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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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    A different approach to leakage of esophageal atresia in children
    (Turkish Association of Trauma and Emergency Surgery, 2020) Basuguy, Erol; Okur, Mehmet Hanifi; Arslan, Serkan; Zeytun, Hikmet; Aydoǧdu, Bahattin
    BACKGROUND: In this study, we aimed to present the results of patients treated for esophageal leakage with a different conservative approach. METHODS: Ninety-eight patients with esophageal atresia and tracheoesophageal fistula (EA) who underwent surgery in our clinic between February 2013 and January 2018 were retrospectively reviewed in this study. Patients’ anastomosis leakage, gestational week, gender, body weight, referral date, recovery time and stenosis were recorded. After leakage detection, the nasogastric catheter was fluoroscopically converted into a nasojejunal catheter using a guidewire and feeding continued. RESULTS: Anastomotic leakage developed in 18 (18.3%) patients. The average gestational age at birth was 35.4 weeks; the patients included ten girls and eight boys of average weight 2.41 kg; the average referral period was 2.1 days after birth and the average time of surgery was 2.4 days after birth. The average recovery time was 21.1 days (range: 8–60 days). Eight patients developed stenosis that recovered with dilatation. CONCLUSION: Our findings suggest that our conservative treatment approach, which uses a nasojejunal catheter, is an effective method that would reduce complications, enable earlier feeding, and reduce the cost compared to other treatment approaches.
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    Laparoscopic versus open portoenterostomy for treatment of biliary atresia: a meta-analysis
    (Springer Science and Business Media, 2023) Okur, Mehmet Hanifi; Aydoǧdu, Bahattin; Azizoǧlu, Mustafa; Bilici, Salim; Bayram, Salih; Salık, Fikret
    Objective: Our goal was to compare laparoscopic portoenterostomy versus open portoenterostomy for the treatment of biliary atresia. Materials and methods: Using the databases EMBASE, PubMed, and Cochrane, we carried out a thorough literature search up to 2022. Studies comparing laparoscopic and open surgery for the treatment of biliary atresia were included. Results: Twenty-three studies comparing laparoscopic portoenterostomy (LPE) (n = 689) and open portoenterostomy (OPE) (n = 818) were considered appropriate for meta-analysis. Age at surgery time was lower in the LPE group than OPE group (I2 = 84%), (WMD − 4.70, 95% CI − 9.14 to − 0.26; P = 0.04). Significantly decreased blood loss (I2 = 94%), (WMD − 17.85, 95% CI − 23.67 to − 12.02; P < 0.00001) and time to feed were found in the laparoscopic group (I2 = 97%), (WMD − 2.88, 95% CI − 4.71 to − 1.04; P = 0.002). Significantly decreased operative time was found in the open group (I2 = 85%), (WMD 32.52, 95% CI 15.65–49.39; P = 0.0002). Weight, transfusion rate, overall complication rate, cholangitis, time to drain removal, length of stay, jaundice clearance, and two-year transplant-free survival were not significantly different across the groups. Conclusions: Laparoscopic portoenterostomy provides advantages regarding operative bleeding and the time to begin feeding. No differences in remain characteristics. Based on the data presented to us by this meta-analysis, LPE is not superior to OPE in terms of overall results.