Browsing by Author "Sahan, A."

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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.
How Does Puncture Modality Affect the Risk of Intraoperative Bleeding During Percutaneous Nephrolithotomy? a Prospective Randomized Trial
(Elsevier Ltd, 2021) Sahan, A.; Cubuk, A.; Ozkaptan, O.; Ertas, K.; Toprak, T.; Eryildirim, B.; Sarica, K.
Introduction and objectives: To evaluate the possible effects of two different renal puncture techniques (ultrasound-assisted [US-assisted], fluoroscopic-guided [FG]) on the intraoperative hemorrhage risk during percutaneous nephrolithotomy (PCNL). Material and methods: A total of 130 patients with Guy stone scores of 1-2 were prospectively allocated to US-assisted and FG puncture groups by simple randomization. Patients with intraoperative pelvicalyceal rupture and the ones requiring multiple accesses were excluded from the study. Apart from the puncture steps, all other steps of the PCNL procedure were performed with similar techniques by a single surgeon. Patient characteristics, operative data, and postoperative outcomes were compared. Results: A total of 10 patients were excluded from the study due to intraoperative complications after puncture. Patient demographics and stone characteristics were similar between the two groups (P > .05). Mean hemoglobin drop was meaningfully greater in the FG group (1.7 g/dL) when compared with US-assisted group (1.3 g/dL) (P < .01). The mean duration of radiation exposure was significantly higher for the FG (P < .001). Total operative time, number of attempts for a successful puncture, length of hospital stay, and stone free rates were similar between the groups (P > .05). In addition, the remaining complications classified according to the modified Clavien-Dindo grading system were similar between groups (P > .05). Conclusion: US-assisted puncture provides significantly decreased level of hemoglobin drop and radiation exposure time when compared with FG. © 2021 AEU