Wos Açık Erişimli Yayınlar
Permanent URI for this collectionhttps://hdl.handle.net/11727/10754
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Item The Course of Renal Function After Radical Cystectomy with Ileal Conduit Diversion for Bladder Cancer(2019) Oze, Cevahir; Goren, Mehmet Resit; Egilmez, Tulga; Kilinc, Ferhat; Guvel, Sezgin; 0000-0002-7850-6912; 0000-0002-2001-1386; 0000-0001-6037-7991; AAM-2222-2020; Y-6143-2019Objective: We evaluated the course of the renal function and potential risk factors for renal deterioration in patients who had undergone radical cystectomy with ileal conduit diversion. Materials and Methods: A retrospective study evaluated 121 patients, including 114 male and 7 female who underwent radical cystectomy with ileal conduit diversion. Estimated glomerular filtration rate (eGFR) was calculated and postoperative changes in renal function were reviewed. The clinical variables influencing renal function were evaluated. Results: The median follow-up period was 35.6 months (range, 12.2 to 139.6 months). The mean eGFR was 78.37 +/- 27.58 mL/min/1.73 m(2) before surgery and 90.14 +/- 29.68 mL/min/1.73 m(2) at 5 years postoperatively. The comparison of preoperative eGFR and the last follow-up eGFR showed the no statistically significant difference (p=0.195). Statistical analysis showed that development of postoperative urinary tract obstruction and postoperative urinary tract infection were significant adverse factors (p=0.008, p=0.026, respectively). Conclusion: Thirty two patients (53.3%) developed renal deterioration during the follow-up period. Development of urinary tract obstruction and urinary tract infection in the postoperative period were found to be significant adverse factors affecting renal function.Item Papillary renal cell carcinoma within a renal oncocytoma: Case report of very rare coexistence(2014) Ozer, Cevahir; Goren, Mehmet Resit; Egilmez, Tulga; Bal, Nebil; 25553171Renal oncocytomas accounts for 3% to 9% of primary renal neoplasms. The coexistence of renal cell carcinoma (RCC) within the oncocytoma is extremely rare. We report the case of an asyptomatic 74-year-old man with papillary RCC within oncocytoma managed with left radical nephrectomy.Item Fever and Systemic Inflammatory Response Syndrome Seen After Percutaneous Nephrolithotomy: Review of 1290 Adult Patients(2015) Egilmez, Tulga; Goren, Mehmet ResitAim: Although accepted as minimally invasive, percutaneous nephrolithotomy (PCNL) still poses a significant risk of complications. Recent studies suggest that the incidence of sepsis may be higher than previously reported. The systemic inflammatory response syndrome (SIRS) seen in the subset of patients with or without bacteremia, is a life threatening complication and the purpose of this study is to give an insight to the relation between a post-operative fever episode and the risk of developing SIRS. Material and Method: Medical files of 1646 adult patients to whom a PCNL operation was performed were reviewed. A total of 1290 patients fulfilled the needed criteria and were included in the study. Study variables were recorded from the medical files for statistical analysis. Results: Stone burden had a statistically significant correlation with SIRS (p<0.05) but not with fever. Comorbidities of the patients alone did not have a correlation with fever or SIRS. But ASA score 3 and 4 showed statistically significant correlations with SIRS (p<0.05). Majority of the 288 complications encountered were Clavian grade 2 and grade >= 2 complications were seen to increase the hospitalization period (p<0.05). Operation time >= 120 min. was the only operative variable that had correlation with both fever and SIRS (p<0.05). Blood loss >2 g/dl (Delta haemoglobin-Hb) and Clavian 5 complications had statistically significant correlations with fever. ASA score >= 3, operation time >120 min. Delta Hb > 2 gr/dl, stone size and Clavian 5 complications had statistically significant correlations with the development of SIRS. The incidence of a fever episode, which was seen in 181 patients (14%), to progress to SIRS, which leaded to death, was found to be 1.6%. Discussion: Postoperative fever has a low risk of progressing to a life threatening condition. But special attention should be given to patients that also have the other SIRS criteria; blood loss more than 2 g/dl and/or operation time more than 120 minutes. Although only encountered in a small subset of patients, multiple organ dysfunctions can develop leading to death.Item Predicting Surgical Outcome of Percutaneous Nephrolithotomy: Validation of the Guy's Stone Score and Nephrolithometric Nomogram in Terms of Success and Complications(2015) Egilmez, Tulga; Goren, Mehmet ResitThis single institution retrospective study aims to validate the ability of Guy's stone score and the nephrolithometric nomogram to predict the success of PCNL and to assess the correlation of the scoring systems with the complications encountered. Material and Method: Medical files of 1646 adult patients to whom a PCNL operation was performed were reviewed. A total of 1325 patients fulfilled the needed criteria and were included in the study. Study variables were recorded from the medical files for statistical analysis. Results: Stone burden was the only pre-operative, operative and post-operative variable that had a statistically significant correlation both with success and also with the complications encountered (p< 0.05). Guy's stone score grade 1 and 2 were associated with success and grade 3 and 4 were associated with complications (p< 0.05). ASA score 3 and 4 were seen to be associated with complications (p< 0.05). Operation time > 120 minutes, presence of a staghorn stone, intra-and post-operative blood transfusion, duration of the nephrostomy catheter, Delta Hg more than 2 gr/dl and and positive post-operative urine/blood culture were the other associated variables related to the complications encountered (p< 0.05). ROC curve analysis performed to the nephrolithometric nomogram data showed that with a cut of value of 80.5% for success, the nomogram has a sensitivity of 71% and specificity of 74% (ROC AUC= 80%). The nomogram was further analyzed for an association between the complications encountered and showed that the association is not strong enough to predict a possible complication (ROC AUC= 67%). Discussion: This study shows that the nephrolithometric nomogram has a good predictive accuracy for success (AUC= 0.80) and the Guys's stone score has a good correlation both with success and with complications (p< 0.05) and can be used for pre-operative counseling and decision making.Item Author response: Papillary RCC and oncocytoma: Longer follow-up reported(2015) Ozer, Cevahir; Goren, Mehmet Resit; Egilmez, Tulga; Bal, Nebil; 26085864Item Bariatric Surgery and Urinary Stone Disease(2016) Ozer, Cevahir; Egilmez, Tulga; 0000-0002-7850-6912; 0000-0001-5644-5672; 0000-0001-6037-7991; AAM-2222-2020; AAK-9166-2021Obesity is a major public health problem and has been suggested to play a role in the etiology of urinary tract stone disease. Furthermore, the increasingly widespread use of surgery in the treatment of obesity also is related with urinary stone disease. In daily practice, patients to whom obesity surgery has been planned or who have undergone obesity surgery are seen more frequently. This review aims to highlight the urological evaluation and management of this patient group.