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  • Küçük Resim
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    Enigmatic traces determined on radical perineal prostatectomy specimens: An anatomohistological study
    (Journal of Clinical and Analytical Medicine, 2014) Akça, Oktay; Yalçın, Savaş; Horuz, Rahim; Boz, Mustafa; Kafkaslı, Alper; Çetinel, Cihangir; Göktaş, Cemal; Çakır, Çağlar; Albayrak, Selami
    Aim: An anatomohistological evaluation of tissue found on specimens of radical perineal prostatectomy which could influence oncological and functional outcome. Material and Method: A certain surgeon's batch of 41 RPP (Radical perineal prostatectomy) specimens were evaluated. The RPP specimens were dissected from apex to basis. The following slices were dissected: 1 from the Apex, 2 from the center of the prostate, and 1 from the basis. Totaling 4 selected slices. Tissue surrounding these slices were anatomohistologically evaluated working from the following 7 parameters determined in light of latest anatomical and pathological insight on the prostate:"Dorsal venous complex(DVC)", "Striated muscle(Rhabdosphincter)", "Periprostatic fascial tissue (PPFT)", "Neurovascular bundle(NVB)", "Bladder neck smooth muscle", "Surgical margins" and "Capsular incision". Results: Whilst no DVC was found in the dissected Apex slices, muscle striation was found with 39 (95,1%) of the patients. PPFT within central prostate sections was found with 36 (87,8%) of the patients, predominantly within posterior quadrants. Again within central prostate sections NVB was found with 23 (56%) of the patients. All basis slices were found to have bladder neck smooth muscle. Surgical margin positivity was found with only 5 (12,1%) of the patients. Capsular incision was found with 15 (36,5%) of the patients. Discussion: Our study provides a quantitative report of the extent to which other anatomi-cal structures are extracted when removing the prostate from the perineum employing the RPP technique. That the specimen show no trace of DVC is significant in terms of pubovesical complex sparing.
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    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, Ziya
    Objective: 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.
  • Küçük Resim
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    Radikal retropubik prostatektomi: Prostat ile birlikte hangi dokular çıkıyor?
    (2013) Akça, Oktay; Yalçın, Savaş; Horuz, Rahim; Boz, Mustafa; Selimoğlu, Ahmet; Kafkaslı, Alper; Çetinel, Cihangir; Çakır, Çağlar; Albayrak, Selami
    Giriş: Radikal retropubik prostatektomi (RRP) spesmeni üzerinde bulunan dokuları histolojik açıdan değerlendirmek. Gereç ve Yöntemler: Kliniğimizde tek cerrahın serisi olarak 30 RRP yapıldı. Patolojik spesmenler apeksten tabana doğru dilimlendi. Bir adet apeksten, iki adet orta prostattan ve 1 adet tabandan olmak üzere 4 adet dilim seçildi. Dilimler transvers planda üretra ortada kalacak şekilde 4 kadrana ayrıldı. Kadranlar, yüzeyel kısımlarında bulunan ve prostatın güncel anatomik ve histolojik bilgileri ışığında belirlenmiş 7 parametre; “Dorsal venöz kompleks (DVC)”, “Çizgili kas (Rabdosfinkter)”, “Periprostatik fasiyal doku (PPFD)”, “Damar sinir paketi”, “Mesane boynu düz kas lifleri”, “Cerrahi sınır” ve “Kapsüler insizyon” yönüyle histolojik olarak araştırıldı. Bulgular: Apekste DVC tüm spesmenlerde gözlenirken çizgili kas 28 (%93,3) hastada ve özellikle prostatın ön yüzünde gözlendi. PPFD prostatın arka yüzünde ağırlıklı olmak üzere spesmenlerin hepsinde gözlendi. Damar sinir paketi 23 (%76,6) hastada gözlenmekle birlikte prostatın posterior yüzünde daha fazlaydı. Prostatın taban kesitlerinde spesmenlerin tümünde düz kas yapıları vardı. Cerrahi sınır pozitifliği 9 (%30) hastada gözlenmekle birlikte bunların 7 tanesi apekste idi. Kapsüler insizyon 9 (%30) hastada pozitifti. Sonuç: Bu çalışmada RRP ameliyatı sonucunda elde edilen prostatektomi materyalinin üzerinde hangi dokuların bulunduğu kantitatif olarak gösterilmiş oldu. Bu bulguların hem prostat anatomisi hem de prostatın cerrahisi açısından yeni fikirler doğurabileceğini düşünmekteyiz.