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    Comparison of the results of pediatric percutaneous nephrolithotomy with different sized instruments
    (Springer, 2017) Celik, Huseyin; Camtosun, Ahmet; Dede, Onur; Dagguli, Mansur; Altintas, Ramazan; Tasdemir, Cemal
    We aim to compare the outcomes, including the morbidity and success rates in children undergoing percutaneous nephrolithotomy (PCNL) using different sized devices. According to the size of instruments used during surgery, three different groups (ultra-mini-PCNL, mini-PCNL and adult size PCNL) were composed and the outcomes were compared between the groups. PCNL was applied to 225 renal units of 220 children, including 5 patients with bilateral kidney stones. Percutaneous nephrolithotomy was performed using adult instruments (24 F) in 82 renal units, using pediatric instruments (18 F) in 89 and using minimal-size instruments (9.5 F) in 50. One-hundred and twenty-four girls and 96 boys with a mean age of 8.33 (< 17) years were assessed. Stone-free rates were 78 % in group 1 (n = 39) using 9.5 F nephroscope, 75.8 % in group 2 (n = 69) using 18 F nephroscope and 71.4 % in group 3 (n = 60) using 24 F nephroscope. Time to access the collecting system, operative time, duration of nephrostomy and average postoperative hospital stay did not differ between the groups. However, mean hematocrit drop and stone burden were significantly lesser in ultra-mini-PCNL group. There was no significant difference in the complication rates between the groups, according to the modified Clavien classification system. As the important complication of PCNL, bleeding seems to be associated with diameter of dilatation, calibre of nephroscopes and stone burden. To reduce the certain complications, pediatric type of instruments is suitable but the use of adult instruments and techniques may achieve equal results.
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    Evaluation of children with inguinoscrotal ectopic adrenal tissues
    (Tubitak Scientific & Technological Research Council Turkey, 2013) Oguz, Fatih; Yildiz, Turan; Beytur, Ali; Soylemez, Haluk; Altintas, Ramazan; Samdanci, Emine; Alan, Saadet
    Aim: To evaluate 6 cases of inguinoscrotal ectopic adrenal nodules, which were detected in 2 hospitals. Materials and methods: A total of 296 male patients who had inguinoscrotal surgery between 2009 and 2011 were retrospectively evaluated. Bright yellow nodular lesions, resembling the adrenal tissue, were excised during surgery. Histopathologic examination of these samples was performed and the clinical data of the patients were evaluated. Results: Ectopic adrenal tissue was detected in 6 patients (2.02%). The mean age of the patients was 4.6 years (range: 3 months to 9 years) years. Ectopic adrenal nodules were localized in the spermatic cord, in the vicinity of the epididymis and appendix testis, on the epididymis, and on the tunica albuginea of an atrophic testis undergoing orchiectomy due to intraabdominal localization. Adrenal cortex cells were found in 5 patients, and both cortex and medullar cells were found in 1 patient. No malign transformation was detected. Hormonal, biochemical, hematologic, and urinary analyses did not yield any significant results. Conclusion: Inguinoscrotal ectopic adrenal tissues are incidentally detected lesions during surgical interventions. They are benign lesions associated with no significant symptoms. Nevertheless, it is considered to be of benefit to remove these tissues in order to perform histopathological evaluation for differential diagnosis.