/- A 84.2 vs. 105.2 +/- A 61.0 s, p = 0.441). Stone-free rates were similar (90.5 % vs. 93.6 %, p = 0.297). We found no statistical differences between the two groups with respect to mean hemoglobin drop and hospitalization time (p = 0.015 and p = 0.917, respectively). The complication rates and analog pain scores were also similar (p = 0.543 and p = 0.365). Our results show that microperc is a feasible surgical modality in the treatment of kidney stone disease under both spinal and general anesthesia. Spinal anesthesia may be considered for patients at a high risk for general anesthesia, and also may be an alternative for patients who are concerned about and/or fearful of general anesthesia.Publication Open 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, SİNAObjective: 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.