Hukuk Fakültesi/ Faculty of Law

Permanent URI for this collectionhttps://hdl.handle.net/11727/1398

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2015 - 20185

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Author: search.filters.author.Duman, Enessearch.filters.applied.f.language: search.filters.language.eng

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    Balloon Dilatation of Iatrogenic Ureteral Strictures after Upper Urinary Tract Reconstruction
    (2015) Duman, Enes; Yildirim, Erkan; Akillioglu, Ishak; Yucesan, Selcuk
    Purpose: Open pyeloplasty is the gold standard treatment of uretero-pelvic junction (UPJ) stenosis. Although failure after open pyeloplasty or uretero-neosistosmy is not common, percutaneous or endoscopic interventions must be necessary in some cases. We present treatment of 6 pediatric patients by balloon dilatation after failed surgery. Material and Methods: Between 2008 and 2013 6 children were treated. Five patients had undergone open pyeloplasty for UP stenosis and, one has uretero-vesical anastomosis stricture after ureteroneosistostomy. Percutaneous antegrade balloon dilatation and double J stent placement were performed in three of six patients. In the other three patients retrograde endoscopic balloon dilatation and double J stent placement were performed. Results: Primary technical success was %50 and %100 for antegrade and retrograde approach respectively. Antegrade approach has failed in 3 patients (%50) and, retrograde approach and treatment were successful in all of these patients. Secondary and tertiary balloon dilatations were done through antegrade approach in 3 patients. Mean duration of double J stent was 114 days. As of today, five patients are followed smoothly. One patient who has UP stenosis underwent secondary open surgery. Conclusion: Balloon dilatation can be used safely in both antegrade and retrograde approaches because of lower profile of balloon catheters, so it could be considered as a first line treatment option after failed surgical treatment of upper urinary tract stenosis in children.
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    Association between treatment with coil embolization of renal artery aneurysm and resistant hypertension
    (2016) Duman, Enes; Yildirim, Erkan; Ciftci, Ozgur; Cifci, Egemen
    Hypertension is the number one risk factor in preventable causes of death in the world. Resistant hypertension is defined as blood pressure that remains uncontrolled despite at least three antihypertensive medications including a diuretic. Treatment of hypertension includes many modalities from lifestyle changing to multiple drug using, angioplasty. In this case report, we aim to emphasize the effects of renal artery aneurysm treatment on resistant hypertension.
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    Percutaneous Placement of Pancreatico-biliary Drainage Catheter for the Treatment of Complicated Pancreatic Anastomotic Leakage: an Alternative Treatment Option
    (2016) Duman, Enes; Yildirim, Erkan; 0000-0002-9057-722X; 27994344; ABI-3856-2020
    A 58-year-old female patient who had anastomotic leakage after a Whipple operation was treated with a percutaneously placed pancreatico-biliary drainage catheter. Complete secondary healing of the anastomotic defect and leakage was seen on control cholangiography examination on the 35th postoperative day, and the pancreatico-biliary drainage catheter was removed. She was discharged on the 39th postoperative day uneventfully. Percutaneous pancreatico-biliary drainage should be kept in mind as an alternative treatment option of complicated pancreatic anastomotic leakage after a Whipple operation.
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    The Efficacy of Flow Diverter Stents in the Treatment of Wide-Necked Intracranial Aneurysms
    (2017) Duman, Enes; Yildirim, Erkan; Ozdemir, Adnan; Arslan, Serdar; Aytekin, Cuneyt; Bovyat, Fatih; 0000-0002-9057-722X; F-4230-2011; ABI-3856-2020
    Background: To present our findings obtained from the treatment of wide-necked intracranial neurysms with flow diverter stents. Patients and Methods: Intracranial aneurysms were determined in 19 patients (14 females, 5 males; mean age, 56.6 years) between May 2011 and June 2014, and the patients were treated using flow diverter stents. A total of 28 flow diverter stents, including 9 Silk and 19 Pipeline stents were used. Occlusion rates evaluated with computed tomography at the end of month 6 and digital subtraction angiography after one year, intraoperative success, morbidity and mortality rates were determined. Results: A total of 20 endovascular interventions, including two interventions in two different aneurysms in one patient were performed in 19 patients. Flow diverter stents were successfully implemented for wide-necked aneurysms at a success rate of 100%. Coil treatment had previously been performed in four patients. Aneurysm occlusion rates were 77.2% at month 6 and 90.9% at the end of month 12. Conclusion: The use of flow diverter stents is a reliable and effective method in the treatment of wide-necked intracranial aneurysms with high aneurysm occlusion, and low morbidity and mortality rates.
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    Evaluation of Prostatic Artery Embolization Efficiency in Benign Prostatic Hyperplasia Patients with High Comorbidity
    (2018) Duman, Enes; Yildirim, Ismail Okan; Firat, Ali; Celik, Huseyin; Sarac, Kaya
    Objective: The purpose of this study was to evaluate efficacy outcomes following prostate artery embolization (PAE) for the treatment of benign prostatic hyperplasia (BPH) patients with high comorbidity. Materials and Methods: This retrospective study included 22 patients treated with PAE from May 2015 to June 2017. Patients with Charlson comorbidity index >= 2, International Prostate Symptom Score (IPSS) >12, prostate specific antigen (PSA) levels <4 ng/mL or between 4 and 10 ng/mL with negative prostate biopsy and total prostate volume (TPV) >90 cm(3) were included. Total PSA, maximum flow rate (Q(max)), TPV, IPSS, post-voiding residual (PVR) values were recorded in all patients in the urology clinic before PAE and at 3 and 6 months after PAE. Results: The average patient age was 73.86 +/- 6.25 years and operative time was 80 minutes (range, 60-120 min). Pre-PAE and 6-month post-PAE values were: IPSS: 25.18 +/- 6.75 an d 11.27 +/- 3.29 (p<0.05), Q(max): 8.31 +/- 3.12 and 17.22 +/- 3.23 (p<0.05), PVR: 87.9 +/- 19.25 and 25.86 +/- 7.72 (p<0.05), TPV: 134.45 +/- 57.56 and 86 +/- 15.4 (p<0.05), and PSA: 3.89 +/- 1.26 and 2.11 +/- 1.06 (p<0.05). Embolization was performed unilaterally due to atherosclerosis and strictures in the internal iliac artery branches in 2 patients. After the procedure, 2 patients experienced transient hematuria which did not require bladder irrigation, 1 patient had acute urinary retention due to dysuria, and 1 patient had transient hematospermia. Conclusion: PAE may be an alternative treatment method in BPH patients with high comorbidity.