Browsing by Author "Ertaş, K."

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Clinical and Pathological Predictors of Prolonged Lymphorrhoea After Pelvic Lymph Dissection in Radical Cystectomy
(Yuzuncu Yil Universitesi Tip Fakultesi, 2020) Özkaptan, O.; Balaban, M.; Çubuk, A.; Sahan, A.; Ertaş, K.; Sevinc, C.; Karadeniz, T.
The aim of the study was to determine different variables that may be predictive for prolonged lymporrhoea and duration of lymphatic drainage. Two hundred and three patients who underwent radical cystectomy (RC) and pelvic lymph node dissection (PLND) were enrolled in this study. Lymphorrhoea was defined as the total amount of lymph drained by the drains until their removal. Duration of drainage was defined as the days until the removal of the last drains. Parameters that might be related to lymphorrhoea and duration of drainage including age, body mass index (BMI), removed lymph nodes, hemoglobin level (gr/dl), estimated blood loss (ml) (EBL), platelet count (PLN), hospital stay (HS) and lymph node status were reviewed retrospectively. Statistical analyses were performed to determine the association between lymphorrhoea with probable predictors for these variables. The mean number of removed lymph nodes was 28.52 (16-58). The mean amount of lymphorrhoea and the duration of drainage were 1504 ml (300-5850) and 10.10 days (2-27), respectively. Multivariate analyses revealed that the mean amount of lymphorrhoea rises gradually as EBL, patients age, negative lymph nodes and lymphadenectomy extension increases (P<0.05). Related to the duration of drainage, multivariate analyses showed that BMI and the number of removed lymph nodes were statistically significant predictors of prolonged drainage (p=0.016, p=0.046; respectively). Predictors for lymphorrhoea may help us mainly to foresee the duration of the hospital stay and the eventual complications that may be induced by lymphorrhoea. In patients with a higher risk for lymphorrhoea, preoperative maneuvers could be applied to decrease lymphorrhoea. © 2020, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
The Effect of Body Mass Index on the Outcomes of Open Simple Prostatectomy
(Yuzuncu Yil Universitesi Tip Fakultesi, 2020) Bulut, E.C.; Ertaş, K.; Koparal, M.Y.; Çetin, S.
Simple prostatectomy remains the gold standard treatment for patients with severe lower urinary tract symptoms (LUTS) and patients with enlarged prostate. Obesity, defined as a body mass index over 30kg/m2 by the World Health Organization (WHO), is associated with some perioperative complications. This study aims to investigate the effects of obesity on the outcomes of open simple prostatectomy. The study includes 72 patients that underwent open simple prostatectomy. We compared the treatment outcomes of 49 patients with a body mass index (BMI)<30kg/m2 and 16 patients with a BMI>30kg/m2. We compared t he two groups in terms of change in International Prostate Symptom Score (IPSS), change in uroflowmetry maximum flow rate (Qmax), operation time, intraoperative blood loss, transfusion requirements. The median of change in IPSS scores was 16(11-30) for the group where BMI>30kg/m2 and 15.5(10-20) for the group where BMI<30kg/m2. This difference was not statistically significant (p=0.383). The mean duration of operation was 90.61±17.45 minutes for patients with BMI<30kg/m2 and 121.87±18.78 minutes for patient s with a BMI>30kg/m2. The difference between the two groups was statistically significant (p<0.001). The median of blood loss was 450(200-700) cc for the BMI<30kg/m2 group and 725 (550-850) cc for the BMI>30kg/m2 group, and this difference was statistically significant (p<0.001). However, the blood transfusion requirements of the two groups were statistically similar (p=0.885). Open simple prostatectomy is very important technic in the treatment of BPH patients with enlarged prostates. Despite obesity is associated with a prolonged operation and increased transfusion rates in open simple prostatectomy, it can still be considered a safe treatment method. © 2020, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Evaluation of Renal Colic Patients Attending the Emergency Department When the Covid 19 Pandemic Was First Announcement
(Yuzuncu Yil Universitesi Tip Fakultesi, 2022) Ertaş, K.; Gizli, G.; Demir, M.; Sevim, M.; Eryılmaz, R.; Aslan, R.; Taken, K.
Renal colic cases, which have an important place among patients presenting to the emergency department with pain complaints, have an important place in urological emergencies. In this study, patients who applied to the emergency department with suspected renal colic diagnosis during the Covid-19 pandemic were compared with those in the pre-pandemic period. Patients who applied to the Emergency Department with the colic type flank pain between March 2020 and May 2020 were included in the study. Diagnostic and treatment parameters of 1699 patients, inclu ding 199 pandemic and 1500 pre-pandemic control group, were evaluated in this study. As a result of the evaluation made, it was seen that emergency physicians preferred ultrasonography less during the pandemic period, and mostly resorted to computer tomography method, and in this period, a decrease in the rate of observed kidney stones, an increase ureter stones were observed. During the pandemic period, there has been a considerable decrease in the rate of hospital admissions As a result of postponing treatment of patients with urinary system stones, secondary pyonephrosis and pyelonephritis rates increased approximately 10 times compared to the pre-pandemic period. © 2022, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Fluoroscopy Free Flexible Ureteroscopy: the Report of 248 Cases
(Yuzuncu Yil Universitesi Tip Fakultesi, 2023) Taken, K.; Eryilmaz, R.; Aslan, R.; Ertaş, K.; Demir, M.; Deniz, B.; Duran, A.M.
The goal of this study was to assess the results of 248 patients who underwent fluoroscopy-free retrograde intrarenal surgery. Between January 2017 and March 2020, 248 cases of retrograde intrarenal surgery (RIRS) were conducted using an access sheath and guidewire. Using ureteroscopy, two hydrophilic guide wires were inserted into the renal pelvis under direct eyesight (URS). When the ureter could not be entered with the 9.5 Fr URS, the ureter was first entered using the 7.5 Fr URS. Then, without flouroscopy, an access sheath was pushed u p to the proximal ureter while examining the opening with URS. When an access sheath could not be placed, a double J stent was implanted. The operation was repeated after 3 weeks. The procedure's success rate was determined by the absence of stones or the presence of leftover fragments smaller than 3 mm. The study included 161 (64.9%) male and 87 (35.1%) female patients with a mean age of 44.03 (± 16.04), (range 18-81) years. Mean stone size was 14.7 (± 3.7) mm. The mean operation time was 62.34 (± 8.2) minutes. Stone-free rate was 88.7% (n: 220). 28 of the patients had residual stone. Twenty patients (8%) had minor complications, including hematuria and fever and in 2 patients (0.8%) subcapsular hematoma was developed. Kidney stones can be treated successfully with minimal morbidity and mortality. The insertion of an access sheath under urs guidance is possible without the need of fluoroscopy. Patients and surgeons are exposed to less radiation as a result of this procedure. © 2023, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
A Novel Indicator for Erectile Dysfunction: S100a4
(Yuzuncu Yil Universitesi Tip Fakultesi, 2024) Demir, M.; Huyut, Z.; Huyut, M.T.; Ertaş, K.; Aslan, R.; Eryılmaz, R.; Taken, K.
This study aimed whether S100A4 would be useful in predicting Erectile Dysfunction (ED) and ED severity. This prospective study included 88 male volunteers aged 18-80 years. The control group consisted of 44 healthy patients and the diabetic group consisted of 44 patients with type-2 diabetes (T2DM). Age, body mass index, smoking status, hypertension status, International Index of Erectile Function 1-5 scores of all the volunteers were evaluated, and also glucose, HbA1c, cholesterol, testosterone, prolactin and S100A4 levels were measured in the serum samples. The relationships between S100A4 and erectile functions were investigated with appropriate statistical analyzes. The mean age of the T2DM group was 51.98 ±10.91 years, while the control group’s mean age was 53.77 ±12.46 years and there was no significant difference between them (p=0.31). Glucose, HbA1c, mean ED severity and S100A4 levels in the T2DM group were higher than in the control group, while testosterone level was lower than in the control (p≤0.05). In addition, it was found that S100A4 levels increased due to the increase in ED severity in both groups (p<0.001). In addition to ED severity, smoking and hypertension were seen as the factors that most affected S100A4. The results indicated that S100A4 may be a useful biomarker in determining ED and ED severity. © 2024, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
A Prospective Analysis of the Efficacy and Safety of Caudal Block for Transrectal Ultrasound Guided Prostate Biopsy in Patients With Anorectal Disorders
(Yuzuncu Yil Universitesi Tip Fakultesi, 2024) Aslan, R.; Günes, H.Y.; Erbin, A.; Eryilmaz, R.; Sevim, M.; Ertaş, K.; Taken, K.
In this study, the efficacy and safety of the caudal block technique for transrectal ultrasonography-guided biopsy (Trus-guided biopsy) in patients with anorectal problems were investigated. A total of 31 consecutive patients with anal-rectal problems underwent prostate needle biopsy. All patients included in the study were examined by an experienced general surgeon, and the presence of anorectal problems was confirmed. The majority of patients (61%) were referred from the outer center to our clinic beca use a biopsy could not be performed due to severe pain felt during rectal probe insertion despite local anesthesia (topical prilocaine or lidocaine cream). A 12-core biopsy protocol was applied to all patients under the caudal block. Pain perception was se parately assessed during caudal anesthesia, probe insertion, and sampling stages using a visual analog scale (VAS) score. The mean age was 64.1 ± 9.1 years. The mean VAS score during caudal anesthesia was 1.8 ± 0.81. At probe insertion, the mean VAS score was 1,44 ± 012. During the needle penetration into prostate tissue and sampling, the mean VAS score was 2.44± 013. All of the patients did not state any bothersome pain at any stage. We did not find any complications related to the anesthesia method. Topical creams and/or periprostatic nerve block (PNB) do not provide adequate analgesia in patients with anorectal disorders undergoing Trus-guided biopsy. Caudal block technique can be performed effectively and reliably in this selected patient group. © 2024, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.