Browsing by Author "Boyvat, Fatih"

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17 Years Of Pediatric Liver Transplantation Experience For Cirrhosis And Hepatocellular Carcinoma
(2022) Ozcay, Figen; Sezer, Oya Balci; Sarialioglu, Faik; Boyvat, Fatih; Coskun, Mehmet; Reyhan, Nihan Haberal; Haberal, Mehmet; https://orcid.org/0000-0002-3462-7632; AAJ-8097-2021
Aortoiliyak arteriyel darlık - tıkanıklıkların tedavisinde primer stent uygulaması
(Başkent Üniversitesi Tıp Fakültesi, 2007) Oğuz, Dilek; Boyvat, Fatih
Periferik arter hastalığı (PAH) genellikle alt ekstremite arterlerinin aterosklerotik hastalığı sonucu ortaya çıkar. Sigara kullanımı en önemli etiyolojik faktördür. Aortik bifurkasyo en sık tutulan bölgedir. Geriye dönük olarak yapılan bu çalışmada Haziran 2004-Kasım 2006 tarihleri arasında aortoiliyak arteriyel darlık ya da tıkanıklıkların tedavisinde primer stentleme uygulaması ve bu tedavinin komplikasyonları ve etkinliği değerlendirilmiştir. Çalışmamız kapsamında 40 hastada toplam 59 darlık (43’ü ana iliyak arterde, 15’i eksternal iliyak arterde, 1’i distal abdominal aortada diffüz) ve 8 tıkanıklığa (5’i ana iliyak arterde, 3’ü eksternal iliyak arterde) primer stentleme yapılmıştır. 1 hastada giriş yerinde cerrahi müdaheleye gerek olmayan psödoanevrizma ve hematom, 1 hastada distal embolizasyon gelişmiştir. 1 hastada işlem sırasında aktif ekstravazasyon görülmüş ancak balon tamponadı ile kontrol altına alınmıştır. 2 hasta koroner anjiyografi ünitesinden ana iliyak arterde diseksiyon gelişmesi üzerine devralınarak işlem yapılmıştır. Kontrolde yerleştirilen toplam 67 stentten 64’ünün (% 95.5) patent olduğu (takip süresi 2-40 ay, ortalama 20.4 ay) saptanmıştır. Takipte 3 hastada stent içi tıkanıklık, 2 hastada stent içi daralma saptanmıştır. Aortoiliyak arteriyel darlık ve tıkanıklıkların primer stentleme ile tedavisi teknik başarısı yüksek, tekrar daralma-tıkanıklık ve komplikasyon oranları düşük, güvenle uygulanabilir bir yöntemdir. Peripheral arterial disease (PAD) generally occurs as a result of atherosclerotic disease of the lower limb arteries. Smoking is the most important factor in etiology. Aortic bifurcation is commonly involved. Treatment of aortoiliac arterial stenoses and occlusions with primary stent implantation, complications and efficacy of this treatment was evaluated between June 2004 and December 2006 in this retrospective study. 40 patients with a total of 59 stenoses (43 located in common iliac artery, 15 located in external iliac artery, 1 located in diffuse distal abdominal aorta) and 8 occlusions (5 located in common iliac artery, 3 located in external iliac artery) were treated primary stent implantation. Pseudoaneurysm and hematoma developed in the puncture site but treated without surgery in 1 patient. Thrombus embolization to distal arteries occured in one patient. Active extravasation was detected during intervention in one patient and treated with balloon tamponade. 2 patients experienced dissection of the common iliac artery during coronary angiography. These patients were transferred to interventional radiology unit and treated with primary stent implantation. 64 of the implanted 67 stents (% 95.5) were detected to be patent in the follow-up (follw-up interval between 2-40 months, mean 20.4 months). 3 patients experienced stent occlusion and 2 other patients experienced in-stent restenosis. Primary stent implantation for treatment of aortoiliac stenoses and occlusions is a safe procedure with low rates of restenosis-occlusions, complications and high rates of technique success.
Arterial complication of irreversible electroporation procedure for locally advanced pancreatic cancer
(2016) Ekici, Yahya; Tezcaner, Tugan; Aydin, Huseyin Onur; Boyvat, Fatih; Moray, Gokhan; 0000-0003-3795-5794; 0000-0003-2498-7287; 0000-0002-3641-8674; 27795815; S-8185-2018; AAE-1041-2021; M-1422-2019; AAD-9865-2021; F-4230-2011
Irreversible electroporation (IRE) is a non-thermal ablation technique used especially in locally advanced pancreatic carcinomas that are considered surgically unresectable. We present the first case of acute superior mesenteric artery (SMA) occlusion secondary to pancreatic IRE procedure that has not been reported before in the literature. A 66-year-old man underwent neoadjuvant chemoradiotherapy for locally advanced pancreatic ductal adenocarcinoma. IRE procedure was applied to the patient during laparotomy under general anesthesia. After finishing the procedure, an acute intestinal ischemia was detected. A conventional vascular angiography was performed and a metallic stent was successfully placed to the SMA and blood flow was maintained. It is important to be careful in such cases of tumor involvement of SMA when evaluating for IRE procedure of pancreatic tumor.
Bilgisayarlı tomografi kılavuzluğu ile gerçekleştirilen perkütan apse drenajlarında teknik, endikasyon ve komplikasyonlar ile klinik sonuçların değerlendirilmesi
(Başkent Üniversitesi Tıp Fakültesi, 2023) Yavuz Sarsam, Büşra; Boyvat, Fatih
Abdominopelvik yerleşimli apselerin tedavisinde temel yaklaşım perkütan drenaj ve antibiyotik tedavisidir. Ultrasonografi ile erişimin mümkün olmadığı apselerde perkütan drenaj BT eşliğinde yapılabilir. Bu çalışmanın amacı abdomen ve pelvik yerleşimli apselere yönelik BT eşliğinde perkütan drenaj yapılmış hastalarda işlem öncesi klinik bulguların incelenmesi, uygun teknik ve erişim yöntemlerinin belirlenmesi ile işlem sonrası klinik sonuçların, komplikasyonların ve maruz kalınan radyasyon dozu miktarının hesaplanması amaçlanmıştır. Çalışmaya 2012-2022 tarihleri arasında BT eşliğinde apse drenajı gerçekleştirilen 218 hastaya (81 erkek, 137 kadın, ortalama yaş: 57.60 ± 16.42) ait 268 apse dahil edilmiş ve retrospektif olarak incelenmiştir. 16 apseye aspirasyon, 252 apseye ise konvansiyonel BT eşliğinde Seldinger yöntemi ile 8F-14F pig tail kateterler kullanılarak perkütan drenaj yapılmıştır. Başarılı drenaj oranı %79,85’tir. Mortalite oranı %1.38’dir. Major komplikasyon oranı %2,75, minör komplikasyon oranı %3,21 olarak bulunmuştur. Çalışmamızda temel olarak 218 hastanın (268 apse) işlem öncesi klinik ve laboratuvar bulguları, işleme ait teknik detayları ve işlemden sonraki takip verileri değerlendirilmiştir. Takip süresi, poşografi (absesogram) sayısı, revizyon gereksinimi ve kültürde üreme olma oranı fistül ya da bağlantı tespit edilen koleksiyonlarda daha yüksek bulunmuştur (p<0.05). Tanısal aspirasyonda püy varlığında kültürde üreme oranı daha yüksektir (p<0.05). DLP değeri ortalama 509,33 ± 391,94 mGy-cm ve efektif doz 7,635 ± 5,88 mSv olarak hesaplanmıştır. 268 koleksiyonun karın kadranlarına ve organlara göre yerleşimine göre DLP değerlerinin farklılık gösterdiği bulunmuştur (p<0.05). Sonuç olarak erişimi zor abdominopelvik yerleşimli apselerin tedavisinde BT eşliğinde perkütan drenaj, cerrahiye kıyasla düşük mortalite ve morbidite oranlarına sahip etkin bir yöntemdir ve güvenle kullanılabilir. Çalışmamız ile BT eşliğinde apse drenajında teknik, izlem ve radyasyon dozu ile ilgili literatüre katkı sağlanması amaçlanmaktadır. The main treatment of abdominopelvic abscesses is percutaneous drainage and antibiotherapy. Percutaneous drainage can be performed with CT guidance in abscesses that can not be accessed by ultrasonography. The aim of this study is to evaluate the clinical findings, technical parameters, clinical outcome, complications and radiation dose that exposed in patients who underwent CT-guided percutaneous intraabdominal abscess drainage.A total of 268 abscess of 218 patients (81 males, 137 females, mean age: 57.60 ± 16.42 years) who underwent CT-guided abscess drainage between 2012 and 2022 were included in the study and analyzed retrospectively. Aspiration was performed in 16 abscess, and percutaneous drainage was performed by the conventional CT on 252 abscess using Seldinger method with 8F-14F pig tail catheters. The successful drainage rate was 79.85%. The mortality rate was 1.38%. Major complication rate was 2.75% and minor complication rate was 3.21%. In our study, the clinical and laboratory findings of 218 patients (268 abscess) before the procedure, the technical details of the procedure and the follow-up data were evaluated. The follow-up period, number of abscessogram, need for revision, and positive culture results were found to be higher in abscess with fistula or connection (p<0.05). In the presence of pus in diagnostic aspiration, positive culture results was higher (p<0.05). The mean DLP value was 509.33 ± 391.94 mGy-cm and the effective dose was calculated 7.635 ± 5.88 mSv. DLP values of 268 abscess were found to differ according to the abdominal quadrants and organ locations (p<0.05). In conclusion, CT-guided percutaneous abscess drainage is an effective method with low mortality and morbidity rates compared to surgery and can be used safely in the treatment of abdominopelvic abscesses that are difficult to access.Our study aims to contribute to the literature on technique, follow-up and radiation dose in CT-guided abscess drainage.
Chest Wall Implantation Metastasis Caused by Percutaneous Radiofrequency Ablation for Hepatic Tumor
(2015) Kilic, Dalokay; Uysal, Cagri; Akdur, Aydincan; Kayipmaz, Cagri; Tepeoglu, Merih; Boyvat, Fatih; 0000-0002-9894-8005; 0000-0002-8726-3369; 0000-0001-6236-0050; 25742838; H-7700-2019; F-4230-2011; AAK-5222-2021; AAA-3068-2021
We report a very rare case of a 55-year-old man with chest wall metastatic tumor caused by seeding of hepatocellular carcinoma after percutaneous radiofrequency ablation (RFA) for hepatic tumor 42 months after the initial operation. The patient was managed with aggressive full-thickness chest wall resection and reconstruction with a Prolene (Ethicon, Somerville, NJ) and methyl methacrylate sandwich graft and subsequent musculocutaneous free-flap transposition. (C) 2015 by The Society of Thoracic Surgeons
Comparison of Transforaminal and Interlaminar Epidural Steroid Injection in Managing Lumbar Radiculopathy
(2017) Rahatli, Feride Kural; Harman, Ali; Boyvat, Fatih; Zararsiz, Gokmen; https://orcid.org/0000-0002-4226-4034; https://orcid.org/0000-0002-7386-7110; AAL-9808-2021; K-9824-2013; F-4230-2011
Purpose: Epidural steroid injection is a commonly used low risky symptomatic treatment option of lumbar radiculopathy in patients with poor response to conservative management. The purpose of this prospective study was to compare the efficacy of transforaminal and interlaminar epidural steroid injection. Materials and methods: In this study computed tomography guided lumbar epidural steroid injections were performed in 87 patients, steroid injections were made by transforaminal and interlaminar technique. The effectiveness of this treatment was evaluated by visual analogue scale at 2 weeks ( acute), 3 months (sub-acute) and 6 months ( chronic) after the injection. Results: In interlaminar group 78.1% patients had effective pain relief at acute term and 73.4% patients had effective pain relief at sub-acute and chronic term. In transforaminal group 82.6% patients had effective pain relief at acute term and 73.9% patients had effective pain relief at sub-acute and chronic term. Transforaminal group showed slightly better pain relief in all terms but the difference was not statistically significant. Patients with symptom duration more than 6 months had statistically significant higher pain relief than the patients with symptom duration less than 6 months in acute term but there was no statistically significant difference between sub-acute and chronic terms. Conclusion: In the current study transforaminal epidural steroid injections for the treatment of lumbar radiculopathy resulted in better pain relief than interlaminar epidural steroid injections in all terms but the difference was not statistically significant.
Diagnostic and interventional radiology in liver & kidney transplantation
(Baskent University, 2020) Haberal, Mehmet; Boyvat, Fatih
The effect of bleomycin embolization on symptomatic improvement and hemangioma size among patients with giant liver hemangiomas
(2018) Kirnap, Mahir; Boyvat, Fatih; Boyacioglu, Sedat; Hilmioglu, Fatih; Moray, Gokhan; Haberal, Mehmet; 0000-0003-2498-7287; AAH-9198-2019
AN EFFECTIVE BRIDGING TIPS TECHNIQUE TO LIVER TRANSPLANTATION FOR BUDD-CHIARI SYNDROME
(2020) Boyvat, Fatih; Harman, Ali; Soy, Ebru H. Ayvazoglu; Haberal, Mehmet A.
Efficacy of the Sonoelastography Method for Diagnosis of Fibrosis in Renal Transplant Patients
(2022) Soudmand, Arash; Ozturk, Funda Ulu; Uslu, Nihal; Haberal, Nihan; Boyvat, Fatih; Moray, Gokhan; Haberal, Mehmet; https://orcid.org/0000-0002-3462-7632; 29993356; AAJ-8097-2021
Objectives: Although biopsy is the most important method for diagnosing the cause of renal allograft dysfunction, sonoelastography, a new ultrasonography method, can be used to distinguish between the soft or hard nature of lesions. In this study, our aim was to investigate whether sonoelastography could diagnose fibrosis in renal transplant patients. Materials and Methods: In this prospective study, we included patients over 18 years old who were recommended for clinical biopsy. Sonoelastographic evaluation was made by conducting acoustic radiation force impulse measurements for each patient after they were admitted to the clinic for biopsy. Measurements were performed just before the biopsy procedure. All results were examined by 2 experienced radiologists using the Siemens S3000 Ultrasound Machine (Erlangen, Germany). Comparisons of ultrasonographic values with biopsy results were made with SPSS software (SPSS: An IBM Company, version 20, IBM Corporation, Armonk, NY, USA). Results: Of the 65 patients included in this study, pathology showed acute T-cell-mediated rejection in 37 patients. There was a significant correlation between the pathologic Banff scores and the sonographic acoustic radiation force impulse values (P = .002), where the degree of Banff increased as the mean acoustic radiation force impulse values elevated. A rise in mean impulse values correlated with increased degree of interstitial fibrosis in renal allografts. Renal parenchymal echogenicity of patients significantly differed by sex (P = .009), with an average renal echogenicity of grade 1 in women and grade 0 in men. Also, a statistically significant difference was found between age of the renal transplant recipient and resistive index values. Conclusions: Our study showed a significant correlation between Banff degree and the acoustic radiation force impulse values of renal transplant patients. In addition to biopsy, sonoelastography can be beneficial for the diagnosis of fibrosis in renal transplant patients.
Embolization of Pulmonary Sequestration with Onyx: An Unusual Application
(2014) Gursu, Alper Hazim; Boyvat, Fatih; Varan, Birgul; Erdogan, Ilkay; https://orcid.org/0000-0002-0707-2678; https://orcid.org/0000-0002-6719-8563; https://orcid.org/0000-0001-6887-3033; 24643150; AHI-4502-2022; F-4230-2011; ABB-1767-2021; ABB-2220-2021
We report a baby with intralobar pulmonary sequestration who was successfully treated with a new embolization agent, Onyx. A 1.5-month-old female infant was admitted to our hospital with sweating and fatigue. Telecardiography showed cardiomegaly, dextrocardia, and increased pulmonary vascular markings. In thoracic computerized tomography, pulmonary sequestration, right pulmonary hypoplasia, and large collateral arteries were seen. The collateral arteries were originating from the celiac trunk and aorta. Echocardiography revealed enlargement of the left atrium and ventricle and left ventricle systolic dysfunction. Angiography revealed a large feeding artery and three branches originating from the aorta and another feeding artery originating from the celiac trunk. We performed embolization of the feeding arteries and their branches, with coils and Onyx. The procedure was performed without complications, and all feeding arteries were completely occluded. The infant started to gain weight. One year later, the infant's body weight had increased and she had no respiratory problems or signs of congestive heart failure. In this case report, we suggest that embolization with Onyx is a reliable alternative method to surgery for infants with pulmonary sequestration. With future studies, pulmonary sequestration embolization with Onyx may become an acceptable and easy treatment option in pediatric patients.
Endovascular Management of Arterial Complications Following Renal Transplant Biopsy
(2018) Ozyer, Umut; Harman, Ali; Soy, Ebru H. Ayvazoglu; Aytekin, Cuneyt; Boyvat, Fatih; Haberal, Mehmet; 0000-0002-4300-009X; 0000-0002-7386-7110; 0000-0002-0993-9917; 0000-0002-3462-7632; AAK-9071-2021; K-9824-2013; AAC-5566-2019; F-4230-2011; AAJ-8097-2021
Endovascular Management of Hematomas in Pediatric Transplant Patients
(2022) Ozen, Ozgur; Boyvat, Fatih; Harman, Ali; Karakaya, Emre; Haberal, Mehmet; 0000-0002-4879-7974; 0000-0001-7122-4130; 0000-0002-3462-7632; 35570602; AAD-5466-2021; AAN-1681-2021; AAJ-8097-2021
Objectives: Transcatheter arterial embolization is used to control active hemorrhage at different anatomic locations. Because hematomas can suddenly deteriorate and become life threatening for transplant patients, they require prompt diagnosis and intervention rather than conservative management. Here, we evaluated computed tomography in treatment planning and transcatheter embolization effectiveness for hematoma management in pediatric liver transplant patients. Materials and Methods: Between June 2012 and December 2021, 10 pediatric liver transplant patients were referred to our interventional radiology unit. Computed tomography and angiograms were reviewed for hematoma location and presence of extravasation. We analyzed correlations between computed tomography and angiography findings and technical and clinical success of the endovascular interventions. Results: Active leak of contrast material during arterial phase was detected on 9/10 CT scans. Although there was no active bleeding on CT in 1 patient, active arterial bleeding was detected on angiography. On the contrary, in 2 patients, although active bleeding was observed on computed tomography, it was not detected on angiography. Source of bleeding was superior mesenteric artery branches in 4, hepatic artery branch in 2, superior epigastric artery in 1, and phrenic artery in 1 patient. Six of 8 patients with active bleeding were treated with endovascular procedures. The remaining 2 patients received surgery: 1 had bleeding from liver cut surface originating from a hepatic artery branch and received open surgery because the bleeding branch was too thin for catheterization, and 1 was hemodynamically unstable and selective catheterization of the internal thoracic artery would take time. Two patients received embolization procedures with N-butyl 2-cyanoacrylate (glue) diluted with iodized oil, and 1 patient had coil and glue with iodized oil. Embolization with coils was performed in 3 patients. Rate of success with transcatheter arterial embolization was 75%. No complications related to patient comorbidities or embolization procedures were shown. No deaths occurred due to progression of the hematoma. Conclusions: Transcatheter arterial embolization is effective and safe for treatment of pediatric liver transplant patients with hematomas. Computed tomography has value in identifying the bleeding source and its anatomic relationships and may enhance our intervention abilities to become quicker, more effective, and more secured.
Fluoroscopically Guided Retrograde Double-J Stent Removal in Renal Transplant Patients
(2018) Aytekin, Cuneyt; Harman, Ali; Ozyer, Umut; Akdur, Aydincan; Boyvat, Fatih; Haberal, Mehmet; 0000-0002-7386-7110; 0000-0002-4300-009X; 0000-0002-8726-3369; 0000-0002-3462-7632; K-9824-2013; AAK-9071-2021; AAA-3068-2021; F-4230-2011; AAJ-8097-2021
Incidence and Management of Bile Stone After Liver Transplantation: Report of A Single Center
(2016) Kirnap, Mahir; Soy, Ebru H. Ayvazoglu; Akdur, Aydincan; Boyvat, Fatih; Moray, Gokhan; Haberal, Mehmet; https://orcid.org/0000-0002-0993-9917; https://orcid.org/0000-0002-8726-3369; https://orcid.org/0000-0003-2498-7287; https://orcid.org/0000-0002-3462-7632; AAH-9198-2019; AAC-5566-2019; AAA-3068-2021; F-4230-2011; AAE-1041-2021; AAJ-8097-2021
Incidence of Urinary Complications With Double J Stents in Kidney Transplantation
(2019) Kirnap, Mahir; Boyvat, Fatih; Torgay, Adnan; Moray, Gokhan; Yildirim, Sedat; Haberal, Mehmet; https://orcid.org/0000-0002-6829-3300; https://orcid.org/0000-0003-2498-7287; https://orcid.org/0000-0002-5735-4315; https://orcid.org/0000-0002-3462-7632; 30777542; AAH-9198-2019; F-4230-2011; AAJ-5221-2021; AAE-1041-2021; AAF-4610-2019; AAJ-8097-2021
Objectives: Ureteral complications remain a major source of morbidity and occasional mortality in renal transplant. Among all ureteral complications, leaks are the most frequently encountered in the early posttransplant period. The routine use of a double-J ureteric stent remains controversial, with reported increased incidence of urinary tract infection. Here, we retrospectively compared the efficacy of a double J stent in kidney transplant patients to investigate ureteral complication incidence in our center. Materials and Methods: Our study included 382 kidney transplant patients. At 5 weeks after transplant, the double J stent was removed under sedation. Patients were divided into 2 groups: 125 patients with double J stent placement (group 1) and 257 patients without double J stent placement (group 2). Results: We observed no significant demographic differences between the 2 groups with regard to patient age (median patient age of 30 y [range, 2-73 y] for group 1; median patient age of 33 y [range, 4-69 y] for group 2), patient sex (30.2% females in group 1, 32.4% females in group 2), and body mass index (median of 25.1 vs 24.9 kg/m 2 in groups 1 and 2, respectively). Cold and warm ischemia time for donor organ, delayed graft function, and episodes of acute rejection did not differ significantly between the groups. Urinary tract infection was observed in 25/125 (20.4%) and 50/257 patients (19.2%) in groups 1 and 2, respectively. Urinary leak was present in 8/125 group 1 (6.4%) and 6/257 group 2 patients (2.3%). Conclusions: A double J stent in ureteral anastomosis was not likely to decrease the frequency of leakage but is likely to reduce the gravity of the complication and the need for reoperation. In addition, the use of a double J stent was not associated with increased urinary tract infections in renal transplant recipients.
Interventional Radiologic Treatment of Hepatocellular Carcinoma
(2017) Boyvat, Fatih; 28301995; F-4230-2011
The current treatment modalities for patients with hepatocellular carcinoma are discussed in this review. Hepatocellular carcinoma arises in up to 90% of cirrhotic patients, mainly due to chronic viral hepatitis and alcohol abuse. Nearly two-thirds of all patients with hepatocellular carcinoma are diagnosed at advanced stages, thus causing problems with treatment. Regardless of the stage of the disease, interventional radiology offers both curative and palliative treatment options in the management of this disease. Selecting the most appropriate treatment requires an initial staging assessment and detailed clinical and radiologic workup. Treatment allocation is based on liver function, size and number of tumors, macrovascular invasion, and extrahepatic spread of disease.
Interventional Treatment Methods for Ureteral Complications After Kidney Transplant: A Single-Center Experience
(2023) Ozen, Ozgur; Karakaya, Emre; Zeydanli, Tolga; Kahraman, Gokhan; Yildirim, Sedat; Boyvat, Fatih; Haberal, Mehmet; 0000-0002-4879-7974; 0000-0001-7122-4130; 37698400; AAD-5466-2021; F-4230-2011; AAN-1681-2021
Objectives: Ureteral complications are one of the most common complications after kidney transplant. Although these complications have been treated surgically in the past, almost all can be successfully treated with interventional methods today. In this study, we assessed the interventional treatment of ureteral complications after kidney transplants performed in our center and the long-term results of these treatments. Materials and Methods: We performed a retrospective analysis of 2223 kidney transplant recipients seen between January 1, 2000, and May 1, 2020. Among these, 70 kidney transplant recipients who experienced ureteral leakage or ureteral obstruction in the early or late posttransplant period were included in the study. Complications within the first 2 months posttransplant were classified as early complications, whereas those occurring after 2 months were considered late complications. We treated all patients with interventional methods.Results: In review of patients, 44 patients were diagnosed with ureteral obstruction (22 patients were early obstruction, 22 were late obstruction) and 26 patients with ureteral anastomosis leakage. All patients with early and late ureteral obstruction were successfully treated with percutaneous methods. In the group of patients with ureteral leakage, all patients except 2 patients were treated with interventional methods. For 2 patients with ureteral leakage, surgical treatment was necessary because of persistent leakage despite percutaneous treatment methods. Conclusions: Ureteral complications after kidney transplant can be successfully treated with interventional methods in experienced centers without the need for surgery.
Karaciğer tümörleri ve cerrahi deneyimlerimiz
(Çocuk Cerrahisi Dergisi ,21 ,1 ,34-38, 2007) Arda, İ.Serdar; Ötgün, İbrahim; Coşkun, Mehmet; Boyvat, Fatih; Güney, L.Hakan; Fakıoğlu, Ender; Bilezikçi, Banu; Özen, Özlem; Hiçsönmez, Akgün; Haberal, Mehmet
Kliniğimizde bir yıl içerisinde karaciğer tümörü netanısı ile izlenen hastaların bulguları sunulmaktadır. Gereç ve Yöntem: Kliniğimizde 1 yıl içerisinde 6 olgu (3 hepatoblastom, 1 hepatosellüler karsinom, 1 metastatik karaciğer kitlesi -opere Wilms' tümörü- ve 1 embriyonel rabdomiyosarkom) izlenmiştir. Bu çalışmada hastaların bulguları geriyedönük olarak taranmıştır. Bulgular: 4'ü erkek ikisi kız olan hastaların yaşları 4 ay ile 6 yaş arasındaydı. Hastaların tümü tümör belirteçleri, dopler ultrasonografi ve bilgisayarlı tomografik hepatik anjiyografi ile değerlendirildi. 4 hastada kitle tam olarak çıkarıldı. Hepatoblastoma tanılı bir hastaya canlı vericiden karaciğer nakli yapıldı. Hepatoblastomlu diğer bir hasta ise kemoembolizasyon sonrasında kemoterapi programına alındı. Sonuç: Çocukluk çağı karaciğer tümörleri ameliyat öncesi bilgisayarlı tomografik hepatik anjiyografi ile ayrıntılı olarak değerlendirilmelidir. Bu hastaların cerrahi sağaltımları deneyimli bir cerrahi ekip tarafından uygun ameliyathane donanımı olan merkezlerde yapılmalıdır. Karaciğer nakli, metastazı olmayan ve çıkarılamayan tümörlerde uygulanması gereken cerrahi sağaltım olmalıdır. Here, we present our one year experience in patients with liver tumors. Patients and Method: 6 patients' data (1 hepatoblastoma, 1 hepatocellular carcinoma, 1 metastatic liver mass -previously operated for Wilms' tumor- and 1 embryonal rabdomyosarcoma) were investigated retrospectively. Results: Four of the patients were male and the others were female. Ages were changed between 4 months and 6 years. All patients were investigated with tumor markers, hematological and biochemical analysis, Doppler ultrasonography and computerized tomographic hepatic angiography. Tumor was totally resected in four patients. One patient underwent live-donor partial liver transplantation. One patient with hepatoblastoma is still receiving preoperative chemotherapy. Conclussion: It is quite important to define the tumor borders with computerized tomographic hepatic angiography. We believe that liver tumor surgery should be performed by experienced surgeons in well-equipped centers. Liver transplantation is the treatment of choice in unresectable non-metastatic tumors
Liver Biopsy Results in Potential Donor Evaluation in Living Related Liver Transplant
(2018) Soy, Ebru H. Ayvazoglu; Boyvat, Fatih; Ozdemir, B. Handan; Haberal, Nihan; Hilmioglu, Fatih; Haberal, Mehmet; 0000-0002-0993-9917; 0000-0002-7528-3557; 0000-0001-9852-9911; 0000-0002-6440-5686; 0000-0002-3462-7632; 29527988; AAC-5566-2019; F-4230-2011; X-8540-2019; AAK-4587-2021; AAJ-4437-2021; AAJ-8097-2021
Objectives: The number of living-donor liver transplants has been increasing due to the growing discrepancy between the number of patients on wait lists for liver transplant and the availability of deceased donations. Evaluations of potential liver donors should ensure the safety of the surgical procedure for both the donor and recipient. Liver biopsy is the criterion standard for selecting optimal donors. In this study, we evaluated the importance of preoperative liver biopsy in selecting donor candidates. Materials and Methods: We evaluated the data of 612 living-related liver donor candidates who received liver biopsies between January 2001 and June 2017 at our center. Results: In the 612 liver donor candidates (328 male, 284 female; age range, 18-69 years), 416 liver biopsies (68%) were reported as normal and 196 liver biopsies (32%) had pathologic findings. Of 196 donors with pathologic findings, 86 (44%) had fatty changes and 24 (12%) had portal inflammation. Conclusions: The high rate of pathologic findings in liver biopsy of healthy-appearing donor candidates indicated the importance of liver biopsy in the preoperative evaluation of donors.