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Öğe Analysis of patients undergoing urological intervention amid the COVID-19: Experience from the pandemic hospital(Springer, 2020) Soytaş, Mustafa; Boz, Mustafa Yücel; Güzelburç, Vahit; Çalık, Gökhan; Kaçtan, Mehmet Çağrı; Horuz, Rahim; Akbulut, Ziya; Albayrak, SelamiPurpose It is reported that surgical procedures performed during the COVID-19 pandemic are accompanied by high complications and risks. In this study, the urological interventions applied with appropriate infrastructure and protocols during the pandemic in the pandemic hospital that is carrying out the COVID-19 struggle are analyzed. Methods Urological interventions were reviewed in the 5-week period between March 11 and April 16. The distribution of outpatient and interventional procedures was determined by weeks concurrently along with the COVID-19 patient workload, and data in the country, subgroups were further analyzed. Patients intervened were divided into four groups as Emergency, High, Intermediate, and Low Priority cases according to the EAU recommendations. The COVID-19-related findings were recorded; staff and patient effects were reported. Results Of the 160 interventions, 65 were minimally invasive or open surgical intervention, 95 were non-surgical outpatient intervention, and the outpatient admission was 777. According to the priority level, 33 cases had emergency and high priority, 32 intermediate and low priority. COVID-19 quarantine and follow-up were performed at least 1 week in 22 (33.8%) operated patients at the last week, 43 (66.2%) patients who were operated in the previous 4 weeks followed up at least 2 weeks. No postoperative complications were encountered in any patient due to COVID-19 during the postoperative period. Conclusion In the COVID-19 pandemic, precautions, isolation, and algorithms are required to avoid disruption in the intervention and follow-up of urology patients; priority urological interventions should not be disrupted in the presence of necessary experience and infrastructure.Öğe Comparison of before and after COVID-19 urology practices of a pandemic hospital(AVES, 2020) Soytaş, Mustafa; Boz, Mustafa Yücel; Güzelburç, Vahit; Çalık, Gökhan; Horuz, Rahim; Akbulut, Ziya; Albayrak, SelamiObjective: The aim of this study is to compare the effects of COVID-19 on urology practice using pre- and post-pandemic data of a pandemic hospital.Material and methods: March 11 is considered as the beginning of COVID-19 and, changes in the number of the outpatient clinic examinations, non-surgical procedures, and surgery in the 8-week period before and during the pandemic were evaluated by weeks. Age, gender, and comorbid diseases of the operated patients were compared statistically. The symptoms, complaints, mortality, and morbidity conditions of the patients were recorded by contacting them. Descriptive data and chi-square test were used.Results: The number of COVID-19 cases has been reported as 8,916 for the hospital, 88,412 for the city and 150,593 for the country. The mean age of the operated patients before and after 11 March was 51 and 47, and comorbidities were 79 and 40, respectively, and there was no statistically significant difference(p<0.05). The number of patients examined was 2,309 and 868, the number of operated patients 173 and 94, the number of patients undergoing non-surgical procedures were 371 and 174, respectively. The names and numbers of surgical and non-surgical procedures are listed according to European Association of Urology (EAU) priority classification. In follow-up, no complication because of COVID-19 was observed in any patient.Conclusion: Our study showed that, although the numbers have decreased, similar operations can be performed in daily urology practice without any contamination and mortality during the pandemic compared to the prepandemic period, by taking precautions and following the algorithms.Öğe Is there a relationship between post-ureteroscopic lesion scale and irrigation fluid absorption in ureteral stone disease patients(2021) Güzelburç, Vahit; Çolakoğulları, Mukaddes; Kiremit, Murat Can; Soytaş, Mustafa; Boz, Mustafa; Altay, Bülent; Erkurt, Bülent; Albayrak, Selami; Akbulut, ZiyaObjective: Post-Ureteroscopic Lesion Scale (PULS) is used to classify ureteral wall injury that occurs during ureteroscopy. In this study we presented the preliminary results of absorbed irrigation fluid volumes according to PULS grades. Material and Methods: Forty-four patients to whom 7F semirigid ureteoscopy was performed due to ureteral stone were included in the study. All patients received general anesthesia. Izotonic containing 1% ethanol was used as irrigation fluid. Ethanol concentration in venous blood was commenced to be measured at the start of irrigation use and was carried on at 15-minute intervals including the post-operative period in the recovery room. Absorbed fluid volume was calculated by using blood ethanol concentrations. Irrigation time, stone size and PULS grade were recorded. Results: Mean operation time was found to be 44.2 ± 19.9 minutes. Mean stone size was measured to be 12.7± 6 mm and mean irrigation fluid amount used was 1371±1262 ml. PULS grade of 0 was seen in 26 patients and that of 1 or more was seen in 18 patients. No patient had a PULS grade of 3 or 4. Mean absorbed fluid volume was measured to be 58 ± 50,6 ml. No significant correlation was found between PULS grade and mean absorbed fluid volume. Conclusion: Fluid absorption during URS is not correlated with the PULS grade. Semirigid URS is a safe treatment option for ureteral stone disease in terms of the level of irrigation fluid being absorbed.Öğe Removing the specimen with traction during robotic radical prostatectomy does not cause a positive surgical margin(Tubitak Scientific & Technical Research Council Turkey, 2016) Altınova, Serkan; İşgören, Abidin Egemen; Akbulut, Ziya; Özcan, Muhammet Fuat; Canda, Abdullah Erdem; Atmaca, Ali Fuat; Balbay, Mevlana DeryaBackground/aim: The aim of this study was to gauge whether removal of a specimen with traction during robot-assisted laparoscopic radical prostatectomy causes a positive surgical margin or not. Materials and methods: One hundred and sixty-nine patients with localized prostate cancer who underwent robot-assisted laparoscopic radical prostatectomy from 2009 to 2011 were included in the study. After dividing the patients into two groups, we recorded their characteristics and pre-op/post-op evaluations. Results: There were 111 and 58 patients in groups 1 (with traction) and 2 (without traction), respectively. We evaluated the patients' ages, follow-up time, body mass index (BMI), prostate-specific antigen (PSA) values, pre-op and post-op Gleason score values, pathological stage, positive surgical margin rates, and biochemical PSA recurrence rates. There was no statistically significant difference between the groups for age, pre-op PSA values, BMI, pre-op and post-op Gleason scores, positive surgical margin rates and biochemical recurrence rates. There was a significant difference between prostate weight, tumor volume, and clinical stage. Conclusion: Removing the specimen with traction during robot-assisted laparoscopic radical prostatectomy does not cause a positive surgical margin. The incision should be as small as possible for cosmetic appearance.Öğe Renal hücreli kanser nedeniyle radikal ve parsiyel nefrektomi yapılan hastaların onkolojik sonuçlarının karşılaştırılması(2019) Gök, Bahri; Ener, Kemal; Canda, Abdullah Erdem; Atmaca, Ali Fuat; Altınova, Serkan; Akbulut, Ziya; Balbay, Mevlana DeryaAmaç Bu çalışmada renal hücreli karsinom (RHK) nedeniyle radikal ve parsiyel nefrektomi yapılan hastaların evrelere göre onkolojik sonuçlarının karşılaştırılması amaçlanmıştır. Bu amaçla klinikopatolojik özelliklerin rekürrenssiz sağkalım ve kansere özgü sağkalım üzerine etkileri incelendi. ( Sakarya Tıp Dergisi 2019, 9(2):326-336 ) Gereç ve Yöntem 2004-2012 tarihleri arasında renal kitle nedeniyle kliniğimizde parsiyel/radikal nefrektomi uygulanan T3a ve altındaki 200 hastanın verilerini retrospektif olarak inceledik. Klinikopatolojik özelliklerin sağkalımlar üzerine istatistiksel etkileri olup olmadığı Log-Rank testi kullanılarak Kaplan Meier sağkalım analizi ile değerlendirildi. Her bir değişkene ilişkin 1- 3 ve 5 yıllık sağkalım hızları, ortalama yaşam süresi ve bu süreyle ilişkili %95 güven aralıkları hesaplandı. Bulgular Tüm olgular içerisinde 1- 3 ve 5 yıllık rekürrenssiz sağkalım % 95.5, 90.5 ve 85.5, kansere özgü sağkalım % 98.8, 96.4 ve 92.3 olarak tespit edildi. PN grubunda RN grubuna göre rekürrenssiz sağkalım istatistiksel olarak daha yüksekti (p=0,014) ama kansere özgü sağkalımda fark gözlenmedi. Evrelere göre T1a, T1b ve T3a’ da rekürrrenssiz sağkalım ve kansere özgü sağkalım T2a ve T2b’ den daha yüksekti (p=0,023 ve p<0,001). T1a ve T1b evrelerinde 1- 3 ve 5 yıllık rekürrenssiz sağkalım ve kansere özgü sağkalım benzer olarak bulundu ve klinikopatolojik özelliklerle istatistiksel olarak ilişki tespit edilmedi. Tüm olgular içerisinde patolojik tümör boyutu (p=0,026)’ nun rekürrenssiz sağkalımı etkilediği görüldü. Tüm olgular içerisinde multivariate analizlerde yaş (p=0,010) ve patolojik tümör boyutunun (p=0,018) kansere özgü sağkalımı etkilediği görüldü. Sonuç T1a ve T1b böbrek tümörlerinde parsiyel nefrektomi ve radikal nefrektomi yapılan hastalar arasında rekürrenssiz ve kansere özgü sağkalımların benzer olduğu gözlendi ve prognozunun herhangi bir klinikopatolojik özellikten etkilenmediği gözlendi. Klinikopatolojik ve demografik özelliklerin ileri evrelerde sağkalımla ilişkili olabileceği düşünüldü.Öğe Retrograd intrarenal cerrahi esnasında oluşan vücut sıcaklık değişikliklerini etkileyen faktörler(2020) Güzelburç, Vahit; Soytaş, Mustafa; Kiremit, Murat Can; Erkurt, Bülent; Altay, Bülent; Darçın, Kamil; Akbulut, Ziya; Albayrak, SelamiAmaç: Retrograd intrarenal cerrahi (RIRC) esnasında diğer endoürolojik operasyonlardan farklı olarak daha düşük debi ve hacimde irrigasyon sıvısı kullanılmaktadır. Çalışmamızda kullanılan irrigasyon sıvısına bağlı olarak vücutta oluşan sıcaklık değişiklikleri ve buna etki eden faktörler incelendi. Gereç ve Yöntemler: Prospektif olarak çalışmaya 128 hasta dahil edildi. Operasyonlarda standart olarak 21°C ameliyathane odasında bulundurulan izotonik irrigasyon sıvısı kullanıldı. Hiçbir hastaya aktif ısıtma uygulanmadı. Hastaların ateşi anestezi indüksiyonu öncesinde ve uyandırma öncesinde periferik yoldan ölçüldü. Ölçülen vücut sıcaklık farklarının hasta özellikleri, operasyon süresi, kullanılan irrigasyon sıvısı hacmi ve taş büyüklüğüyle ilişkisi değerlendirildi. Bulgular: Operasyona girişte timpanik ortalama vücut sıcaklığı 36,3±0,35°C iken operasyon sonunda 35,8±0,5°C hesaplandı. Hastaların 102’sinde (%79,7) post-op vücut sıcaklık düşüşü (0,67±0,47°C) kaydedildi. Operasyon öncesi ve sonrasındaki vücut sıcaklık değerleri karşılaştırıldığında anlamlı düşüş saptandı (p<0,0001). Bu düşüş ile hasta ve operatif veriler arasında istatistiksel anlamlı bir ilişki saptanmadı. Sonuç: RIRC sonrasında vücut sıcaklığı düşmektedir ancak ameliyathane oda sıcaklığı dışındaki hasta ve operatif verilerle ateş değişimi arasında ilişki kurulamamıştır.
