Person: KARDAŞ, SİNA
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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 Factors affecting hospital readmission and rehospitalization following percutaneous nephrolithotomy(2016-01-01T00:00:00Z) Tepeler, Abdulkadir; Karatag, Tuna; Tok, Adem; Ozyuvali, Ekrem; Buldu, Ibrahim; KARDAŞ, SİNA; Kucukdagli, Okkes Taha; ÜNSAL, ALİ; KARDAŞ, SİNAPurpose To identify patient- and procedure-related factors that increase the risk of hospital readmission and emergency room (ER) visits after percutaneous nephrolithotomy (PNL).Publication Metadata only MICROPERC IN HORSESHOE KIDNEY(2012-09-01T00:00:00Z) Armagan, Abdullah; Tepeler, Abdulkadir; Erdem, Mehmet Remzi; Silay, Mesrur Selcuk; AKÇAY, MUZAFFER; Elbir, Fatih; KARDAŞ, SİNA; Onol, Sinasi Yavuz; AKÇAY, MUZAFFER; KARDAŞ, SİNAPublication Open Access Reduced Radiation Fluoroscopy Protocol during Retrograde Intrarenal Surgery for the Treatment of Kidney Stones(2014-05-01T00:00:00Z) Kirac, Mustafa; Tepeler, Abdulkadir; Guneri, Cagri; KALKAN, Senad; Kardas, Sina; Armagan, Abdullah; Biri, Hasan; KALKAN, SENAD; KARDAŞ, SİNAPurpose: To discuss whether fluoroscopic imaging is essential during the ureteroscopic treatment of kidney stones in an effort to diminish radiation exposure. Materials and methods: Seventy-six patients with kidney stones were treated with retrograde intrarenal surgery (RIRS). In the operation room, a mobile C-arm fluoroscopy system was ready to use in case fluoroscopic imaging was needed. The manipulations were performed with tactile and visual cues. The perioperative and postoperative parameters were retrospectively evaluated. Results: The mean age of the patients was 39.9 ± 13.8 years. The mean stone size was 14.1 ± 4.1 mm. The insertion of the access sheath was performed over the guidewire under single shoot fluoroscopic imaging in all patients. Additional fluoroscopic imaging was required to localize the stone (n = 2) and to determine the collecting system anatomy (n = 2) for 4 (5.2%) patients with previous renal surgery and severe hydronephrosis. Stone-free status was accomplished in 63 (82.9%) patients. Conclusion: The RIRS with low-dose fluoroscopy protocol for kidney stones can be safely and effectively performed in patients with no special circumstances such as anatomical abnormalities or calyceal diverticular stones.Publication Metadata only Comparison of Flexible and Rigid Cystoscopy-Assisted Ureteral Catheter Insertion Before Percutaneous Nephrolithotomy: A Prospective Randomized Trial(2013-06-01T00:00:00Z) TEPELER, Abdulkadir; SILAY, Mesrur Selcuk; AKMAN, Tolga; Akcay, MUZAFFER; Ersoz, CEVPER; Kardas, SİNA; ERDEM, Mehmet Remzi; ARMAGAN, Abdullah; ONOL, Sinasi Yavuz; AKÇAY, MUZAFFER; ERSÖZ, CEVPER; KARDAŞ, SİNABackground and Purpose: To compare the advantages of flexible and rigid cystoscopy-assisted ureteral catheter placement before prone percutaneous nephrolithotomy (PCNL).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.