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Item A New Approach To The Management Of Acute Appendicitis: Decision Tree Method(2022) Erkent, Murathan; Karakaya, Emre; Yucebas, Sait Can; https://orcid.org/0000-0002-3592-5092; 35152124; CAA-2756-2022Background: It is important to distinguish between complicated acute appendicitis (CAA) and noncomplicated acute appendicitis (NCAA) because the treatment methods are different. We aimed to create an algorithm that determines the severity of acute appendicitis (AA) without the need for imaging methods, using the decision tree method. Methods: The patients were analyzed retrospectively and divided into two groups as CAA and NCAA. Age, gender, Alvarado scores, white blood cell values (WBC), neutrophil/lymphocyte ratios (NLR), C-reactive protein value (CRP), albumin value and CRP/Albumin ratios of the patients were recorded. Results: In the algorithm we created, the most important parameter in the distinction between CAA and NCAA is CRP. NLR is predictive in patients with a CRP value of <= 107.565 mg/L, and the critical value is NLR 2.165. In pa-tients with a CRP value of >107.565 mg/L, albumin is the determinant and the critical value is 2.85 g/dL. Age, gen -der, alvarado score and CRP/albumin ratio have no significance in distinguishing between CAA and NCAA. In the statistical analysis, there were significant differences between NCAA and CAA groups in terms of age (39.56 years vs 13,675 years), gender (48.1% male vs 71.4% male), WBC (13,891.10/mL vs 11,614.76/mL), CRP (27 mg/L vs 127 mg/L), albumin (3 g/dL vs 3 g/dL) and CRP/albumin (9.50 vs. 41). Conclusion: Thanks to the algorithm we created, CAA and NCAA distinction can be made quickly. In addition, by avoiding unnecessary surgical procedures in NCAA cases, patients' quality of life can be increased and morbidity rates can be minimized.(c) 2022 Elsevier Inc. All rights reserved.Item Assessment Of Long-Term Outcomes Of Pediatric Liver Transplant Recipients(2022) Karakaya, Emre; Akdur, Aydincan; Soy, Ebru H. Ayvazoglu; Ozcay, Figen; Moray, Gokhan; Haberal, Mehmet; https://orcid.org/0000-0002-0993-9917; https://orcid.org/0000-0002-3462-7632; AAC-5566-2019; AAJ-8097-2021Item Long Term Outcomes Of Kidney Transplant In Pediatric Recipients(2022) Karakaya, Emre; Akdur, Aydincan; Soy, Ebru H. Ayvazoglu; Baskin, Esra; Moray, Gokhan; Haberal, Mehmet; https://orcid.org/0000-0002-0993-9917; https://orcid.org/0000-0002-3462-7632; AAC-5566-2019; AAJ-8097-2021Item The Relationship Between Mental Health Status And Social Life In Children And Adolescents With Kidney Transplantation(2022) Taner, Hande Ayraler; Sari, Burcu Akin; Kaya, Zulal Torenli; Baskin, Esra; Gulleroglu, Kaan; Yilmaz, Aysun Caltik; Karakaya, Emre; Moray, Gokhan; Haberal, Mehmet; https://orcid.org/0000-0003-1434-3824; https://orcid.org/0000-0003-0774-4419; https://orcid.org/0000-0002-3462-7632; F-3294-2013; AAD-1877-2021; AAJ-8097-2021Item A model for acute kidney injury in severe burn patients(2022) Karakaya, Emre; Akdur, Aydincan; Aydogan, Cem; Turk, Emin; Sayin, Cihat Burak; Soy, Ebru Ayvazoglu; Yucebas, Sait Can; Alshalabi, Omar; Haberal, Mehmet; 0000-0002-4879-7974; 0000-0002-8726-3369; 0000-0002-8726-3369; 0000-0002-0993-9917; 0000-0002-3462-7632; 33879373; AAD-5466-2021; AAA-3068-2021; AAA-3068-2021; AAC-5566-2019; AAJ-8097-2021Introduction: In patients with severe burns, morbidity and mortality are high. One factor related to poor prognosis is acute kidney injury. According to the AKIN criteria, acute kidney injury has 3 stages based on urine output, serum creatinine level, and renal replacement therapy. In this study, we aimed to create a decision tree for estimating risk of acute kidney injury in patients with severe burn injuries. Methods: We retrospectively evaluated 437 adult patients with >20% total burn surface area injury who were treated at the Baskent University Ankara and Konya Burn Centers from January 2000 to March 2020. Patients who had high-voltage burn and previous history of kidney disease were excluded. Patient demographics, medical history, mechanism of injury, presence of inhalation injury, depth of burn, laboratory values, presence of oliguria, need for renal replacement therapy, central venous pressure, and prognosis were evaluated. These data were used in a "decision tree method" to create the Baskent University model to estimate risk of acute kidney injury in severe burn patients. Results: Our model provided an accuracy of 71.09% for risk estimation. Of 172 patients, 78 (45%) had different degrees of acute kidney injury, with 26 of these (15.1%) receiving renal replacement therapy. Our model showed that total burn surface area was the most important factor for estimation of acute kidney injury occurrence. Other important factors included serum creatinine value, burn injury severity score, hemoglobin value, neutrophil-tolymphocyte ratio, and platelet count. Conclusion: The Baskent University model for acute kidney injury may be helpful to determine risk of acute kidney injury in burn patients. This determination would allow appropriate treatment to be given to high-risk patients in the early period, reducing the incidence of acute kidney injury. (c) 2021 Published by Elsevier Ltd.Item Comparison of Long-term Clinical Outcomes of the Preferred Surgical Techniques in Secondary Hyperparathyroidism Cases(2022) Karakaya, Emre; Erkent, Murathan; https://orcid.org/0000-0002-4879-7974; https://orcid.org/0000-0002-3592-5092; AAD-5466-2021; CAA-2756-2022Objective: Secondary hyperparathyroidism (SHPT), that progresses with the deterioration of calcium-phosphorus metabolism detected in chronic kidney disease patients. Recurrence of SHPT may result in the recurrence of symptoms. Our aim was to compare the 5-year clinical results of autotransplantation after total parathyroidectomy (PTX-AT) with subtotal parathyroidectomy (SPTX). Materials and Methods: We analyzed 140 patients retrospectively from January 2000 and October 2020 who were operated due to SHPT. Clinical and demographic characteristics of the patients, preoperative and postoperative (1st day, 1st month, 6th month, 1st year, 5th years) serum PTH, calcium (Ca), phosphorous (P) values and length of hospital stay (LOS) were compared in terms of operations performed. The Shapiro-Wilks test was used for analyzing normally distributed datas. Mann Whitney U test used to evaluate of comparison of numerical data. Fisher's Exact or chi-square test was used for ratio comparisons or correlation. P<0.05 was considered statistical significance level. Results: Of these 140 patients, 106 (75.7%) had SPTX. On the other hand, 34 patients (24.3%) underwent PTX-AT surgery. When the groups were compared in terms of the gender, age and comorbidities, the differences were statistically significant. Additionally, no statistically significant difference was found between the groups in terms of postoperative complications (p=0.206). The difference between the weights and sizes of the parathyroid glands removed between the operation groups was not statistically significant (p=0.751, p=0.176). The difference was not statistically significant between the groups in terms of PTH, Ca and P levels measured. LOS was statistically significantly longer in PTX-AT patients (p=0). Conclusion: The surgical methods in the treatment of SHPT have no difference each other. Depending on the surgeon's preference, both surgical methods can be safely applied with high success rates.Item Treatment of Posttransplant Hepatocellular Carcinoma Recurrence(2022) Haberal, Mehmet; Karakaya, Emre; Akdur, Aydincan; Soy, Ebru Ayvazoglu; https://orcid.org/0000-0002-3462-7632; https://orcid.org/0000-0002-8726-3369; https://orcid.org/0000-0002-0993-9917; 35060449; AAJ-8097-2021; AAA-3068-2021; AAC-5566-2019Objectives: In patients who receive liver transplant to treat hepatocellular carcinoma, 10% to 15% posttransplant recurrence is observed. In the present study, we evaluated the long-term outcomes of patients who had received liver transplant for treatment of hepatocellular carcinoma. Materials and Methods: Of the 683 liver transplants that we performed, 72 were in response to hepatocellular carcinoma. The physical examination and laboratory and imaging results of the patients were retrospectively analyzed and recorded. The recipients were evaluated according to the Baskent criteria and divided into 2 groups: early diagnosis and late diagnosis. Results: Among 72 total patients in our study, 19 (26.3%) were pediatric recipients. Hepatocellular carcinoma recurred in 7 patients (9.7%; 5 adult, 2 pediatric). Except for one patient, all were in the late diagnosis group.The mean survival time of all patients was 137.45 +/- 10 months.The mean survival in the early diagnosis group was longer than in the late diagnosis group. During follow-up, 11 patients died from recurrence and distant metastasis. Conclusions: In patients with hepatocellular carcinoma who received liver transplant, we found that postoperative recurrence of hepatocellular carcinoma and distant metastasis can be treated with surgery and/or with interventional radiology methods, which may improve patient survival after liver transplant.Item Success Rate of Grafts With Multiple Renal Vessels in 3136 Kidney Transplants(2021) Karakaya, Emre; Akdur, Aydincan; Soy, Ebru Ayvazoglu; Moray, Gokhan; Haberal, Mehmet; https://orcid.org/0000-0002-4879-7974; https://orcid.org/0000-0002-8726-3369; https://orcid.org/0000-0002-0993-9917; https://orcid.org/0000-0003-2498-7287; https://orcid.org/0000-0002-3462-7632; 32967599; AAD-5466-2021; AAA-3068-2021; AAC-5566-2019; AAE-1041-2021; AAJ-8097-2021Objectives: Multiple renal vessels are often detected in living and deceased organ donors. In the past, transplant with multiple renal vessel grafts has been a contraindication because of high vascular and urological complication rates. However, improvements in vascular reconstruction and anastomosis techniques have allowed graft function to be maintained for many years. Here, we retrospectively evaluated transplant of multiple renal vessel grafts and graft survival and postoperative vascular and urological complications. Materials and Methods: From November 1975 to July 2020, there were 3136 renal transplants (716 deceased donors, 2420 living donors) performed in our center. There were 2167 living donors and 643 deceased donors with single renal vessel grafts and 253 living donors and 73 deceased donors with multiple renal vessel grafts. For anastomoses, external iliac, internal iliac, common iliac, and inferior epigastric arteries and external iliac veins were used. Cold ischemia time, anastomosis time, postoperative vascular and urological complications, acute tubular necrosis, creatinine clearance, serum creatinine levels, graft rejection episodes, and graft and patient survival rates were evaluated. Results: With regard to creatinine clearance, cold ischemia and anastomosis time, acute tubular necrosis, rejection episodes, and 1-, 2-, and 5-year posttransplant serum creatinine levels, there were no significant differences between the groups. Graft survival rates in the single renal vessel group were 92.9% at 1 year posttransplant and 78.3% at 5 years posttransplant; rates in the multiple renal vessel group were 93.1% at 1 year and 79.7% at 5 years. The corresponding patient survival rates were 95.5% (1 year) and 92.9% (5 years) for the single renal vessel group and 96.9% (1 year) and 87.2% (5 years) for the multiple renal vessel group. Conclusions: Improved anastomosis and reconstruction techniques have allowed the safe transplant of multiple renal vessel grafts that may remain functional for many years.Item Concurrence of rectocoele and anal incontinence, and outcome of their simultaneous surgical correction(2021) Haberal, Elifcan; Yarbug Karakayali, Feza; Karakaya, Emre; 0000-0002-4879-7974; 34334007; AAD-5466-2021Item The Clinical Outcomes Of Covid-19 Disease In Patients With Solıid Organ Transplantation(2021) Yuce, Gulbahar Darilmaz; Ulubay, Gaye; Karakaya, Emre; Tek, Korhan; Akdur, Aydincan; Bozbas, Serife Savas; Gedik, Ender; Kupeli, Elif; Erol, Cigdem; Arslan, Hande; Akcay, Sule; Haberal, Mehmet; 0000-0002-8726-3369; 0000-0002-2535-2534; 0000-0002-5708-7915; 0000-0002-3462-7632; AAA-3068-2021; AAJ-1219-2021; ABG-7034-2021; AAJ-8097-2021
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