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    Absolute white blood cell count and neutrophil-lymphocyte ratio may predict the need for double- J stent Insertion in ureteral stones in children: A comparative study
    (2023) Önen, Abdurrahman; Aydoğdu, Bahattin; Okur, Mehmet Hanifi; Karabel, Musemma; Arslan, Serkan; Azizoğlu, Mustafa; Kamcı, Tahsin Onat
    Objective: Our goal was to determine whether or not a double-J (DJ) stent insertion is required in cases of ureteral stones based on the absolute white blood cell (WBC) counts, neutrophil-lymphocyte ratio (NLR), absolute monocyte counts, and other laboratory markers. Materials and Methods: The patients were divided into two groups as those who did (Group 1), and did not (Group 2) need DJ stent insertion. The age, symptoms, diagnosis, hemogram parameters, and treatment results of the patients were evaluated. Results: Forty-nine percent (n=44) of the patients were female and 51% (n=46) were male. The groups did not differ in terms of age and gender (p>0.05). A higher incidence of hematuria was observed in Group 1 (p<0.05). WBC (p<0.05), NLR (p<0.05), and monocyte counts (p<0.05) were found to be higher in Group 1. In the ROC analysis; WBC and NLR were found to be two predictive markers for the need for DJ stent insertion. At a cut-off value of 12.6 x 109/L, WBC had 37% sensitivity, and 81% specificity (AUC: 0.67; 95% CI: 0.54-0.80), and at a cut-off value of 3.8, NLR had 65% sensitivity, and 76% specificity (AUC: 0.70; 95%CI: 0.57-0.82) in predicting the need for a DJ stent insertion. Reoperation was not required in any case. Conclusion: In cases of ureteral stones, the absolute WBC count and NLR may help determine the requirement (if any) for a DJ stent insertion.
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    Acute abdomen caused by spontaneous perforation of the urinary bladder in childhood: Report of one case
    (2015) Uygun, İbrahim; Arslan, Mehmet Şerif; Arslan, Serkan; Zeytun, Hikmet; Basuguy, Erol; Okur, Mehmet Hanifi; Aydoğdu, Bahattin
    Spontaneous urinary bladder rupture in children is a very rare clinical occurrence that can be life threatening if left untreated. Patients usually present with symptoms of peritonitis and the correct diagnosis is usually made at surgery. Here, we present a case of spontaneous bladder perforation that was operated with a diagnosis of acute abdomen. No etiological factor for bladder perforation was found, and after the operation, the patient experienced no further problems
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    Adölesan varikosel tedavisinde laparoskopik Palomo yöntemi sonuçlarımız
    (MEDİTAGEM Ltd. Şti., 2017) Arslan, Serkan; Basuguy, Erol; Zeytun, Hikmet; Arslan, Mehmet Şerif; Aydoğdu, Bahattin; Bayram, Salih; Okur, Mehmet Hanifi; Önen, Abdurrahman
    Öz:Amaç: Bu çalışmanın amacı adölesan yaş grubunda varikosel nedeniyle cerrahi tedavi yapılan hastaların sonuçlarını sunmaktır.Gereç ve Yöntem: Şubat 2012- Şubat 2016 tarihleri arasında varikosel nedeniyle ameliyat edilen hastaların dosyaları geriye dönük olarak incelendi. Hastalar, demografik verileri, klinik şikâyetleri, fizik muayene bulguları ve radyolojik olarak skrotal renkli doppler ultrasonografi (US) sonuçları ile değerlendirildi. Varikosel, Hoekstra ve ark. yaptığı dilate ven çapının değerlendirildiği sınıflamaya göre evrelendirildi. Semptomatik evre 2-3 varikosel ve testis boyutlarında küçülme olan hastalara cerrahi yapıldı. Tedavi sonuçları ve komplikasyonları kaydedildi. Bulgular: Yaş ortalaması 13±2 olan 14 hasta değerlendirildi. Hastaların tamamı skrotumda ağrı ve şişlik şikayetleri ile başvurmuşlardı. Hastaların tümünde varikosel sol tarafta idi. Hastaların 7'si (%50) evre 2, 7'si (%50) evre 3 idi. Cerrahi yöntem olarak laparoskopik Palomo yöntemi uygulandı. Ortalama ameliyat süresi 28±4 dakika. Ameliyat sırasında hiçbir hastada komplikasyon yaşanmadı. Ortalama hastanede kalış süresi 2 gün idi. Ortalama ameliyat sonrası izlem 12±9 ay idi. Kontrolde hastaların 11'inde varikosel düzeldi, 3 hastada ise evre 3'ten evre 1'e geriledi. Nüks görülmedi. Sadece bir hastada (%7) hidrosel gelişti. Sonuç: Laparoskopik Palomo yöntemini yüksek başarı, düşük komplikasyon oranı, daha az ağrı, kısa sürede sosyal yaşama dönüş, iyi kozmetik sonuç gibi faydaları sebebiyle avantajlı bir yöntemdir. Ayrıca single port laparoskopide ise eldiven yardımı ile hazırlanan torakoport düşük maliyet ve kolay ulaşılabilir olması sebebiyle tercih edilebilir.
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    The adrenal gland: An organ neglected in pediatric trauma cases
    (Urology and Nephrology Research Centre, 2016) Aydoǧdu, Bahattin; Okur, Mehmet Hanifi; Arslan, Serkan; Arslan, Mehmet Şerif; Zeytun, Hikmet; Basuguy, Erol; İçer, Mustafa
    Purpose: Adrenal Gland Injury (Agi) Caused By Trauma May Cause Bleeding And Life-Threatening Problems In Children. The Objective Of This Study Was To Analyze The Prevalence Of Agi In Final Diagnoses Of Trauma. Materials And Methods: The Records Of 458 Patients With Abdominal Trauma (Out Of A Total 8,200 Pediatric Patients With Trauma Of Any Sort), Who Were Referred To Our Clinic Between January 2009 And July 2014, Were Reviewed Retrospectively. The Numbers Of Patients With Agi And Their Ages, Gender, Trauma Patterns, Affected Organs, Pediatric Trauma Scores (Ptss), And Injury Severity Scores (Isss) Were Recorded, As Well As The Associated Ultrasound (Us) And Tomographic Scan Data, Treatments, And Complications. Computed Tomography (Ct) Scans Obtained After Trauma Were Subjected To Both Primary And Secondary Evaluation. Results: In Total, 28 Patients With Agi Were Detected; Their Average Age Was 8.54 ± 4.09 (3–17) Years. Twenty (71%) Patients Were Male And 8 (29%) Were Female. Nineteen (68%) Patients Had Fallen From Heights; The Most Commonly Injured Organs Were The Kidneys, Spleen, And Lungs. Injuries Were Right-Sided In 26 (92.9%) Patients. The Mean Iss Was 13.2 (Range 5–50) And The Mean Pts 8.6 (Range 0–11). Seven Patients Had Iss > 16 And Nine Had Pts < 8. Agi Was Diagnosed By Ct In 14 (50%) Patients And In 3 (9%) By Us At Primary Evaluation. Upon Secondary Scan Inspection Focusing On The Possibility Of Adrenal Gland Injury, Such Injury Was Ultimately Detected In 28 Patients. All Patients Underwent Conservative Follow-Up, And One Died. Conclusion: We Recommend Calculation Of The Pts, As Well As Other Trauma Scores, When Pediatric Patients SufferIng Multiple Or Blunt Abdominal Trauma(S) Present To The Emergency. In Addition, We Believe That In Children With Trauma Involving The Liver, Spleen Or Kidneys, Careful Evaluation Using A Ct Scan Would Increase The Diagnosis Of Agi And Reveal A Realistic Rate Of Agi In Trauma Cases.
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    Analysis of Complications of a Neglected Disease: 13 Years of Experience with Liver Hydatid Cysts in a High-Volume Hospital
    (Mdpi, 2024) Azizoglu, Mustafa; Aydogdu, Bahattin; Kamci, Tahsin Onat; Arslan, Serkan; Basuguy, Erol; Bilici, Salim; Okur, Mehmet Hanifi
    Background and Objectives: The aim of this study was to evaluate the clinical presentation, treatment outcomes, and complications associated with hepatic hydatid cysts in a pediatric population. Materials and Methods: This retrospective study analyzed 214 pediatric patients with liver hydatid cysts, focusing on clinical presentation, treatment outcomes, and associated complications. Patients were classified based on treatment modality, including non-operative management with albendazole, PAIR, and surgical intervention. This study compared cyst characteristics, recurrence rates, and complications such as cysto-biliary fistulas. Results: Among the patients, 68% (n = 145) had a single cyst and 86% (n = 184) were found to have isolated liver cysts. No significant statistical difference was observed between Group 1 and Group 2 in terms of age, gender, and basic laboratory values and general characteristics of the cysts, such as the lobe where the cyst was located, involvement of multiple organs, number of cysts, the state of cyst rupture, and recurrence; no statistically significant difference was found between the groups (p > 0.05 for each comparison). Cyst rupture incidence was 6%, and the average incidence of recurrence was 2%, with a surgical recurrence incidence of 3%. A total of 37 patients had a laparotomy, while 7 had laparoscopic surgery. In total, capitonnage was performed in 68 patients, omentopexy in 4, and cystostomy in 6. Consequently, among the treated patients (PAIR + surgery), the incidence of cysto-biliary fistula was 11%, anaphylaxis was 2%, surgical recurrence was 3%, and the incidence of reoperation (Clavien-Dindo >= 3) was 6%. The average follow-up period was 72 months, during which no mortality was observed. Conclusions: We identified key clinical outcomes related to both non-surgical treatments (cyst rupture and recurrence) and surgical groups (cysto-biliary fistulas, anaphylaxis, the need for reoperation, rupture, and recurrence).
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    Analysis of mortality and long-term outcomes of pediatric patients with tracheoesophageal fistula/esophageal atresia
    (Edizioni Luigi Pozzi, 2023) Cal, Suat; Arslan, Serkan; Okur, Mehmet Hanifi; Basuguy, Erol; Aydogdu, Bahattin
    BACKGROUND/PURPOSE: This study analyzed factors that affect mortality in patients surgically treated for EA, then explored the long-term problems encountered by these patients.MATERIALS AND METHODS: Among 252 patients with EA who were either diagnosed, treated, and subsequently followed at the Department of Pediatric Surgery, Dicle University Medical Faculty Hospital, or were treated surgically elsewhere but followed at our center, between January 2010 and January 2020,214 patients were included in the study.RESULTS: Early complications:One or more early complications were observed in 132(62.5%) of the 211 patients who underwent surgical EA repair. The most common early complication was AS, which developed in 106(50.2%) patients. Anastomosis leakage. Was detected in 48 (22.7%) patients. Late complications: The late findings of 161 patients who underwent definitive surgery and had a mean follow-up period of 68 months (range, 6-120 months) were evaluated. The most common late complication was GER. Mortality: Of the 214 patients in our study, 63(29.4%) died, including 48(76.2%) during the early period after the first surgery. Of the 10(15.9%) patients who died during the late period.CONCLUSION: In our study, the most common early complication was anastomotic stenosis in patients with esophageal atresia. We recommend balloon dilation in the treatment of anastomotic stenosis.Gastroesophageal reflux is the most common long-term complication. Most of these can be treated conservatively and medically. The association of low birth weight, cardiac anomalies, prematurity and VACTERL increased mortality in patients with esophageal atresia in our study.
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    Analysis of Ovarian Pathology in Children: Ten-years Experience
    (2023) Arslan, Serkan; Basuguy, Erol; Aydoğdu, Bahattin; Otcu, Serap Mutlu Özçelik; Salık, Fikret; Okur, Mehmet Hanifi
    Objective: In this study, we aimed to analyze whether laparoscopy is a feasible and safe surgical option for ovarian pathologies in children. Method: Our study included 43 patients who were followed up and treated for ovarian pathology in our clinic between January 1, 2012, and January 1, 2022. The clinical information and data for the patients were reviewed retrospectively. The patients were divided into 2 groups: Laparoscopy and the laparotomy group. Demographic data of the patients, complaints at presentation, localization of the mass, laboratory hormone levels and surgical findings, histopathological diagnoses, treatment methods, and treatment results were evaluated. Results: In the study, 43 female patients with a mean age of 9.6 years (1 month-15 years) were evaluated. It was the most common on the right side (58%). The most common symptom was abdominal pain (70%). Thirteen (30%) patients had acute abdomen findings. For surgical intervention, laparoscopy was performed in 22 (51%) patients and laparotomy was performed in 19 (44%) patients. Unilateral oophorectomy or salpingo-oophorectomy was performed in 28 (65%) of the patients as surgical treatment. Twenty-three (53%) of the ovarian pathologies were neoplastic, and 20 (47%) patients were non-neoplastic. Pathological diagnoses of ovarian pathologies 19 (44%) patients had ovarian torsion and 14 (33%) patients had teratoma. The operation time was shorter in the laparoscopy group (p<0.05). Tumor size was smaller in the laparoscopy group and larger in the conventional laparotomy surgery group (p<0.05). There was no significant difference between the laparoscopy group and the laparotomy surgery group in terms of age, tumor size, malignancy status, the presence of neoplastic mass, laterality, and tumor markers (p>0.05). While 42 of 43 patients survived, one patient with immature teratoma died from tumor-associated metastasis. Conclusion: Although the majority of ovarian pathologies are benign, since malignant masses may occur, surgery should be performed as early as possible. In lesions that are thought to be benign, ovarian- sparing surgery should be performed as much as possible. Laparoscopy is a feasible and safe surgical option for ovarian pathologies even, in malignant patients.
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    Analysis of risk factors for appendicitis in children: A multicenter epidemiological study
    (Dicle Üniversitesi Tıp Fakültesi, 2016) Arslan, Serkan; Aydoğdu, Bahattin; Arslan, Mehmet Şerif; Zeytun, Hikmet; Okur, Mehmet Hanifi; Basuguy, Erol; Karakaya, Ali Erdal; Uygun, İbrahim; Otcu, Selcuk
    Objectives: In our study, the assessment of age, gender, incidence and seasonal differences in the regions related to appendicitis were investigated. Methods: 676 patients that received an operation following a diagnosis of appendicitis in 3 hospitals from 3 different regions of Turkey occurring at different dates were examined retrospectively after being categorized by region. The differences among groups were compared to each. Results: The mean age of male (63%) (n = 426) and female (37%) (n = 250) patients (total = 676) was 10.8 years (range, 1–18 years). The percentage of female patients in the The Black Sea Region (BR) group was significantly higher (48%) than that in the other two groups (%33 for SR, 30% for MR) (P = 0.001). The frequency of appendicitis was higher (36%) in the spring and winter (25%) than that during summer or fall. The number of cases increased the most in the BR group in spring (47%) (P < 0.001). When the types of appendicitis in the different age groups were compared with season, acute appendicitis (P < 0.02) was more frequently (93%) seen in the child-adolesan (CA) group in the spring; however, perfore apandicitis (45%) was greater in the Infant-Preschool (IPS) group (P < 0.02). Acute appendicitis comprised 55% and perforated appendicitis comprised 45% of cases in the IPS group, whereas acute appendicitis comprised 78% and perforated appendicitis comprised 22% in the CA group. Conclusion: According to the results of our study, appendicitis was most frequently seen in the spring and winter seasons and more frequent in boys between the ages of 10-13 years. As age decreases, the frequency of perforated appendicitis increases. Appendicitis is affected by environmental factors. Reducing the incidence of appendicitis may be possible by establishing regional and specific studies related to this subject and the etiologies of the disease.
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    Anti-inflammatory and anti-oxidant role of ursolic acid in cerulein-induced acute pancreatitis in rats
    (Acad Nacional Medicina Mexico, 2023) Turkoglu, Ahmet; Ibiloglu, Ibrahim; Kaplan, Ibrahim; Arslan, Serkan; Halil-Ocal, Ibrahim; Gumus, Metehan
    Background: Ursolic acid (UA) is found in many plants, and has been reported to have anti-protease, antioxidant, anti-inflammatory, antimicrobial, nephroprotective, hepatoprotective, and cardioprotective effects. Objective: The purpose of this study was to investigate the effects of ursolic acid in cerulein-induced acute pancreatitis (AP). Materials and methods: Thirty-two Wistar albino rats were randomly assigned to 4 equal groups: Sham, acute pancreatitis, treatment, and ursolic acid group. Results: Serum amylase levels in the AP and treatment groups were significantly higher than in the others (p < 0.05). In addition, serum IL-113, IL-6, and TNF-& alpha; levels were significantly higher in the AP group in comparison with the treatment group. Although pancreatic tissue total oxidant activity in the AP and treatment groups was similar, pancreatic tissue total antioxidant capacity was significantly higher in the treatment group than in the AP group. Conclusions: Damage to the pancreas and remote organs in AP was observed to be reduced by UA. In addition, oxidative stress was observed to be decreased by the effect of UA.
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    The beneficial effects of the transanastomotic feeding tube in the management of congenital duodenal obstruction: a meta-analysis
    (Mexican Acad Surgery, 2023) Arslan, Serkan; Azizoğlu, Mustafa
    Objective: We aimed to assess the evidence on the efficacy and safety of transanastomotic feeding tubes (TAFTs) in neonates with congenital duodenal obstruction (CDO), we conducted a systematic review. Material and methods: Using the databases EMBASE, PubMed, and Cochrane, we carried out a thorough literature search up to 2022. Studies comparing TAFT + and TAFT -for CDO were included. We applied a random effect model. Results: 505 CDO patients who met the inclusion criteria were selected. The TAFT + group had a shorter time to reach full feeds (weighted mean difference [WMD]: -6.63, 95% confidence interval [CI]: -8.83 --4.43; p < 0.001) and had significantly less central venous catheter (CVC) insertion (I2 = 85%) (RR: 0.43, 95% CI: 0.19-1.00; p < 0.05). Fewer patients in the TAFT + group received parenteral nutrition (PN) (I2 = 78%) (RR: 0.43, 95% CI: 0.20-0.95; p < 0.05). There was no statistically significant difference in terms of the development of sepsis (I2 = 37%) (risk ratio [RR]: 1.35, 95% CI: 0.52-3.46; p > 0.05). No statistically significant difference was observed in terms of length of stay (I2 = 82%) (WMD: 2.22, 95% CI: -7.59-12.03; p > 0.05) and mortality (I2 = 0%) (RR: 0.55, 95% CI: 0.07-4.34; p > 0.05). Conclusions: The use of the transanastomotic tube resulted in early initiation of full feeding, less CVC insertion, and less need for PN.
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    Can direct bilirubin-to-lymphocyte ratio predict surgery for pediatric adhesive small bowel obstruction?
    (Mexican Acad Surgery, 2024) Azizoglu, Mustafa; Arslan, Serkan; Kamci, Tahsin O.; Basuguy, Erol; Aydogdu, Bahattin; Karabel, Muesemma A.; Okur, Mehmet H.
    Objective: Estimating which patients might require surgical intervention is crucial. Patients with complete bowel obstructions exhibit disrupted enterohepatic cycles of bile and bacteremia due to bacterial translocation. The goal of this study was to develop a prediction index using laboratory inflammatorydatato identifypatients who mayneed surgery. Materials and methods: The patients were divided into two groups based on their management strategy: Non -operative management (Group 1) and surgical management (Group 2). Results: The indirect bilirubin, direct bilirubin, and total bilirubin were significantly higher in Group 2 than in Group 1 (p = 0.001, p < 0.001, and p < 0.001, respectively). The neutrophil-to-lymphocyte ratio (NLR), platelet-to-NLR (PNLR), and direct bilirubin-to-lymphocyte ratio (DBR) were significantly higher in Group 2 compared to Group 1 (p = 0.041, p = 0.020, and p < 0.001, respectively). In group 2, 78% have viable bowels. Resection was performed in 40% of cases, with 12% mortality and a 10 -day average hospital stay. DLR performs the best overall accuracy (72%), demonstrating a well-balanced sensitivity (62%) and specificity (81%). Conclusions: This study suggested that DBR is a more accurate predictive index for surgical intervention in pediatric adhesive small bowel obstruction patients compared to NLR and PNLR, providing valuable guidance for treatment strategies.
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    The cause of depression in adolescence: peer bullying
    (2023) Karabel, Müsemma Alagöz; Arslan, Serkan; Şimşek, Ş.; Azizoǧlu, Mustafa
    OBJECTIVE: Depression affects adolescents worldwide and often predicts more serious disease manifestations in later lifetimes. Peer victimization or bullying, another form of child abuse, increases symptoms of depression. In this paper, the relationship between peer bullying and depression in adolescence was investigated. SUBJECTS AND METHODS: Each adolescent who was admitted to the adolescent unit completed forms referred to as the ‘Depression Scale For Children’ and the ‘Multidimensional Peer Victimization Scale’. Sociodemographic features and results of the scales’ evaluation were studied. SPSS 16.0 program was used for statistical analysis. The p-value below 0.05 was considered statistically significant. RESULTS: 239 adolescents, 120 of whom were male, were investigated. A positive relationship was determined among total and subscale scores of peer victimization-determining scale and depression scale scores. A negative relationship was determined between height, weight, age of the child, and sub-scale score of threat/intimidation. Both the total score of the peer victimization-determining scale and subscale scores of ridicule, open attack, and relational attack pertaining to patients with depression proved to be significantly higher than in those without depression. CONCLUSIONS: The awareness of educators and parents, notably adolescents, must be raised in regard to peer victimization, and activities for increasing the communicative skills of adolescents and for allowing them to be able to express their emotions should also be performed. Identifying and preventing peer victimization, one of the causes of depression, and launching the treatment process for this are the first steps to be taken in terms of a healthy adulthood.
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    Çocuk cerrahisi kliniğinde ultrasonografinin yeri ve önemi
    (Dokuz Eylül Üniversitesi Tıp Fakültesi, 2014) Arslan, Serkan; Okur, Mehmet Hanifi; Zeytun, Hikmet; Basuguy, Erol; Arslan, Mehmet Şerif; Aydoğdu, Bahattin; Goya, Cemil
    Öz:Amaç: Son bir yılda çocuk cerrahisi kliniğimizde Ultrasonografi (USG) rehberliğinde yapılan işlemlerin ve çocuk cerrahları tarafından USG'nin kullanım alanlarının değerlendirmesi yapıldı. Klinisyenler tarafından USG'nin kullanımının ne derece yaygın olması gerektiği, radyologlar ve klinisyenlerin USG kullanımındaki yerlerinin belirlenmesi amaçlandı. Gereç ve Yöntem: Bu çalışmada Ocak 2013-2014 yılları arasında 63 hasta geriye dönük olarak değerlendirildi. Üriner sistem patolojisi ve/veya santral damar yolu gibi girişimsel işleme gereksinim olan hastalar USG ile değerlendirildi. Üriner sistem ile ilgili patoloji olduğu düşünülen hastalara başvuruları sırasında poliklinikte, klinisyen tarafından USG ile hastaların böbrek, üreter, ve mesaneleri değerlendirildi. Daha sonra radyolog tarafından USG'leri tekrarlanarak ikinci kez değerlendirme yapıldı. Santral kateter gereksinimi olan hastaların karotis arter ve internal juguler ven USG ile görüntülendikten sonra 45 derece açı ile seldinger yöntemi ile kateterizasyon sağlandıktan sonra işlem sonlandırıldı. Üriner sistem patolojilerinde nefrostomi veya sistofiks gerekli olan hastalara USG eşliğinde kateter takıldı. Tüm bu işlemler Çocuk Cerrahisi Kliniğinde gerçekleştirildi. Bulgular: 2013-2014 yılları arasında 30'u erkek, 33'ü kız olmak üzere toplam 63 hastanın bilgileri geriye dönük olarak değerlendirildi. Hastaların 42'sine tanısal amaçlı USG yapılırken, 21 hastaya invaziv girişimler USG eşliğinde yapılmıştır. Sonuç: Üriner USG'ler her zaman hem radyolog, hem de klinisyen tarafından ayrı ayrı yapılarak çift kontrollü olarak değerlendirilmelidir. Ayrıca Santral Venöz Kateterizasyon (SVK), kateter ihtiyacı takılması gibi invaziv girişimlerin USG eşliğinde yapılması non invaziv olup işlem süresini kısaltmakta, hem de komplikasyonları azaltmaktadır. İnvaziv girişimler öğrenme eğrisine bağlı olarak değişmekle beraber yeterli sayıda tanısal amaçlı yapılan USG'lerden sonra yapılmalıdır.
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    Çocuklarda apandisit için risk faktörleri analizi: Çok merkezli epidemiyolojik çalışma
    (2016) Uygun, İbrahim; Otçu, Selçuk; Basuguy, Erol; Arslan, Serkan; Aydoğdu, Bahattin; Zeytun, Hikmet; Okur, Mehmet Hanifi
    Amaç: Çalışmamızda apandisitin yaşı, cinsiyeti, insidansı ve mevsimsel olarak bölgesel farklılıkların değerlendirilmesi amaçlanmıştır. Yöntemler: Bu çalışmada Türkiye'nin 3 farklı bölgesindeki, 3 hastanede çeşitli tarihlerde apandisit tanısı ile ameliyat edilen 676 hasta bölgelerine göre gruplandırılarak gruplar arasındaki farklar birbirleri ile karşılaştırıldı. Bulgular: Toplamda (n = 676) hastaların %63'ü (n = 426) erkek, %37'si (n = 250) kız, yaş ortalaması 10.8 yıl (range, 1-18 years) idi. The Black Sea Region (karadeniz bölgesi) (BR) grubundaki kız hastaların yüzdesi diğer iki grupla karşılaştırıldığında istatistiksel olarak anlamlı derece yüksek (%45, p=0.001) idi. Mevsimsel olarak değerlendirildiğinde en sık (%36) ilkbahar ve kış (%25) aylarında apandisite rastlandı. İlkbaharda en çok BR grubunda hasta sayısı artmıştır (P < 0.001). Farklı yaş gruplarında apandisitin tipi mevsimler olarak karşılaştırıldığı zaman akut apandisit (%93) ilkbaharda child-adolesan (çoçuk-erişkin) (CA) grubunda daha sık idi (P < 0.02). Ancak perforasyon (%45) Infant-Preschool(bebek-okul öncesi) (IPS) grubunda daha fazla idi (P < 0.02). IPS grubunda Akut apandisit %55, perfore apandisit %45 buna karşın CA grubunda akut apandisit %78, perfore apandisit %22 oranında görüldü. Sonuç: Çalışmamızın sonuçlarına göre apandisit en sık ilkbahar ve kış mevsimlerinde, 10-13 yaşlar arasındaki erkek çocuklarda daha çok görülmüştür. Yaş küçüldükçe perfore apandisit sıklığı artmıştır. Apandisit çevresel faktörlerden etkilenmektedir. Bu konuda yapılacak bölgesel ve spesifik çalışmalar ile etiyolojiler tespit edilerek apandisitin azaltılması gelecekte mümkün olabilir.
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    Çocuklarda başlangıç perkütan nefrolitotomi deneyimimiz
    (Dicle Üniversitesi Tıp Fakültesi, 2014) Okur, Mehmet Hanifi; Arslan, Mehmet Şerif; Aydoğdu, Bahattin; Arslan, Serkan; Uygun, İbrahim; Önen, Abdurrahman; Otçu, Selçuk
    Amaç: Mart 2012 ve Kasım 2013 tarihleri arasında Dicle Üniversitesi Tıp Fakültesi Çocuk Cerrahisi Kliniğinde çocuk yaş grubunda yapılan perkütan nefrolitotomi (PNL) deneyimlerimizi sunmaktır. Yöntemler: On üç böbrek ünitesine (12 hasta) PNL uygulandı. Hastalar, yaş, ameliyat öncesi idrar, idrar kültürü, tam kan sayımı, serum biyokimyası, rutin koagülasyon ile radyolojik tetkikler, taş yerleşimi, taş yükü (direk grafiye göre), operasyon öncesi nefrostomi kullanımı, ortalama floroskopi süresi yönünden değerlendirildi. Nefrostomi traktından erişim mekanik dilatasyon sonrası sağlandı. PNL prosedürü sonrası hastalar, rezidü (>4 mm), komplikasyonlar (Clavien sınıflamasına göre) ve tedavi sonuçları yönünden değerlendirildi. Tüm hastalara postoperatif nefrostomi yerleştirildi. Bulgular: Hastaların yaş ortalamaları 11(6-14) yıl olarak saptandı. Laboratuar testleri normal idi. Taşların 11’i pelvis renalis, 2’si pelvis + kaliks yerleşimliydi. Ortalama taş boyutu 260 mm2 idi. 10 renal üniteye intraoperatif, 3 renal üniteye preoperatif renal giriş sağlandı. Ortalama floroskopik manipülasyon süresi 4,8 dakika (2-11) idi. Post operatif 1 günde taşsızlık oranı %85 idi. Komplikasyonlar toplam 3 hastada görüldü; bir hastada renal erişim sağlanamadı (Grade 3b), bir hastada ameliyat esnasında işlem sonunda pelvis ekstravazasyonu görüldü (Grade 3a). Bir hastada post op transfüzyon gerekti (Grade 2). Ortalama hastanede yatış süresi 5.5 gün (5-7 gün) idi. Sonuç: Pediatrik PNL işlemi, yüksek taşsızlık oranı, belirgin estetik üstünlük ve minimal invaziv cerrahi girişim sağlar. Yeterli donanım ve ekipmanın bulunduğu çocuk cerrahi kliniklerinde deneyimli kişiler tarafından, PNL prosedürü kolaylıkla kullanılabilir.
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    Çocuklarda böbrek taşlarında Retrograd Intrarenal Cerrahinin (RİRC) erken dönem sonuçları: Ön çalışma
    (Fırat Üniversitesi Tıp Fakültesi, 2017) Zeytun, Hikmet; Arslan, Serkan; Arslan, Mehmet Şerif; Basuguy, Erol; Aydoğdu, Bahattin; Okur, Mehmet Hanifi; Önen, Abdurrahman; Otçu, Selçuk
    Öz:Amaç: Bu çalışmada kliniğimizde böbrek taşı nedeniyle Retrograd İntrarenal Cerrahi (RİRC) uygulanan hastaların sonuçlarının sunulması amaçlandı. Gereç ve Yöntem: Dicle Üniversitesi Çocuk Cerrahisi-Çocuk Ürolojisi kliniğinde, 2015-2016 yılları arasında RİRC uygulanan hastaların demografik verileri geriye dönük olarak değerlendirilip analiz edildi. Taş boyutu ultrasonografi ve direkt üriner sistem grafisi ile tek boyutta hesaplanan en uzun ölçüm olarak belirtildi. RİRC işlemi, genel anestezi altında üretere yerleştirilen sheath içinden fleksibl üreteroskop ile böbreğe ulaşılıp, holmium lazer ile taşlar fragmante edilerek yapıldı. Nispeten büyük parçalar forseps yardımıyla dışarı alınırken küçük parçalar doğal yolla atılmaya bırakıldı. Bulgular: Yaş ortalaması 8 yıl (2-12 yaş) olan 10 hastaya RİRC uygulandı. Hastaların 7 (%70)'si erkek, 3 (%30)'ü kız idi. Taşlar, hastaların yarısında sağ, yarısında sol böbrek yerleşimli idi. Özgeçmişlerinde 4 hastaya estrakorporeal şok dalga litotiripsi , 2 hastaya ise perkütan nefrolitotomi yapılmış- tı. Taşlar 7 hastada alt kaliks, 2'sinde pelvis, 1 hastada ise orta kaliks yerleşimli idi. Taş boyutları ortalama 9,7 mm (7-12) idi. Yedi (%70) hastada RİRC öncesi pasif dilatasyon yapıldı. Yedi (%70) hastada RİRC esnasında sheath kullanıldı. Operasyon süresi ortalama 54 (46-83) dakika idi. İki (%20) hastada konservatif tedavi ile düzelen hematüri görüldü. Taşsızlık oranı tek seansta %90 olup, 1 hastada ise ikinci kez RİRC yapılarak %100 taşsızlık sağlandı. Sonuç:RİRC'in, seçilmiş çocuk hastalarda başarı şansı yüksek, hastanede kalış süresi kısa, komplikasyon oranı düşük bir endoüroloji seçeneği olduğunu düşünmekteyiz.
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    Öğe
    Çocuklarda Böbrek Taşlarında Retrograd İntrarenal Cerrahinin (RİRC) Erken Dönem Sonuçları: Ön Çalışma
    (2017) Basuguy, Erol; Arslan, Mehmet Şerif; Zeytun, Hikmet; Arslan, Serkan; Okur, Mehmet Hanifi; Önen, Abdurrahman; Aydoğdu, Bahattin
    Amaç: Bu çalışmada kliniğimizde böbrek taşı nedeniyle Retrograd İntrarenal Cerrahi (RİRC) uygulanan hastaların sonuçlarının sunulması amaçlandı.Gereç ve Yöntem: Dicle Üniversitesi Çocuk Cerrahisi-Çocuk Ürolojisi kliniğinde, 2015-2016 yılları arasında RİRC uygulanan hastaların demografikverileri geriye dönük olarak değerlendirilip analiz edildi. Taş boyutu ultrasonografi ve direkt üriner sistem grafisi ile tek boyutta hesaplanan en uzunölçüm olarak belirtildi. RİRC işlemi, genel anestezi altında üretere yerleştirilen sheath içinden fleksibl üreteroskop ile böbreğe ulaşılıp, holmiumlazer ile taşlar fragmante edilerek yapıldı. Nispeten büyük parçalar forseps yardımıyla dışarı alınırken küçük parçalar doğal yolla atılmaya bırakıldı.Bulgular: Yaş ortalaması 8 yıl (2-12 yaş) olan 10 hastaya RİRC uygulandı. Hastaların 7 (%70)'si erkek, 3 (%30)'ü kız idi. Taşlar, hastaların yarısındasağ, yarısında sol böbrek yerleşimli idi. Özgeçmişlerinde 4 hastaya estrakorporeal şok dalga litotiripsi , 2 hastaya ise perkütan nefrolitotomi yapılmış-tı. Taşlar 7 hastada alt kaliks, 2'sinde pelvis, 1 hastada ise orta kaliks yerleşimli idi. Taş boyutları ortalama 9,7 mm (7-12) idi. Yedi (%70) hastadaRİRC öncesi pasif dilatasyon yapıldı. Yedi (%70) hastada RİRC esnasında sheath kullanıldı. Operasyon süresi ortalama 54 (46-83) dakika idi. İki(%20) hastada konservatif tedavi ile düzelen hematüri görüldü. Taşsızlık oranı tek seansta %90 olup, 1 hastada ise ikinci kez RİRC yapılarak %100taşsızlık sağlandı.Sonuç:RİRC'in, seçilmiş çocuk hastalarda başarı şansı yüksek, hastanede kalış süresi kısa, komplikasyon oranı düşük bir endoüroloji seçeneği olduğunu düşünmekteyiz.
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    Çocuklarda dirençli ürinom'un perkütan kateter veya üreteral stent ile tedavisi: Olgu sunumu
    (Van Yüzüncü Yıl Üniversitesi Tıp Fakültesi, 2016) Arslan, Serkan; Arslan, Mehmet Şerif; Okur, Mehmet Hanifi; Aydoğdu, Bahattin; Zeytun, Hikmet; Basuguy, Erol; Önen, Abdurrahman; Uygun, İbrahim; Otçu, Selçuk
    Ürinom, ciddi üriner obstrüksiyon, travma veya endoüroloji girişimleri sonucu oluşmaktadır. Ürinom tanısı, altta yatan problemi düzeltmek ve gelişebilecek ürosepsis veya intraabdominal sepsis gibi komplikasyonları önlemek açısından önemlidir. Bu çalışmada perkütan tedavi ile düzelmeyen ürinomun cerrahi tedavi yönetimini sunmayı amaçladık. Travma sonrası ürinom gelişen hastaya perkütan drenaj takıldı. Perkütan drenajın uzun sürmesi üzerine Double J stent yerleştirilmeye karar verildi. Sistoskopiyle skopi altında çekilen retrograd pyelografide (RPG) üreteropelvik bileşkede ciddi ekstravazasyon saptandı. Skopi altında 3.8 Fr Double J stent renal pelvise gönderildi. 3 aylık takiplerinde klinik şikayeti olmayan hastanın üriner USG’sinde hafif hidronefroz dışında patoloji saptanmadı. Renal travmalı hastalarda geç dönemde ürinom görülebileceği, takiplerde akıldan çıkarılmamalıdır. Dirençli ürinomlu hastalarda infeksiyon ve apse gelişimini önlemek için girişim gerekebilir. Bu girişimin tipi hastaya göre perkütan drenaj veya Double J stent olabilir.
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    Öğe
    Comparison of Neuroendocrine Responses in Open and Laparoscopic Appendectomies in Children: A Randomized Controlled Trial
    (Galenos Yayincilik, 2016) Salkaya, Aysel Erdem; Ozbagriacik, Ozgur; Akay, Alp; Oba, Sibel; Arslan, Serkan
    Aim: To compare the neuroendocrine changes and responses to surgical stress in open and laparoscopic appendectomy techniques in children. Materials and Methods: Sixty-seven patients aged between six and 14 years presented to the pediatric surgery clinic between July and September 2008 with acute abdominal pain and were enrolled into this study. Patients had class I-II disease, according to the American Society of Anesthesiology, and were scheduled for open and laparoscopic appendectomies. The patients were randomly divided into two groups according to the method of appendectomy used. The neuroendocrine responses of both groups were then compared. Results: No statistical difference was observed between the open and laparoscopic appendectomy groups in terms of age, gender, weight, or duration of surgery (p> 0.05). In addition, no statistical difference was observed between the mean arterial pressure ( MAP), cardiac apex beat (CAB), peripheral oxygen saturation ( SpO(2)), and end tidal carbon dioxide pressure (ETCO2) values of the open and laparoscopic appendectomy groups at 0, 5, 10, 15, 30, 60 minutes, and at the end of the operation ( p> 0.05). There was no statistical difference between the mean values of MAP, CAB, SpO2, or ETCO2 of the groups at the end of the operation and at 1, 2, 3, 12, and 24 hours postoperatively ( p> 0.05) or between the mean glucose, prolactin, or cortisol levels of the two groups at 0 and 30 minutes and at the end of the operation ( p> 0.05). Conclusions: This study demonstrated that neuroendocrine responses to surgical stress were similar in open and laparoscopic appendectomy operations in children. No significant difference was found between the responses developed in either group.
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    Comparison of single-incision laparoscopic percutaneous and cystoscope forceps assisted morgagni hernia repair techniques
    (W.B. Saunders, 2024) Okur, Mehmet Hanifi; Aydoğdu, Bahattin; Azizoğlu, Mustafa; Arslan, Serkan; Bayram, Salih; Basuguy, Erol; 0000-0002-9217-423X; 0000-0002-6720-1515; 0000-0003-2858-3984; 0000-0002-3456-9217; 0000-0002-4360-6892
    Objective: Our goal was to compare single-incision laparoscopic percutaneous and cystoscope forceps-assisted Morgagni hernia repair techniques. Materials and methods: A total of 40 patients were allocated to two groups, each with 20 patients. Group 1: Single incision (port) laparoscopic surgical percutaneous Morgagni hernia repair (with a 5 mm Storz laparoscopic scope entered through the umbilicus). Group 2: Single incision (port) laparoscopic surgical percutaneous Morgagni hernia repair (with an 11 Fr [3.6 mm] cystoscope entered through the umbilicus + using forceps + sac plication, and sac cauterization). In Group 1; the sac was not removed. In group 2; we advanced the forceps through the cystoscope, caught the sac, pushed the needle through the sac, plicated the sac, and then cauterized the sac with Bugbee electrode. Results: Of the 40 patients, 70 % (n = 28) were male. The symptoms at admission included repeated chest infections (40 %), dyspnea (30 %), vomiting (22 %), and abdominal pain (22 %). No difference was found between groups in terms of age, gender symptomatology, or associated anomalies. The operation time was shorter in group 2 compared to group 1 (p < 0.05; 25 min vs 40 min). Although there was one recurrence in Group 1, no recurrence was reported in Group 2. The recurrence incidence did not differ between groups (p > 0.05). Conclusions: Cystoscope-assisted repair of Morgagni hernia was found to be superior in terms of safety and shorter operation time. Level of evidence: Type III. Type of the study: Retrospective study.