Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Tandem Ureteral Stents in the Management of Double-J Stent Dysfunction in Gynecological Malignancies(2017) Ozyer, U.; Dirim, A.; 0000-0002-4300-009X; 0000-0003-2898-485X; 28802719; AAK-9071-2021; AAJ-5689-2021Purpose: The goal of this study was to determine the efficacy and safety of tandem ureteral stent placement in the management of malignant ureteral obstruction (MUO) refractory to single ureteral double-J stent drainage in women with gynecological malignancies. Materials and methods: A retrospective study was performed on 14 women (mean age, 54.5 +/- 9.6 [SD] years; range: 38-70 years) who had tandem stent placement following failed single ureteral double-J stent placement from 2012 to 2017. Survival analyses were performed with Kaplan-Meier method. Results: Twenty-nine successful procedures were performed on 19 ureters (19 primary stent placement and 9 exchange procedures). Technical success of primary tandem stent placement was 95% (19/20 procedures). Mean follow-up was 180.1 +/- 173.7 (SD) days (range: 62-616 days). Median estimated survival of the patients was 118 days (Q1: 261, Q3: 95; range: 62-616 days). Primary stent failure rate was 25% and assisted stent failure rate was 21.4%. There was no significant difference among survival of patients with and without tandem stent failure. Mean estimated primary stent patency and assisted stent patency were 171.4 +/- 13.8 (SD) days and 409.9 +/- 59.8 (SD) days, respectively. Four patients underwent 1 to 3 stent exchanges. Median exchange time was 181 days (Q1: 151, Q3: 191, range: 141-214 days) and technical success rate was 100%. Grade 2 and 3 complication rates were 25% and 3.6%, respectively. Conclusion: Tandem ureteral stent placement is a feasible, safe and effective procedure for the management of failed ureteral double-J stent placement in women with gynecological malignancies. (C) 2017 Editions francaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.Item Long-Term Results of Percutaneous Cholecystostomy for Definitive Treatment of Acute Acalculous Cholecystitis : A 10-Year Single-Center Experience(2018) Ozyer, U.; 0000-0002-4300-009X; 30350527; AAK-9071-2021Background and study aims : Conventional use of percutaneous cholecystostomy [PC] is bridging therapy todelayed cholecystectomy for acute cholecystitis in high-surgical risk patients. Primary aim of this report is to evaluate the long-term outcome of PC as a definitive treatment for acute acalculous cholecystitis [AAC]. Patients and methods : Seventy-one AAC patients who underwent PC procedure were identified. Fifty-one interventions in 47 patients who were treated only with PC and followed-up after catheter withdrawal were reviewed to evaluate the long-term efficacy of PC as a definitive treatment for AAC. Results : Technical and short-term clinical success rates were 100% ) and 92%, respectively. In-hospital mortality rate was 9.3%, minor complication rate was 5.3%, major complication rate was 2.7% and procedure related mortality was 0%. Median follow-up after catheter withdrawal was 8 months. Long-term primary clinical success after removal of the catheter was 87.2%. With the repeated PC in 4 of 6 recurrences, clinical success was 95.7%. Presence of bile sludge, perforation or a co-existing disease did not result in a significant difference in recurrence free survival. Conclusions : PC was a safe and easy to perform procedure with high positive clinical response and low long-term recurrence rate. PC without subsequent cholecystectomy may be a favorable treatment for AAC with respect to high surgical risk present in most of the AAC patients.