Ünal Güvenç - Academia.edu (original) (raw)

Papers by Ünal Güvenç

Authorea (Authorea), Jan 31, 2024

Diseases of the Esophagus, 2019

Aim The data of the Turkish Esophageal Atresia Registry (TEAR) was evaluated to define the surviv... more Aim The data of the Turkish Esophageal Atresia Registry (TEAR) was evaluated to define the survival rate and risk factors of mortality in infants with esophageal atresia (EA). Methods The data of 389 cases registered by 23 centers between 2014 and 2018 were evaluated for demographic features, associated anomalies, surgical treatment and mortality-related outcome. Each parameter was evaluated for cases with mortality (CM) and compared with the results of survivors. Also, prognostic factors were investigated in CM. Results The overall survival rate was 81.09% and the mortality was 19.02% (n = 74). The male/female ratio was 1:1 in CM and 1.2:1 in survivors. The mean weight and height measurements in CM were lower than in survivors (1956 ± 658 g- 43.2 ± 5.7 cm vs 2534 ± 609 g-46.4 ± 4.3 cm) (P 0.05). Tube feeding was more common in CM and the incidence of full oral feedings was significantly higher in survivors (P

European Journal of Pediatric Surgery, 2020

Introduction The data of the Turkish Esophageal Atresia Registry (TEAR) was evaluated to define t... more Introduction The data of the Turkish Esophageal Atresia Registry (TEAR) was evaluated to define the outcome of very low birth weight (VLBW) and low BW (LWB) infants with esophageal atresia (EA). Materials and Methods The data registered by 24 centers between 2014 and 2018 were evaluated for demographic features, prenatal findings, associated anomalies, surgical treatment, and outcome. Patients were enrolled in three groups according to their BWs (VLBW <1,500 g), LWB = 1,500–2,500 g), and normal BW (NBW; >2,500 g). Results Among the 389 cases, there were 37 patients (9.5%) in the VLBW group, 165 patients (42.4%) in the LBW group, and 187 patients (48.1%) in the NBW group. Prenatal diagnosis rates were similar among the three groups (29.7, 34.5, and 24.6%, respectively). The standard primary anastomosis was achieved at a significantly higher rate in NWB cases than in the other groups (p < 0.05). In patients with tracheoesophageal fistula (TEF), patients of the NBW group had s...

İstanbul Kanuni Sultan Süleyman Tıp Dergisi, 2016

İnfantil hipertrofik pilor stenozunun (İHPS) tanı ve tedavisi ile ilgili deneyimlerimiz ışığında ... more İnfantil hipertrofik pilor stenozunun (İHPS) tanı ve tedavisi ile ilgili deneyimlerimiz ışığında hastalığın öneminin vurgulanması amaçlanmıştır.

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 2017

Intestinal perforation or inflammation due to appendicitis is rarely encountered in the neonatal ... more Intestinal perforation or inflammation due to appendicitis is rarely encountered in the neonatal period. The diagnosis may be delayed due to the lack of specific clinical symptoms and its rarity in this patient population. Early surgical treatment is the main treatment strategy with a good prognosis. However, delayed diagnosis may result in complications and even death. Herein, we describe a late preterm female neonate without any risk factors who had a diagnosis of perforated appendicitis at postnatal day 5. To the authors' knowledge, this case represents the earliest presentation of neonatal perforated appendicitis elucidated by prompt diagnostic laparotomy. Neonatal appendicitis should be considered in the differential diagnosis of infants with abdominal clinical findings.

Journal of Pediatric Surgery, 2021

AIM Preservation of the azygos vein (AV) maintains normal venous drainage of the mediastinum and ... more AIM Preservation of the azygos vein (AV) maintains normal venous drainage of the mediastinum and decreases postoperative congestion. The modification of esophageal atresia (EA) repair by preserving AV may prevent postoperative complications and may lead to better outcomes. The data from the Turkish Esophageal Atresia Registry (TEAR) were evaluated to define the effect of AV preservation on postoperative complications of patients with EA. METHODS Data from TEAR for a period of five years were evaluated. Patients were enrolled into two groups according to the preservation of AV. Patients with divided (DAV) and preserved AV (PAV) were evaluated for demographic and operative features and postoperative complications for the first year of life. The DAV and PAV groups were compared according to the postoperative complications, such as fistula recanalization, symptomatic strictures, anastomotic leaks, total number of esophageal dilatations, and anti-reflux surgery. In addition, respiratory problems, which required treatment, were compared between groups. RESULTS Among 502 registered patients; the data from 315 patients with the information of AV ligation were included. The male female ratio of DAV (n = 271) and PAV (n = 44) groups were 150:121 and 21:23, respectively (p > 0.05). The mean body weight, height, gestational age, and associated anomalies were similar in both groups (p > 0.05). The esophageal repair with thoracotomy was significantly higher in DAV group, when compared to the PAV group (p < 0.05). The rates of primary anastomosis and tensioned anastomosis were similar in both groups (p > 0.05). There was no difference between DAV and PAV groups for anastomotic leaks, symptomatic anastomotic strictures, fistula recanalization, and the requirement for anti-reflux surgery (p > 0.05). The rate of respiratory problems, which required treatment, was significantly higher in the DAV group (p < 0.05) CONCLUSION: The data in the TEAR demonstrated that preserving the AV during EA repair led to no significant advantage on postoperative complications, with exception of respiratory problems. AV should be preserved as much as possible to maintain a normal mediastinal anatomy and to avoid respiratory complications.

Turkish Association of Pediatric Surgeons, 2017

Castleman hastalığı (anjiyofoliküler lenfoid hiperplazi, dev lenf nodülü hiperplazisi), nedeni ta... more Castleman hastalığı (anjiyofoliküler lenfoid hiperplazi, dev lenf nodülü hiperplazisi), nedeni tam aydınlatılamamış ender bir hastalıktır. Tedavide hastalığın klinik ve histolojik şekli belirleyicidir. Bu çalışmada, sağ koltuk altında kitle nedeniyle on yaşında ameliyat edilen ancak kitlenin tam olarak çıkarılamadığı tek-bölgeli, hiyalin vasküler tip Castleman Hastalığı saptanan bir olgu sunulmuş, hastalığın özellikleri ve tedavi yöntemleri literatür bilgileri ışığında tartışılmıştır.

Turkish Association of Pediatric Surgeons, 2016

de çoğunlukla mukozal konjesyon, ödem, kanama ve iskemik değişiklikler bildirildi. Ektopik doku o... more de çoğunlukla mukozal konjesyon, ödem, kanama ve iskemik değişiklikler bildirildi. Ektopik doku olarak 26 olguda (%22) mide mukozası, 1 olguda ise pankreas dokusu varlığı belirlendi. Ameliyat sonrasında olguların 2'si bağırsak yapışıklığı nedeniyle yeniden ameliyat edildi. Üç olgu yaygın/ gecikmiş peritonite bağlı çoklu organ yetersizliği tablosuyla kaybedildi. Rastlantısal saptanıp takibe alınan iki hasta semptomatik hale geldi; 1'i rektal kanama, 1'i invajinasyon nedeniyle opere edildi. Sonuç: Semptomatik olgularda sıklıkla akut karın tablosu ön planda olup, tanıda gecikmeler ölümcül komplikasyonlara neden olabilmektedir. Tanıda zorluk yaşanan olgularda MD'ne bağlı komplikasyonların akılda tutulması gerekmektedir.

Turkish Association of Pediatric Surgeons, 2016

Kısa bağırsak sendromu (KBS) bağırsak uzunluğu ve mukoza alanı yetersizliğinden kaynaklanan bir e... more Kısa bağırsak sendromu (KBS) bağırsak uzunluğu ve mukoza alanı yetersizliğinden kaynaklanan bir emilim sorunu olup, ağır enerji, protein, vitamin ve elektrolit bozukluğu ile seyreder. KBS'nin en sık nedenleri, nekrotizan enterekolit, ince bağırsak atrezileri, orta bağırsak volvulusu ve gastroşizisdir. Çalışmamızda Bianchi yöntemi ile bağırsak uzatılması yapılan KBS'li 2 olgu sunulmuş ve literatür taramasıyla ülkemiz çocuk cerrahisi topluluğunun KBS olgularına yaklaşımı özetlenmeye çalışılmıştır.

International Surgery, 2016

Purpose: In infants, the duodenum is the most frequently obstructed region of the gastrointestina... more Purpose: In infants, the duodenum is the most frequently obstructed region of the gastrointestinal tract. The objective of the present study was to summarise the causes of early mortality and morbidity in infants with congenital duodenal obstruction (CDO). Methods: Data on a total of 94 patients with CDO diagnosed in our clinic, and treated surgically between January 1993 and December 2012, were studied retrospectively. Patients were divided into three groups in terms of diagnosis: annular pancreas (n = 45), duodenal atresia (n = 31), and duodenal web (n = 18). The groups were compared in terms of sex, birth weight, age at the time of operation, and morbidity and mortality rates. Results: Of the patients, 54 were males and 40 females, and the mean birth weight was 2,278 (range, 1,180-3,400) g. The average age at the time of the operation was 6.96 (range 1-38) days. The time to full oral intake postoperatively was 10.32 (range, 4-38) days. Additional anomalies were found in 61 (64.8%...

Advances in Urology, 2016

Aim. Ureteropelvic junction obstruction (UPJO) is rarely associated with a duplex collecting syst... more Aim. Ureteropelvic junction obstruction (UPJO) is rarely associated with a duplex collecting system. We review this unusual anomaly in terms of presentation, diagnostic evaluation, and surgical management.Method. We retrospectively reviewed the medical records of patients diagnosed with a duplex system with UPJO.Result. Sixteen patients (6 girls, 10 boys) with 18 moieties were treated surgically and four patients were treated conservatively. The median age at surgery was two years (range, 2 months to 7 years). The lower pole and upper moiety were affected in 12 and two kidneys, respectively, and both were affected in two patients. The anomaly was right-sided in 12 moieties and left-sided in six. The duplication was incomplete in seven patients and complete in nine. The mean renal pelvis diameter at the time of surgery was 25.6 (range 11–48 mm) mm by USG. The mean renal function of the involved moiety was 28.3% before surgery. Management included pyelopyelostomy or ureteropyelostomy ...

Pakistan Journal of Medical Sciences, 2016

Objective: This study summarises the outcomes of 149 patients who underwent surgery for antenatal... more Objective: This study summarises the outcomes of 149 patients who underwent surgery for antenatally diagnosed unilateral hydronephrosis. Methods: The medical records of such patients over a 23-year period were reviewed retrospectively. Age at the time of operation, preoperative and postoperative mean pelvic diameter on ultrasound, split renal function, washout patterns on scintigraphy, and early and late complications were recorded. Results: The mean preoperative follow-up period was five months (range: 1-66 months). One patient was operated on after 12 months and two patients after five years of follow-up. Mean preoperative pelvic diameter and renal function were 30.8 mm and 38.6%, respectively; all patients had an obstructive washout pattern. In the postoperative period, the corresponding measurements were 11.7 mm and 39.2%, with 111 non-obstructive, 24 partially obstructive, and 14 obstructive wash-out patterns. Three patients with severe caliectasis and low renal function underwent surgery despite mild hydronephrosis. The mean postoperative follow-up period was six (range 4-11) years. Complications developed in 14 (9.3%) patients. Conclusion: Patients with antenatal hydronephrosis may need surgery even after a follow-up period of six years. Because of the potential late development of complications, postoperative follow-up should be continued for 10 years.

İstanbul Kanuni Sultan Süleyman Tıp Dergisi, 2016

Yabancı cisim yutulması, çocukluk çağının sık karşılaşılan bir sorunudur. Bu cisimler bazen çok c... more Yabancı cisim yutulması, çocukluk çağının sık karşılaşılan bir sorunudur. Bu cisimler bazen çok ciddi komplikasyonlara yol açabilmektedir. Makalemizdeki amaç, gastrointestinal sistemde yabancı cisimlerin oluşturduğu cerrahi sorunlarla ilgili klinik deneyimlerimizi literatür eşliğinde tartışmaktır. Gereç ve Yöntem: İki merkezde 1987 ile 2013 yılları arasında yabancı cisim yutulması tanı ve tedavisi yapılan çocukların hastane arşivlerinden ulaşılabilen dosyaları geriye dönük olarak incelendi.

Turkish Association of Pediatric Surgeons, 2016

Tüm olgular ortalama 11 aylıkken (2-35 ay) TERPT yöntemiyle ameliyat edildi ve ortalama 15 cm (8-... more Tüm olgular ortalama 11 aylıkken (2-35 ay) TERPT yöntemiyle ameliyat edildi ve ortalama 15 cm (8-38 cm) barsak bölümü çıkarıldı. TERPT ameliyatına; enterostomi açılmış olan altı hastanın üçünde karın içi yapışıklıkların ameliyatı güçleştirebileceği düşüncesiyle, enterostomisiz hastalardan ise birine uzun segment Hh şüphesiyle laparatomi ile başlandı. Enterostomili iki hasta ile enterostomisiz bir hastada ise ameliyata transanal yoldan başlanmasına karşın tatminkar bir serbestleştirme sağlanamadığından karına dönüldü. Ameliyat sonrası erken dönemde 1 olguda karın kesisinin açılması nedeniyle girişim gerekti, 1 olgumuz ise erken dönemde kaybedildi. Hastalarımızın hastanede kalma süresi ortalama 6 gündü (4-12 gün). On beş olgumuzun ortalama 14 aylık (1-21 ay) takibinde; 3 (%20) olguda anastomoz darlığı nedeniyle genişletme gerekirken, 10 (%66,6) olguda perineal dermatit tablosuyla karşılaşıldı. Bakımlarla iyileşen hastalarımızın günlük kaka yapma sayısı ameliyattan sonraki ilk üç ayda 8-10 kez iken sonrasında günde 1-3'e dek düştüğü gözlendi. Tüm hastalarımızın takibi halen sorunsuz şekilde sürmektedir. Sonuç: Hh tedavisinde kurulduğundan beri Rehbein yöntemini tercih eden kliniğimizin ilk TERPT deneyimlerinden sonra yöntemin güvenilir bir histopatolojik değerlendirme olanağı bulunması koşuluyla, özellikle batın açılmadan tek ameliyat olarak uygulanması durumunda daha yüksek oranda cerrahi ve aile memnuniyeti sağlayacağını düşünmekteyiz.

İstanbul Kanuni Sultan Süleyman Tıp Dergisi, 2015

Kasık fıtığı/hidrosel çocuklarda günübirlik ameliyatların en sık nedenidir. Bu makalede, kliniğim... more Kasık fıtığı/hidrosel çocuklarda günübirlik ameliyatların en sık nedenidir. Bu makalede, kliniğimizin 27 yıllık deneyimlerinin aktarılması ve konu ile ilgili olarak çocuk hekimlerimiz ile yapılan bir anket çalışmasının sonuçlarının paylaşılması amaçlanmıştır.

International Urology and Nephrology, 2015

five females, four males), a misdirected urethral catheter was discovered in one of the ureters. ... more five females, four males), a misdirected urethral catheter was discovered in one of the ureters. The urethral catheter was in the left ureter in four patients and in the right ureter in five patients. Cystoscopic examination found ectopic ureteral openings in six patients: at the bladder neck in four and just below the bladder trigone in two. Three patients in this group with ectopic ureters were followed due a misdiagnosis of VUR. The remaining three patients had grade 3 or 4 VUR. In this group, the catheter passed into the ureter because of the enlarged ureterovesical junction. In one patient with VUR, intraparenchymal fluid leakage and transient hematuria occurred due to the rapid tension increase following the fast injection of contrast with liquid to one ureter. Conclusion Although placing an indwelling urethral catheter is a relatively safe procedure, complications can occur, particularly in patients with ureterovesical anomalies, such as high-grade VUR or an ectopic ureter. Using catheters with inflating balloons can cause rapid increases in tension in the ureter, and related complications.

Jinekoloji Obstetrik Pediatri ve Pediatrik Cerrahi Dergisi, 2012

İnfantil hipertrofik pilor stenozunun (İHPS) tanı ve tedavisi ile ilgili deneyimlerimiz ışığında ... more İnfantil hipertrofik pilor stenozunun (İHPS) tanı ve tedavisi ile ilgili deneyimlerimiz ışığında hastalığın öneminin vurgulanması amaçlanmıştır.

Authorea (Authorea), Jan 31, 2024

Diseases of the Esophagus, 2019

Aim The data of the Turkish Esophageal Atresia Registry (TEAR) was evaluated to define the surviv... more Aim The data of the Turkish Esophageal Atresia Registry (TEAR) was evaluated to define the survival rate and risk factors of mortality in infants with esophageal atresia (EA). Methods The data of 389 cases registered by 23 centers between 2014 and 2018 were evaluated for demographic features, associated anomalies, surgical treatment and mortality-related outcome. Each parameter was evaluated for cases with mortality (CM) and compared with the results of survivors. Also, prognostic factors were investigated in CM. Results The overall survival rate was 81.09% and the mortality was 19.02% (n = 74). The male/female ratio was 1:1 in CM and 1.2:1 in survivors. The mean weight and height measurements in CM were lower than in survivors (1956 ± 658 g- 43.2 ± 5.7 cm vs 2534 ± 609 g-46.4 ± 4.3 cm) (P 0.05). Tube feeding was more common in CM and the incidence of full oral feedings was significantly higher in survivors (P

European Journal of Pediatric Surgery, 2020

Introduction The data of the Turkish Esophageal Atresia Registry (TEAR) was evaluated to define t... more Introduction The data of the Turkish Esophageal Atresia Registry (TEAR) was evaluated to define the outcome of very low birth weight (VLBW) and low BW (LWB) infants with esophageal atresia (EA). Materials and Methods The data registered by 24 centers between 2014 and 2018 were evaluated for demographic features, prenatal findings, associated anomalies, surgical treatment, and outcome. Patients were enrolled in three groups according to their BWs (VLBW <1,500 g), LWB = 1,500–2,500 g), and normal BW (NBW; >2,500 g). Results Among the 389 cases, there were 37 patients (9.5%) in the VLBW group, 165 patients (42.4%) in the LBW group, and 187 patients (48.1%) in the NBW group. Prenatal diagnosis rates were similar among the three groups (29.7, 34.5, and 24.6%, respectively). The standard primary anastomosis was achieved at a significantly higher rate in NWB cases than in the other groups (p < 0.05). In patients with tracheoesophageal fistula (TEF), patients of the NBW group had s...

İstanbul Kanuni Sultan Süleyman Tıp Dergisi, 2016

İnfantil hipertrofik pilor stenozunun (İHPS) tanı ve tedavisi ile ilgili deneyimlerimiz ışığında ... more İnfantil hipertrofik pilor stenozunun (İHPS) tanı ve tedavisi ile ilgili deneyimlerimiz ışığında hastalığın öneminin vurgulanması amaçlanmıştır.

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 2017

Intestinal perforation or inflammation due to appendicitis is rarely encountered in the neonatal ... more Intestinal perforation or inflammation due to appendicitis is rarely encountered in the neonatal period. The diagnosis may be delayed due to the lack of specific clinical symptoms and its rarity in this patient population. Early surgical treatment is the main treatment strategy with a good prognosis. However, delayed diagnosis may result in complications and even death. Herein, we describe a late preterm female neonate without any risk factors who had a diagnosis of perforated appendicitis at postnatal day 5. To the authors' knowledge, this case represents the earliest presentation of neonatal perforated appendicitis elucidated by prompt diagnostic laparotomy. Neonatal appendicitis should be considered in the differential diagnosis of infants with abdominal clinical findings.

Journal of Pediatric Surgery, 2021

AIM Preservation of the azygos vein (AV) maintains normal venous drainage of the mediastinum and ... more AIM Preservation of the azygos vein (AV) maintains normal venous drainage of the mediastinum and decreases postoperative congestion. The modification of esophageal atresia (EA) repair by preserving AV may prevent postoperative complications and may lead to better outcomes. The data from the Turkish Esophageal Atresia Registry (TEAR) were evaluated to define the effect of AV preservation on postoperative complications of patients with EA. METHODS Data from TEAR for a period of five years were evaluated. Patients were enrolled into two groups according to the preservation of AV. Patients with divided (DAV) and preserved AV (PAV) were evaluated for demographic and operative features and postoperative complications for the first year of life. The DAV and PAV groups were compared according to the postoperative complications, such as fistula recanalization, symptomatic strictures, anastomotic leaks, total number of esophageal dilatations, and anti-reflux surgery. In addition, respiratory problems, which required treatment, were compared between groups. RESULTS Among 502 registered patients; the data from 315 patients with the information of AV ligation were included. The male female ratio of DAV (n = 271) and PAV (n = 44) groups were 150:121 and 21:23, respectively (p > 0.05). The mean body weight, height, gestational age, and associated anomalies were similar in both groups (p > 0.05). The esophageal repair with thoracotomy was significantly higher in DAV group, when compared to the PAV group (p < 0.05). The rates of primary anastomosis and tensioned anastomosis were similar in both groups (p > 0.05). There was no difference between DAV and PAV groups for anastomotic leaks, symptomatic anastomotic strictures, fistula recanalization, and the requirement for anti-reflux surgery (p > 0.05). The rate of respiratory problems, which required treatment, was significantly higher in the DAV group (p < 0.05) CONCLUSION: The data in the TEAR demonstrated that preserving the AV during EA repair led to no significant advantage on postoperative complications, with exception of respiratory problems. AV should be preserved as much as possible to maintain a normal mediastinal anatomy and to avoid respiratory complications.

Turkish Association of Pediatric Surgeons, 2017

Castleman hastalığı (anjiyofoliküler lenfoid hiperplazi, dev lenf nodülü hiperplazisi), nedeni ta... more Castleman hastalığı (anjiyofoliküler lenfoid hiperplazi, dev lenf nodülü hiperplazisi), nedeni tam aydınlatılamamış ender bir hastalıktır. Tedavide hastalığın klinik ve histolojik şekli belirleyicidir. Bu çalışmada, sağ koltuk altında kitle nedeniyle on yaşında ameliyat edilen ancak kitlenin tam olarak çıkarılamadığı tek-bölgeli, hiyalin vasküler tip Castleman Hastalığı saptanan bir olgu sunulmuş, hastalığın özellikleri ve tedavi yöntemleri literatür bilgileri ışığında tartışılmıştır.

Turkish Association of Pediatric Surgeons, 2016

de çoğunlukla mukozal konjesyon, ödem, kanama ve iskemik değişiklikler bildirildi. Ektopik doku o... more de çoğunlukla mukozal konjesyon, ödem, kanama ve iskemik değişiklikler bildirildi. Ektopik doku olarak 26 olguda (%22) mide mukozası, 1 olguda ise pankreas dokusu varlığı belirlendi. Ameliyat sonrasında olguların 2'si bağırsak yapışıklığı nedeniyle yeniden ameliyat edildi. Üç olgu yaygın/ gecikmiş peritonite bağlı çoklu organ yetersizliği tablosuyla kaybedildi. Rastlantısal saptanıp takibe alınan iki hasta semptomatik hale geldi; 1'i rektal kanama, 1'i invajinasyon nedeniyle opere edildi. Sonuç: Semptomatik olgularda sıklıkla akut karın tablosu ön planda olup, tanıda gecikmeler ölümcül komplikasyonlara neden olabilmektedir. Tanıda zorluk yaşanan olgularda MD'ne bağlı komplikasyonların akılda tutulması gerekmektedir.

Turkish Association of Pediatric Surgeons, 2016

Kısa bağırsak sendromu (KBS) bağırsak uzunluğu ve mukoza alanı yetersizliğinden kaynaklanan bir e... more Kısa bağırsak sendromu (KBS) bağırsak uzunluğu ve mukoza alanı yetersizliğinden kaynaklanan bir emilim sorunu olup, ağır enerji, protein, vitamin ve elektrolit bozukluğu ile seyreder. KBS'nin en sık nedenleri, nekrotizan enterekolit, ince bağırsak atrezileri, orta bağırsak volvulusu ve gastroşizisdir. Çalışmamızda Bianchi yöntemi ile bağırsak uzatılması yapılan KBS'li 2 olgu sunulmuş ve literatür taramasıyla ülkemiz çocuk cerrahisi topluluğunun KBS olgularına yaklaşımı özetlenmeye çalışılmıştır.

International Surgery, 2016

Purpose: In infants, the duodenum is the most frequently obstructed region of the gastrointestina... more Purpose: In infants, the duodenum is the most frequently obstructed region of the gastrointestinal tract. The objective of the present study was to summarise the causes of early mortality and morbidity in infants with congenital duodenal obstruction (CDO). Methods: Data on a total of 94 patients with CDO diagnosed in our clinic, and treated surgically between January 1993 and December 2012, were studied retrospectively. Patients were divided into three groups in terms of diagnosis: annular pancreas (n = 45), duodenal atresia (n = 31), and duodenal web (n = 18). The groups were compared in terms of sex, birth weight, age at the time of operation, and morbidity and mortality rates. Results: Of the patients, 54 were males and 40 females, and the mean birth weight was 2,278 (range, 1,180-3,400) g. The average age at the time of the operation was 6.96 (range 1-38) days. The time to full oral intake postoperatively was 10.32 (range, 4-38) days. Additional anomalies were found in 61 (64.8%...

Advances in Urology, 2016

Aim. Ureteropelvic junction obstruction (UPJO) is rarely associated with a duplex collecting syst... more Aim. Ureteropelvic junction obstruction (UPJO) is rarely associated with a duplex collecting system. We review this unusual anomaly in terms of presentation, diagnostic evaluation, and surgical management.Method. We retrospectively reviewed the medical records of patients diagnosed with a duplex system with UPJO.Result. Sixteen patients (6 girls, 10 boys) with 18 moieties were treated surgically and four patients were treated conservatively. The median age at surgery was two years (range, 2 months to 7 years). The lower pole and upper moiety were affected in 12 and two kidneys, respectively, and both were affected in two patients. The anomaly was right-sided in 12 moieties and left-sided in six. The duplication was incomplete in seven patients and complete in nine. The mean renal pelvis diameter at the time of surgery was 25.6 (range 11–48 mm) mm by USG. The mean renal function of the involved moiety was 28.3% before surgery. Management included pyelopyelostomy or ureteropyelostomy ...

Pakistan Journal of Medical Sciences, 2016

Objective: This study summarises the outcomes of 149 patients who underwent surgery for antenatal... more Objective: This study summarises the outcomes of 149 patients who underwent surgery for antenatally diagnosed unilateral hydronephrosis. Methods: The medical records of such patients over a 23-year period were reviewed retrospectively. Age at the time of operation, preoperative and postoperative mean pelvic diameter on ultrasound, split renal function, washout patterns on scintigraphy, and early and late complications were recorded. Results: The mean preoperative follow-up period was five months (range: 1-66 months). One patient was operated on after 12 months and two patients after five years of follow-up. Mean preoperative pelvic diameter and renal function were 30.8 mm and 38.6%, respectively; all patients had an obstructive washout pattern. In the postoperative period, the corresponding measurements were 11.7 mm and 39.2%, with 111 non-obstructive, 24 partially obstructive, and 14 obstructive wash-out patterns. Three patients with severe caliectasis and low renal function underwent surgery despite mild hydronephrosis. The mean postoperative follow-up period was six (range 4-11) years. Complications developed in 14 (9.3%) patients. Conclusion: Patients with antenatal hydronephrosis may need surgery even after a follow-up period of six years. Because of the potential late development of complications, postoperative follow-up should be continued for 10 years.

İstanbul Kanuni Sultan Süleyman Tıp Dergisi, 2016

Yabancı cisim yutulması, çocukluk çağının sık karşılaşılan bir sorunudur. Bu cisimler bazen çok c... more Yabancı cisim yutulması, çocukluk çağının sık karşılaşılan bir sorunudur. Bu cisimler bazen çok ciddi komplikasyonlara yol açabilmektedir. Makalemizdeki amaç, gastrointestinal sistemde yabancı cisimlerin oluşturduğu cerrahi sorunlarla ilgili klinik deneyimlerimizi literatür eşliğinde tartışmaktır. Gereç ve Yöntem: İki merkezde 1987 ile 2013 yılları arasında yabancı cisim yutulması tanı ve tedavisi yapılan çocukların hastane arşivlerinden ulaşılabilen dosyaları geriye dönük olarak incelendi.

Turkish Association of Pediatric Surgeons, 2016

Tüm olgular ortalama 11 aylıkken (2-35 ay) TERPT yöntemiyle ameliyat edildi ve ortalama 15 cm (8-... more Tüm olgular ortalama 11 aylıkken (2-35 ay) TERPT yöntemiyle ameliyat edildi ve ortalama 15 cm (8-38 cm) barsak bölümü çıkarıldı. TERPT ameliyatına; enterostomi açılmış olan altı hastanın üçünde karın içi yapışıklıkların ameliyatı güçleştirebileceği düşüncesiyle, enterostomisiz hastalardan ise birine uzun segment Hh şüphesiyle laparatomi ile başlandı. Enterostomili iki hasta ile enterostomisiz bir hastada ise ameliyata transanal yoldan başlanmasına karşın tatminkar bir serbestleştirme sağlanamadığından karına dönüldü. Ameliyat sonrası erken dönemde 1 olguda karın kesisinin açılması nedeniyle girişim gerekti, 1 olgumuz ise erken dönemde kaybedildi. Hastalarımızın hastanede kalma süresi ortalama 6 gündü (4-12 gün). On beş olgumuzun ortalama 14 aylık (1-21 ay) takibinde; 3 (%20) olguda anastomoz darlığı nedeniyle genişletme gerekirken, 10 (%66,6) olguda perineal dermatit tablosuyla karşılaşıldı. Bakımlarla iyileşen hastalarımızın günlük kaka yapma sayısı ameliyattan sonraki ilk üç ayda 8-10 kez iken sonrasında günde 1-3'e dek düştüğü gözlendi. Tüm hastalarımızın takibi halen sorunsuz şekilde sürmektedir. Sonuç: Hh tedavisinde kurulduğundan beri Rehbein yöntemini tercih eden kliniğimizin ilk TERPT deneyimlerinden sonra yöntemin güvenilir bir histopatolojik değerlendirme olanağı bulunması koşuluyla, özellikle batın açılmadan tek ameliyat olarak uygulanması durumunda daha yüksek oranda cerrahi ve aile memnuniyeti sağlayacağını düşünmekteyiz.

İstanbul Kanuni Sultan Süleyman Tıp Dergisi, 2015

Kasık fıtığı/hidrosel çocuklarda günübirlik ameliyatların en sık nedenidir. Bu makalede, kliniğim... more Kasık fıtığı/hidrosel çocuklarda günübirlik ameliyatların en sık nedenidir. Bu makalede, kliniğimizin 27 yıllık deneyimlerinin aktarılması ve konu ile ilgili olarak çocuk hekimlerimiz ile yapılan bir anket çalışmasının sonuçlarının paylaşılması amaçlanmıştır.

International Urology and Nephrology, 2015

five females, four males), a misdirected urethral catheter was discovered in one of the ureters. ... more five females, four males), a misdirected urethral catheter was discovered in one of the ureters. The urethral catheter was in the left ureter in four patients and in the right ureter in five patients. Cystoscopic examination found ectopic ureteral openings in six patients: at the bladder neck in four and just below the bladder trigone in two. Three patients in this group with ectopic ureters were followed due a misdiagnosis of VUR. The remaining three patients had grade 3 or 4 VUR. In this group, the catheter passed into the ureter because of the enlarged ureterovesical junction. In one patient with VUR, intraparenchymal fluid leakage and transient hematuria occurred due to the rapid tension increase following the fast injection of contrast with liquid to one ureter. Conclusion Although placing an indwelling urethral catheter is a relatively safe procedure, complications can occur, particularly in patients with ureterovesical anomalies, such as high-grade VUR or an ectopic ureter. Using catheters with inflating balloons can cause rapid increases in tension in the ureter, and related complications.

Jinekoloji Obstetrik Pediatri ve Pediatrik Cerrahi Dergisi, 2012

İnfantil hipertrofik pilor stenozunun (İHPS) tanı ve tedavisi ile ilgili deneyimlerimiz ışığında ... more İnfantil hipertrofik pilor stenozunun (İHPS) tanı ve tedavisi ile ilgili deneyimlerimiz ışığında hastalığın öneminin vurgulanması amaçlanmıştır.