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Öğe COMPARISON OF RETROGRADE INTRARENAL SURGERY AND PERCUTANEOUS NEPHROLITHOTOMY IN MULTIPLE CALYCEAL STONES: A MATCH PAIR ANALYSIS OF 190 CASES(Iniestares, S.A., 2021) Baran, O.; Aykac, A.OBJECTIVES: The current nephrolithiasis guidelines have no recommendation about multiple calyceal stones treatment. We aimed to compare the results of two effective methods of RIRS and PNL operations in the treatment of multicalyx stones. METHODS: Data of patients who underwent RIRS or PNL for multicalyx stones between September 2014 and May 2019 in our clinic were evaluated retrospectively. In both groups, stone-free and complication rates, hospital stay, scopy times, and operation times were examined. In RIRS group, the number of sessions and total stone-free rates at the end of each session were evaluated separately. RESULTS: A total of 162 patients in the RIRS group, and 103 patients in the PNL group were evaluated. After the match pair 1:1, data of 95 patients were selected in each group. Stone burden, number, density, ASA scores, BMI were similar in both groups. At the end of the first session RIRS, 59 (62.1%) patients became stone-free, while in the PNL group 73 (76.8%) patients (p: 0.027). The statistical analysis showed that the stone-free rates obtained in the second sessions in the RIRS group were similar to those of the PNL group. After a total of 124 sessions of RIRS, a stone-free rate of 81.1% was achieved by 1.3 sessions on average. CONCLUSION: At least two session of RIRS is as effective as PNL on multiple calyceal stones. Stage RIRS can be an alternative to PNL at multicalyceal renal stones. © 2021 Iniestares, S.A.. All rights reserved.Öğe Hydrocele with Paratesticular Liposarcoma(College of Physicians and Surgeons Pakistan, 2022) Baran, O.; Bozkurt, U.; Aykac, A.Paratesticular liposarcoma (PLS) is a rare type of genitourinary malignancy in the spermatic cord presenting as scrotal swelling. In this case study, we report an 82-year male who presented with prolonged left scrotal swelling and pain that did not respond to analgesic treatment for one week. His ultrasound confirmed increased fluid content in the left scrotal compartment in the form of septated hydrocele, and hydrocelectomy was planned. During the operation, infected fluid was drained. The testicle and surrounding tissues were infected; hence, left orchiectomy was performed. The pathological examination revealed a dedifferentiated liposarcoma. To our knowledge, this is the first report of liposarcoma of the spermatic cord with hydrocele in the literature. © 2022 College of Physicians and Surgeons Pakistan. All rights reserved.Öğe Reconstruction of scrotal skin defects using bilobed pudendal flap(Wolters Kluwer Medknow Publications, 2022) Abaci, M.; Baran, O.Background: Due to its unique cosmetic appearance and functioning, scrotal skin offers a major clinical challenge in terms of reconstruction. Thus, successful reconstruction of scrotal skin should include both provision of pliable texture and protection of testicular functions. Skin grafts and flaps are important options for such reconstruction; however, they both have unique features that bring about specific limitations and specific problems. Aims and Objectives: In the light of the negativities related to the widely used skin grafts and flaps, this study aims to discuss the use of bilobed pudendal flap - a simple, uniform, and pliable tissue - for the first time in the related literature for the reconstruction of scrotal skin defects caused by Fournier's gangrene. Materials and Methods: This study was performed using the single-step method of scrotal skin reconstruction on eight patients who had developed scrotal skin defects and underwent reconstruction by using three-dimensional bilobed pudendal flaps (defect and reconstructive tissues planned on different planes) from December 2016 to August 2019. Results: No complication such as infection, bleeding, hematoma, partial or complete flap loss, scar contraction, urinary problem, erectile dysfunction or discomfort, or sensation loss was observed in seven out of eight study patients. The only complication to have developed in one patient was minimal dehiscence, which was then corrected by restoration. Conclusion: Repair of scrotal skin defect using a three-dimensional bilobed pudendal flap enabled an elastic scrotal repair acceptable in sensorial and visual terms. © 2022 Wolters Kluwer Medknow Publications. All rights reserved.Öğe Retrograde intrarenal surgery for stone disease under spinal anaesthesia, a minimally invasive technique. A retrospective analysis of 1,467 cases(Ene Ediciones Sl, 2019) Baran, O.; Aykac, A.; Sari, S.; Ates, A.; Ozok, U.; Sunay, M.Introduction and objectives: The aim of the present study was to compare RIRS procedures applied under general anaesthesia (GA) and spinal anaesthesia (SA) regarding success and complication rates. Materials and methods: A retrospective evaluation was conducted with the data obtained from patients treated with RIRS under SA and GA at 2 centres from October 2014 until January 2018. The SA and GA groups were evaluated according to the parameters of stone-free and complication rates, postoperative pain control and length of in-hospital stay. The stone-free rates from the RIRS procedures applied with SA were evaluated by the surgeons who participated in the study. Results: A total of 1361 patients were included in the study. A stone-free rate of 84.4% was obtained in the global results: 85.3% in the SA group and 83.5% in the GA group (P = .364). No statistically significant difference was determined regarding surgeons who practiced RIRS under SA with respect to success/complication rates and operating time (P = .676). Operating time was determined as 44.2 +/- 14.2 mins in the SA group and 49.7 +/- 19.1 mins in the GA group (P = .014). Conclusions: The RIRS method can be applied safely, either under spinal anaesthesia, or under general anaesthesia. The success of RIRS under spinal anaesthesia has been shown as an independent factor regarding surgeon. It can be considered a good alternative to general anaesthesia. (C) 2019 AEU. Published by Elsevier Espana, S.L.U. All rights reserved.
