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Öğe A Comparison of Holmium YAG Laser and Electrokinetic Lithotripter in Pediatric Ureteral Stone Treatment(KOWSAR CORP, 2017) Gunduz, Metin; Ciftci, Ilhan; Sekmenli, Tamer; Elmaci, Ahmet Midhat; Peru, HarunBackground: We evaluated endoscopic treatment of ureter stones with a holmium: yttrium-aluminum-garnet laser (Ho: YAG) lithotripter and an electrokinetic lithotripter (EKL) in children. Methods: Patients with ureteral stones, admitted to the pediatric surgery department of our hospital between November 2011 and January 2015, were evaluated retrospectively. Demographic data, initial symptoms, age, sex, stone size, preoperative renal pelvis diameter, use of a jj stent, and complications were recorded. We used a 4.5 Fr semirigid ureterorenoscope with a Ho: YAG lithotripter and an EKL to treat ureteral stones. Results: In patients treated with Ho: YAG lithotripter, a total of 17 ureteroscopic procedures were performed on seven female and six male children having a mean age of 7.62 +/- 4.46 years. Seven of these patients had right, five had left, and one had bilateral ureteral stones, with a mean diameter of 8.96 +/- 3.52 mm. Preoperative pelvis renalis diameter was 16.22 +/- 11.45 mm. A jj stent was used in all patients. Abdominal pain, hematuria, nausea-vomiting, and pollakiuria were the initial symptoms with complications such as hematuria, ureteral damage, infection, and spontaneous jj stent removal. In three cases, fragmentation was not successful and we needed a second session. In the EKL group, a total of 18 ureteroscopic procedures were performed on ten female and six male children with a meanage of 6.81 +/- 3.67 years. Six of these patients had right, eight had left and two had bilateral ureteral stones, with a mean diameter of 8.26 +/- 2.83 mm. Mean preoperative pelvis renalis diameter was 10.18 +/- 2.66 mm. No jj stent was used in these patients. Initial symptoms were abdominal pain, hematuria, nausea-vomiting, vomiting, dysuria, and pain in the costovertebral region, while hematuria was also among the postoperative complication. In two cases, fragmentation was not successful and an extra session was needed. Conclusions: Either of Ho: YAG lithotripter or EKL are effective and can be successfully used in ureteroscopic management of pediatric ureterolithiasis. The complication rate was slightly lower when an EKL was used.Öğe Comparison of the Radiologic and Clinical Findings of Adolescents With Breast Complaints(LIPPINCOTT WILLIAMS & WILKINS, 2018) Sekmenli, Tamer; Koksal, Hande; Gunduz, Metin; Bostanci, Hasan; Ciftci, Ilhan; Koksal, YavuzIntroduction:The American College of Radiology's Breast Imaging Reporting and Data System (BI-RADS) was developed to guide imaging-based surgical treatment in patients with breast cancer. Studies confirming the BI-RADS did not include adolescents. To evaluate the validity of this classification system in adolescents, we aim to investigate the relationship between the BI-RADS and pathology findings in adolescents. Methods:The medical data of 67 female adolescent patients, aged 12 to 18, referred to our clinic for breast-related complaints between 2013 and 2016 were reviewed retrospectively for demographic data and the results of radiologic and surgical pathologies. Results:The main underlying reasons for the visit at the clinic were fullness, tenderness, pain, and palpable masses. Of the 67 patients, 46 were enrolled in the study. After breast ultrasonography, patients whose complaints had diminished were subtracted from the follow-up. The mean age of the patients was 16 years (12 to 18y). The mean mass diameter size was 3.69 cm (0.9 to 15 cm), and the mean clinical follow-up was 65.3 days (11 to 1095 d). All the patients who were surgically intervened had benign pathology. Of the 21 surgically intervened patients with BI-RADS levels of >= 3, most had fibroadenomas. Conclusions:The BI-RADS classification-based treatment algorithm may not be valid in adolescents. In the present study, all patients with lesions with BI-RADS >= 3 levels had revealed benign pathologies. The BI-RADS classification may show an increased risk. However, to determine the need for a biopsy in adolescents, there is a need for larger-scale pediatric and adolescent studies using the BI-RADS classification.Öğe Do JJ Stents Increase the Effectiveness of Extracorporeal Shock Wave Lithotripsy for Pediatric Renal Stones?(KARGER, 2017) Gunduz, Metin; Sekmenli, Tamer; Ciftci, Ilhan; Elmaci, Ahmet MidhatPurpose: We aimed to evaluate the effects of preoperative urinary catheterization in nephrolithiasis treatment with extracorporeal shock wave lithotripsy (SWL). Methods: Patients admitted to the Department of Pediatric Surgery for renal stones between June 2012 and June 2014 were evaluated retrospectively. Patients were divided into 2 groups based on JJ stent placements. Group 1 did not receive JJ stents, while group 2 did. The recorded demographic data for each group included age, gender, stone size, location, sessions, and complications. The Elmed Complit ESWL system was used with 11-13 kV, and 1,000-1,200 shots in patients 2-4 years of age, and 11-14 kV, and 1,000-1,500 shots for patients over 4 years. Results: In group 1, 18 sessions of SWL were performed on 8 female and 2 male children with a mean age of 4.5 (range 2-12) years and stone diameter of 9 (range 7-15) mm. The locations of the renal stones were in the upper pole in 1 patient, 7 in the lower pole, and 2 in the pelvis renalis. Postoperatively, 1 patient had hematuria, 2 had dysuria, and one had a stone in the external urethral meatus. Eighty percent of patients were stone free; there were no fragmentations in 2 patients, and 1 patient discontinued treatment. In group 2, 15 SWL sessions were performed on 5 female and 5 male children aged 4 (range 3-5) and the stone diameter was 9 (range 7-16) mm. The locations of the renal stones were in the upper pole in 6 patients, in the lower pole in 3 patients, and in the ureteropelvic junction in one patient. JJ stents were placed in all patients preoperatively. Postoperatively, 3 patients had hematuria and one had dysuria. At the end of the study, all of the patients were stone free. Statistically, there were no differences in age, gender, stone size, location, and the number of sessions. Conclusions: Our results indicate that SWL without preoperative ureteral stenting is an effective and safe procedure that can be carried out in the pediatric population. Preoperative JJ stenting is unnecessary in patients, especially in those with smaller stone diameters. (C) 2016 S. Karger AG, BaselÖğe Evaluation of congenital anomalies accompanying gastrointestinal system malformation(Cukurova Medical Journal, 2019) Konak, Murat; Sert, Ahmet; Gunduz, Metin; Soylu, Hanifi; Uygun, Saime SundusPurpose: The aim of this study was to review accompanied congenital anomalies to gastrointestinal pathologies. Materials and Methods: The medical records of patients who were admitted to neonatal intensive care unit with gastrointestinal system surgical pathologies during 2015-2018 were retrospectively evaluated for associated congenital anomalies. Results: 67 patients were identified during the study period. The most common gastrointestinal system pathology was anal atresia in 15 cases (22.4%), followed by diaphragmatic hernia in 14 cases (20.9%), esophageal atresia (n: 10) and ileal atresia (n: 10) (14.9%). Thirty two patients (48.8%) have had accompanied congenital anomalies to gastrointestinal system pathologies. Congenital heart disease was the most common anomaly and the most frequent one was atrial septal defect in 18 cases (26.8%). In addition, there was complex congenital heart disease in (n: 13) 19.4%. In 12 patients (17.9%), accompanied extracardiac anomalies were detected. Hydronephrosis and sludge in gall bladder were detected in three patients (4.5%). Vesicoureteral reflux or ectopic kidney or polysplenia was detected as a separate anomaly in each case. In our cases, prematurity rate was found in 54%. Conclusion: Gastrointestinal system pathologies are frequently associated with multiple anomalies, especially with congenital heart diseases. In addition, these patients are likely to be preterm baby.Öğe Little negligence leading to irreparable harm: Thinner burns(2017) Arslan, Kemal; Atay, Arif; Sekmenli, Tamer; Gunduz, Metin; Dogru, Osman; Ciftci, IlhanThe aim of the present study is to evaluate the epidemiology and outcome of paint thinner induced burn injuries at a local burn center. A retrospective analysis of 55 patient paint thinner thermal burn cases was conducted. Relevant patients’ data such as age, sex, etiologic factors, burn extent and localization, employed methods of treatment, hospitalization period, and results were evaluated in retrospect from patients’ records. 50 male and five female patients with a mean age of 26,78 years participated in the presented study. Kindling fire with paint thinner was the most frequent etiologic factor. Total body surface burn area was 22,5 % . The mean hospitalization period of the survivors was 24 days. Early excision and split-thickness sking grafting was applied in 22 patients. The remaining 26 patients were treated with topical agents. Total mortality was only 7 (12.7%). These patients had paint thinner induced burned body surfaces of 60 % with accompanying inhalation injuries. Paint thinner may cause catastrophic thermal injuries even with terminal outcomes and should therefore never used to kindle a fireÖğe Massive hemorrhage: a late complication of replacement percutaneous endoscopic gastrostomy: case report(SOC ARGENTINA PEDIATRIA, 2018) Sekmenli, Tamer; Gunduz, Metin; Akbulut, Hikmet; Emiroglu, H. Haldun; Koplay, Mustafa; Ciftci, IlhanPercutaneous endoscopic gastrostomy (PEG) is used as an alternative to enteral/nasoenteral feeding in situations where long-term oral feeding is ineffective or not tolerated. It is mostly preferred in patients with neurological conditions and also to support nutrition in patients with congenital heart diseases, cystic fibrosis, inflammatory bowel disease, and various oropharyngeal diseases. Although it is easily applicable compared to many invasive procedures, it has complications ranging from wound infection to death. PEG requires experienced medical personnel, appropriate prophylactic antibiotics and exhaustive information to the patients or their families about the procedure and subsequent care. We present a rare but important complication during the replacement of the gastrostomy tube subsequent to the "cut and push" method. The bumper portions, which should move to the distal end of the stomach, moved upwards to the proximal esophagus, caused a deep ulcer in the esophageal mucosa and a massive hemorrhage.Öğe Modified Hinderer's Technique for Serious Proximal Hypospadias with Ventral Curvature: Outcomes and Our Experience(UROL & NEPHROL RES CTR-UNRC, 2019) Ciftci, Ilhan; Gunduz, Metin; Sekmenli, TamerPurpose: Hypospadias is a congenital anomaly that includes deficient ventral structure of the penis. Proximal hypospadias cases make up 20% of all hypospadias cases. The choice of operative technique for hypospadias repair depends on the severity, and it is influenced by the surgeon's experience and perception of where priorities should lie. Several other factors interact to determine the type of repair, such as meatal site, presence of chordee, availability of the prepuce, and quality of the urethral plate and in addition surgeon's experience affects the type of repair. Materials and Methods: The treatment records of 42 penoscrotal and perineal hypospadias cases that were treated in our clinic from 1998 to 2017 were reviewed retrospectively. Cases with penoscrotal and perineal meatus were included in the study at the beginning of the urethroplasty. All cases had surgical intervention via Hinderer's technique. Results: Acceptable cosmetic results were obtained in 37 (85%) patients with an objective scoring system (HOSE) for evaluating the results of hypospadias surgery score. The mean score after surgery was 14.8. Fistula and wound breakdown occurred in 7 out of the 42 cases. Conclusion: In conclusion, the modified Hinderer's technique is a safe and reliable technique for both proximal and perineal hypospadias. Low complication rates and application in a single surgical session increase the comfort of both the patient and the surgeon.Öğe A Rare Cause of Acute Pancreatitis: Gastrostomy Catheter Migration(SOC ARGENTINA PEDIATRIA, 2018) Sekmenli, Tamer; Gunduz, Metin; Ciftci, Ilhan; Emiroglu, Haldun H.; Koplay, Mustafa[Abstract not Available]Öğe Response to the Letter: The Effects of JJ Stents for Extracorporeal Shock Wave Lithotripsy in Pediatric Urolithiasis (Do JJ Stents Increase the Effectiveness of Extracorporeal Shock Wave Lithotripsy for Pediatric Renal Stones?)(KARGER, 2018) Gunduz, Metin; Sekmenli, Tamer; Ciftci, Ilhan; Elmaci, Ahmet Midhat[Abstract not Available]Öğe Ruptured Hemorrhagic Cyst of Undescended Ovary Mimicking Mucocele: A Rare Pediatric Case(SHIRAZ UNIV MEDICAL SCIENCES, 2017) Sekmenli, Tamer; Gunduz, Metin; Ciftci, IlhanUndescended ovary is a rare entity and usually presented as a case report. It is associated with urinary and uterine anomalies. Symptomatic patients are diagnosed during surgery. Most of the patients are asymptomatic and treatment is unnecessary. They are incidentally diagnosed during infertility evaluation and treatment such as ovarian hyperstimulation studies. A 15-year-old female patient presented with the diagnosis of renal cystic massas identifiedduring ultrasonography in another hospital. Abdominal computedtomography image was requested. A cystic lesion of about 48x34 mm with well-defined borders associated with the appendix and probably with mucocele of the appendix was reported in the lower right abdominal quadrant close to the cecum. During exploration, the right ovary was seen to be attached to the cecum and was higher in position as well as a right ovary originated cystic structure of 5x5 cm. Using needle aspiration, intraovarian hemorrhage was confirmed and partial cystectomy was performed. The present study reports on an undescended ovary that hadacute abdomen symptoms imitating mucocele. In girls referring to the hospital with abdominal pain, although quite rare, undescended ovaries are to be also considered. As the incidence of renal and uterine anomalies is higher in suchpatients, in symptomatic cases relevant organs are to be investigated carefully during surgical intervention.Öğe Shivlilik burns: injuries resulting from traditional celebrations(E-CENTURY PUBLISHING CORP, 2015) Gunduz, Metin; Ciftci, Ilhan; Sekmenli, TamerIntroduction: In Konya, Turkey, the community celebrates the traditional ceremony of Shivlilik, which occurs on the first day of the seventh month in the lunar-based Hijri calendar. In the evening, people light bonfires of tires in the streets, and children and young people attempt to jump over the flames. Flame burns regularly occur due to falling. Attention should be given to preventing injuries such as these that are caused by social and regional customs. Methods: This retrospective study was carried out using data from the Konya Education and Research Hospital Burn Unit. Patients admitted to our hospital between June, 2009, and May, 2012, was evaluated. Results: Eleven patients were admitted to hospital with flame burns caused by jumping over fires on the days when the traditional Shivlilik ceremony was celebrated. The clinical data evaluated included the patient's age and sex, the depth of the burn injury, the total burned surface area (TBSA), and the distribution of the burn areas. Conclusions: Serious flame burns occur because of the traditional Shivlilik ceremony. We must promote some changes in this ceremony in order to prevent these burns.Öğe Spermatic cord hydatid cyst: an unusual locatization(W B SAUNDERS CO-ELSEVIER INC, 2007) Yurtcu, Muesolim; Gunduz, Metin; Toy, Hatice; Guenel, EnginLesions of the groin include hernia, hydrocele, spermatic cord cyst, undescended testes, lymphadenopathy, and abscess. Hydatid cysts are endemic in certain regions of the world. They are usually located in the liver, lung, spleen, brain, and kidney. Although many uncommon locations have been reported, hydatid disease has been reported 3 times in the spermatic cord. This is the first report of a child with hydatid disease in the spermatic cord. A 9-year-old boy with a spermatic cord cyst proven to be a hydatid cyst is reported. (C) 2007 Elsevier Inc. All tights reserved.
