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Öğe Can revision of RYGB to sleeve gastrectomy be a solution to inadequate weight loss treatment?(Mexican Acad Surgery, 2022) Okut, Gokalp; Turgut, Emre; Kaplan, Kuntay; Sumer, Fatih; Kayaalp, CuneytWe aimed to discuss the weight loss success of the revision of RYGB to sleeve gastrectomy (SG). Between January 2019 and June 2020, four patients' files were analyzed retrospectively. Post-RYGB mean minimal BMI was 27.4 +/- 9.47 kg/m2, be-fore SG the mean BMI was 43.41 +/- 4.16 kg/m2. Post-operative gastric fistula developed in two patients. The mean follow-up time after revision surgery was 17.25 +/- 6.89 months, mean excess weight loss (EWL) was 74.77 +/- 8.94%, and mean BMI was 32.65 +/- 2.9 kg/m2. Despite high rate of major complications, revision of RYGB to SG is successful in weight loss and resolving certain complications of RYGB.Öğe A case of cardiac cyst hydatid with multiple system involvement(2021) Dogan, Gulec Mert; Dogan, Sait Murat; Tasolar, Sevgi; Okut, Gokalp; Sigirci, Ahmet; Elkiran, Ozlem; Karakurt, CemsitThe larval form of the Echinococcus granulosus causes cystic echinococcosis. The liver and the lungs are the most commonly affected organs. Echinococcosis can also be present in other organs although it is rare. We reported a case with sacral bone, cardiac, lung and liver involvement. Clinical and radiological findings of this unique case were discussed. At the Thoracic Computed On the thoracic computed tomography (CT) scan of a 16-year-old female patient was seen multiple parenchymal and subpleural nodular lesions and a cystic mass in the right ventricular cavity. Echocardiographic examination of the patient also observed on CT. Most cases of cardiac cystic echinococcosis were occurred on adult patients, while only 20 cases were in children. For the 20 reported cases in children, there were 9 cases of cardiac echinococcosis involving left ventricle. Because of the possible complications in the presence of cardiac hydatid cyst, treatment should be surgery.Öğe A case of cardiac cyst hydatid with multiple system involvement(2021) Dogan, Gulec Mert; Dogan, Sait Murat; Tasolar, Sevgi; Okut, Gokalp; Sığırcı, Ahmet; Elkıran, Özlem; Karakurt, CemşitAbstract: The larval form of the Echinococcus granulosus causes cystic echinococcosis. The liver and the lungs are the most commonly affected organs. Echinococcosis can also be present in other organs although it is rare. We reported a case with sacral bone, cardiac, lung and liver involvement. Clinical and radiological findings of this unique case were discussed. At the Thoracic Computed On the thoracic computed tomography (CT) scan of a 16-year-old female patient was seen multiple parenchymal and subpleural nodular lesions and a cystic mass in the right ventricular cavity. Echocardiographic examination of the patient also observed on CT. Most cases of cardiac cystic echinococcosis were occurred on adult patients, while only 20 cases were in children. For the 20 reported cases in children, there were 9 cases of cardiac echinococcosis involving left ventricle. Because of the possible complications in the presence of cardiac hydatid cyst, treatment should be surgery.Öğe A case of cardiac cyst hydatid with multiple systeminvolvement(2021) Dogan, Gulec Mert; Dogan, Sait Murat; Taşolar, Sevgi; Okut, Gokalp; Sığırcı, Ahmet; Elkiran, Ozlem; Karakurt, CemsitThe larval form of the Echinococcus granulosus causes cystic echinococcosis. The liver and the lungs are the most commonlyaffected organs. Echinococcosis can also be present in other organs although it is rare. We reported a case with sacral bone, cardiac,lung and liver involvement. Clinical and radiological findings of this unique case were discussed. At the Thoracic Computed On thethoracic computed tomography (CT) scan of a 16-year-old female patient was seen multiple parenchymal and subpleural nodularlesions and a cystic mass in the right ventricular cavity. Echocardiographic examination of the patient also observed on CT. Mostcases of cardiac cystic echinococcosis were occurred on adult patients, while only 20 cases were in children. For the 20 reportedcases in children, there were 9 cases of cardiac echinococcosis involving left ventricle. Because of the possible complications in thepresence of cardiac hydatid cyst, treatment should be surgery.Öğe Classical Maple Syrup Urine Disease successfully treated with living donor liver transplantation(2021) Dogan, Gulec Mert; Dogan, Sait Murat; Okut, Gokalp; Sigirci, Ahmet; Yilmaz, SezaiMaple syrup urine disease (MSUD) is a disease that causes ketoacid accumulation in body. Diffusion-weighted imaging (DWI) is an important imaging modality for the diagnosis. Two children were diagnosed with MSUD at the neonatal period. They had uncontrolled ketosis and epileptic seizures although they were in compliance with their medical nutrition. Their DWIs were similar and showed high signal intensity localized within the myelinated white matter areas. Both of the patients were treated with living donor liver transplantation. The patients with classic form of MSUD are normal at birth. If the disease is not diagnosed and treated early, it can lead to serious neurological complications. Most researchers conclude that, the best choice for detecting MSUD encephalopathy in newborns is DWI. The traditional treatment of MSUD had been a protein-restricted diet until the liver transplantation became an alternative and better option for the cure of the patients..Öğe Classical Maple Syrup Urine Disease successfully treatedwith living donor liver transplantation(2021) Doğan, Güleç Mert; Doğan, Sait Murat; Okut, Gokalp; Sığırcı, Ahmet; Yılmaz, SezaiMaple syrup urine disease (MSUD) is a disease that causes ketoacid accumulation in body. Diffusion-weighted imaging (DWI) is animportant imaging modality for the diagnosis. Two children were diagnosed with MSUD at the neonatal period. They had uncontrolledketosis and epileptic seizures although they were in compliance with their medical nutrition. Their DWIs were similar and showedhigh signal intensity localized within the myelinated white matter areas. Both of the patients were treated with living donor livertransplantation. The patients with classic form of MSUD are normal at birth. If the disease is not diagnosed and treated early, it canlead to serious neurological complications. Most researchers conclude that, the best choice for detecting MSUD encephalopathyin newborns is DWI. The traditional treatment of MSUD had been a protein-restricted diet until the liver transplantation became analternative and better option for the cure of the patients..Öğe Comprehensive Analysis of Long-term Splenic Volume Changes in Pediatric Liver Transplant Patients: Does It Correlate With Adverse Graft Outcomes?(Elsevier Science Inc, 2021) Dogan, Gulec Mert; Dogan, Sait Murat; Okut, Gokalp; Karakas, Serdar; Kutluturk, Koray; Ulubaba, Hilal Er; Sahin, Tevfik TolgaObjectives. Splenomegaly and hypersplenism caused by liver failure increase the mortality and morbidity of patients even after liver transplantation if they do not regress. We evaluated the relation of splenic volume change and transplanted liver function. Material and Methods. A total of 59 of 207 pediatric patients who had liver transplantation between 2013 and 2018 in our institute were evaluated. The relation of spleen volume changes (splenic volume to standard splenic volume ratio [SV/SSV]) were measured at 0, 1, 6, 12, 24, and 36 months of follow-up by constructing electronic three-dimensional structure of the spleen at dynamic computed tomography (CT), and the course of liver functions were evaluated. Results. The SV/SSV ratio decreases in the first postoperative 6 months. After 6 months, SV increases and SV/SSV increases gradually. In a normal functioning graft, SV/SSV significantly decreased in all time points (P < .001). In patients with adverse events, SV/SSV started to increase after 6 months. In patients with fulminant hepatic failure, SV/SSV started to increase after postoperative 6 months. Adverse events in patients with fulminant hepatic failure were more than the patients with chronic liver disease (58% vs 28%). There was an inverse correlation between SV/SSV and thrombocyte levels (P < .001). Conclusions. SV/SSV seems to be correlated to the adverse events (ie, rejection). Together with thrombocyte levels, it can be used as a noninvasive test for follow-up of transplant patients in terms of adverse events in graft function.Öğe Effects of 4% icodextrine, magnesium sulfate, and 0.9% sodium chloride on postoperative intraabdominal adhesions(Mexican Acad Surgery, 2022) Baran, Necip T.; Okut, Gokalp; Pekcici, Mevlut R.Objective: Postoperative intraabdominal adhesions are obvious cause of postoperative morbidity. In this experimental study, our aim is to compare the effects of 4% icodextrin produced for adhesion prevention, magnesium sulfate used as an anticonvulsant in obstetrics and also as a thickening lubricant in the detergent industry, and saline, which we use most frequently in abdominal irrigation, on adhesion formation. Materials and methods: A total of 4 groups were formed, 8 in the control group (K), 8 in the icodextrin group (I), 8 in the magnesium sulfate group (M), and 8 in the saline group (SF). Adhesions were quantitatively evaluated with the classification defined by Nair and microscopic grading defined by Zuhlke. Results: The macroscopic staging degree was statistically significantly lower in Group M, I, and SF compared to Group K. Again, the degree of microscopic staging was significantly lower in Group M and I compared to Group K. Conclusions: Three different materials were used in our study. It was observed that they significantly reduced adhesions. This study once again demonstrates the limited ability of these materials to prevent adhesion, despite the wide variety of materials used, and the need for careful adherence to tissue-respectful surgical techniques.Öğe First two cases of literature: Caustic sclerosing cholangitis due to percutaneous treatment of hydatid liver disease causing liver transplantation(Kare Publ, 2024) Okut, Gokalp; Saglam, Kutay; Kocaaslan, Huseyin; Kayaalp, CuneytEchinococcus granulosus is predominantly found in the liver and can be effectively managed through antihelminthic therapy, surgical intervention, or interventional radiology. Percutaneous treatment (PT) has gained widespread popularity due to its minimally invasive nature. An integral step in surgical and PT procedures involves the utilization of protoscolicidal agents to eliminate the parasites. However, the administration of protoscolicidal agents carries the risk of inducing caustic sclerosing cholangitis (SC) if there is a communication between the cyst and the biliary tract. In this pioneering study, we present two cases of caustic SC that occurred subsequent to PT for hydatid liver, necessitating further progression of the disease and ultimately leading to liver transplantation.Öğe Genitourinary Cancers Following Kidney Transplant: Our 20 Years of Experience With Mechanistic Target of Rapamycin Inhibitors(Baskent Univ, 2022) Karatas, Murat; Okut, Gokalp; Simsek, Cenk; Dogan, Sait Murat; Zengel, Baha; Alkan, Funda Tasli; Tatar, ErhanObjectives:We investigated patientswithgenitourinary cancer after kidney transplant and the effects of immunosuppression reduction and switching to mechanistic target of rapamycin inhibitors. Materials and Methods: We retrospectively evaluated kidney transplant recipients seen at our center between January 2000 and January 2020. Patients with <1 year of follow-up were excluded. Results: Of 827 patients, genitourinary cancer was detected in 11 (1.3%): prostate cancer in 5 patients (45%), renal cell carcinoma in native kidney in 3 (27%), renal cell carcinoma in allograft kidney in 2 (18%), and transitional cell carcinoma of the bladder in 1 (9%). All patients had surgery. Two patients had bone metastasis due to prostate cancer at diagnosis. Two patients had allograft nephrectomy due to de novo renal cell carcinoma. Mean followup and age were 97 +/- 45 months (range, 26-189) and 50 +/- 10.2 years (19% female). After cancer diagnosis, excluding the 2 patients with allograft nephrectomy, immunosuppression was changed in 8 patients (88.8%) (1 patient received the same treatment before and after cancer diagnosis). Six patients received double-drug and 3 received triple-drug protocols. Of 9 patients, 2 were already using mechanistic target of rapamycin inhibitors before cancer diagnosis and 7 were switched: 4 to double-based and 3 to triplebased regimens. Six were switched from tacrolimus. With new treatments, patients showed no progressive kidney failure or rejection (38 +/- 40 mo average follow-up). At last follow-up, mean glomerular filtration rate was 62.8 +/- 34 mL/min/1.72 m2, which was similar to rate at cancer diagnosis (58.9 +/- 24 mL/ min/1.72 m2; P =.78). During follow-up, no patients developed local recurrence of primary tumor or new metastasis, and none showed adverse effects after switch to mechanistic target of rapamycin inhibitors. Three patients died of malignancy-unrelated reasons (ileus, urinary sepsis, heart failure). Conclusions: Mechanistictarget of rapamycin inhibitorbased drugs can be an important maintenance immunosuppressive treatment option for kidney transplant recipients with genitourinary cancers.Öğe Helicobacter pylori Increases Gastric Compliance on Resected Stomach After Laparoscopic Sleeve Gastrectomy(Springer, 2021) Kaplan, Kuntay; Turgut, Emre; Okut, Gokalp; Bag, Yusuf Murat; Sumer, Fatih; Kayaalp, CuneytBackground The relationship between high body mass index (BMI) and Helicobacter pylori (HP) was reported previously. But the mechanism is not clear. We aimed to evaluate the effect of HP on gastric compliance and volumes in obese patients. Materials and Methods One hundred fifty-nine patients who underwent sleeve gastrectomy due to morbid obesity were enrolled in the study and were divided into two groups as HP+ (n = 86) and HP- (n = 73) according to the HP status in resection materials. Demographics, pathological data, specimen sizes, volume, and compliance were retrospectively analyzed. Results The median age of the study group was 34 years (17-64 years) while the median BMI was 43 kg/m(2) (35-64, 3 kg/m(2)). Most of the patients (n = 134, 84.3%) were female. The median diameter of the widest point of the specimen was 22.5 cm (14-32 cm), and the median volume of the specimen was 790 cc (330-1920 cc). Both the diameter of the widest point and the volume of the specimens were significantly increased in the HP+ group compared to the HP- group (p < 0.001 and p = 0.017, respectively). In addition, the median compliance was 52.6 cc/mmHg, and the compliance was significantly higher (p < 0.001) in the HP+ group. There were no significant differences in specimen sizes between the two groups. Conclusion This is the first study showing that HP increases gastric compliance in obese patients who underwent LSG. The etiology and the effects of this increase in compliance have not been fully clarified yet. Further studies are needed to shed light on these effects.Öğe How much more can minimally invasive surgery be minimized? Mini-laparoscopic Nissen fundoplication in adults(2021) Sümer, Fatih; Okut, Gokalp; Kaplan, Kuntay; Baran, Necip Tolga; Kayaalp, CuneytIntroduction: Mini-laparoscopy has become a current issue as a minimally invasive technique in gastroesophageal reflux surgery, which does not require specimen extraction. There are a limited number of cases of Nissen fundoplication performed in the adult age group using the mini-laparoscopic method. In this article, our aim is to draw attention to the fact that mini-laparoscopy is a preferable technique in Nissen fundoplication surgery. Materials and Methods: Seven patients underwent mini-laparoscopic Nissen fundoplication between January 2010 and December 2019. Demographic data and perioperative parameters were analyzed retrospectively. Results: Three of our patients (43%) were female and the average age of our patients was 45.4±11.1. All patients presented with complaints of heartburn and regurgitation. There was Barrett metaplasia in the pathology results and no dysplasia was observed in any patient. Mean operation time was 117±49.9 min, bleeding amount was <10 ml in all surgeries. The median time to oral intake was 8th post-operative h, and no complications developed in any of our patients. In the post-operative period, there was no need for narcotic analgesic, after a single dose of nonsteroidal anti-inflammatory drugs, the treatment was continued with two doses of oral analgesic. Median length of stay hospital was 3 (2–4) days, the median follow-up period was 67 (29–120) months. Conclusion: Anti-reflux surgery can be easily performed, mini-laparoscopically since it is not a resective surgical procedure. It can provide advantages such as better cosmesis, less port site complications, and less analgesic useÖğe Is It Possible to Estimate the Liver Left Lobe Volume Using Preoperative Data Before Bariatric Surgery?(Springer, 2022) Okut, Gokalp; Turgut, Emre; Kaplan, Kuntay; Bag, Yusuf Murat; Sumer, Fatih; Kayaalp, CuneytY Purpose Retraction of the left lobe of the liver (LLL) is an important step in bariatric surgical procedures. A good liver retraction will both facilitate the operation and reduce complications. The aim of the study is to identify patients with large LLL with preoperative anthropometric and laboratory data, and to reveal complications due to large LLL. Materials and Methods The data of 245 patients who underwent bariatric surgery in our department between April 2019 and March 2021 were retrospectively analyzed. The patients were divided into two groups according to the visibility of the caudate lobe of the liver, the left diaphragmatic artery-vein, and the fat pad on the esophagus after liver retraction. Results Univariate analyses revealed significant differences in BMI, waist and hip circumferences, TG, DM, and HbA1c values, but only BMI (p = 0.001) and the presence of DM (p = 0.017) were found to be independent predictors of LLL size. BMI >= 42.1 kg/m(2) indicates the size of LLL with 83% sensitivity and 49% specificity. Retractor-related complications were significantly higher in the large LLL group (p = 0.036). There was no difference between the two groups in terms of complications related to trocar insertion (p = 0.014) and postoperative liver enzyme levels (p = 0.714). The operation time (laparoscopic sleeve gastrectomy [LSG]; p = 0.021) (laparoscopic Roux-N-Y gastric bypass [LRYGB]; p = 0.020) and the amount of bleeding (LSG; p < 0.001) (LRYGB; p = 0.011) are higher in patients with large LLL. Conclusion Large LLL can be predicted and complications may be reduced with the help of preoperative data.Öğe Is Previous Abdominal Surgery an Obstacle to Laparoscopic Bariatric Surgery?(Springer India, 2021) Turgut, Emre; Kaplan, Kuntay; Okut, Gokalp; Bag, Yusuf Murat; Sumer, Fatih; Kayaalp, CuneytIt is generally considered that a previous history of abdominal surgery can negatively impact the patient's perioperative course. But the effects of it on laparoscopic bariatric surgery have not been sufficiently documented. Therefore, our study aims to analyse the impact of previous abdominal surgery on patients undergoing bariatric surgery. Data from patients who underwent surgery between January 2011 and November 2019 was analysed retrospectively. The study population was divided into the following four groups: those with no history of previous abdominal surgery (group A), those who had previously undergone lower abdominal (group B), upper abdominal (group C) and those who had both lower and upper abdominal surgery (group D). Patients' demographic data, type of surgical procedure, operative time, length of hospitalization, perioperative and postoperative complications were recorded for each patient in the database. In the case of 4 (0.3%) patients, conversion to open surgery from a laparoscopic intervention was required. No significant difference was found between the groups with previous abdominal surgery in terms of intraoperative complications (p: 0.551). The rate of postoperative complications was higher in patients who had previously undergone upper abdominal surgery; however, the difference in this rate compared to the other groups was found to be statistically insignificant (p: 0.189). We believe that during the decision-making process, neither patients nor surgeons should see previous abdominal surgery as an obstacle to laparoscopic bariatric surgery, thus permitting more freedom in selecting the most appropriate type of surgery for the patient.Öğe Is Sleeve Gastrectomy or Roux-en-Y Gastric Bypass Better in Terms of Quality of Life?(Mary Ann Liebert, Inc, 2021) Turgut, Emre; Okut, Gokalp; Kaplan, Kuntay; Bag, Yusuf Murat; Sumer, Fatih; Kayaalp, CuneytIntroduction: Obesity has increased in frequency over recent years. Laparoscopic sleeve gastrectomy (LSG) is the most commonly used technique worldwide, followed by the laparoscopic Roux-en-Y gastric bypass (LRYGB). This study aims to compare the effects of these two techniques, LSG and LRYGB, on the patients' quality of life. Material and Methods: All patients who underwent surgery or postoperative checkups at our obesity clinic between December 2018 and December 2019 completed two face-to-face questionnaires: the Short Form 36 Health Survey and the Obesity-related Problems Scale. Information on each patient such as demographic data, American Society of Anesthesiologists scores, any previous surgeries, preoperative and/or postoperative complications, the type of surgery, and time elapsed since surgery was compared, retrospectively. Results: No significant statistical differences were found between the two procedures. A significant improvement in the postoperative quality of life was observed in all patients. Scores for female patients were observed to be lower than for male patients. No significant statistical difference was observed between the two age groups (50 years and older or <50 years) for either the LSG or LRYGB patients. Higher body mass index levels have prolonged hospital stay and score lower on many of the parameters.Öğe Management of the staple line bleeding in laparoscopic sleeve gastrectomy: monopolar cautery versus oversewing(Mexican Acad Surgery, 2022) Okut, Gokalp; Turgut, Emre; Kaplan, Kuntay; Karahan, Mehmet; Bag, Yusuf M.; Sumer, Fatih; Kayaalp, CuneytObjective: Staple line bleeding control (SLBC) after laparoscopic sleeve gastrectomy (LSG) is a serious problem. Cauterization alone is generally not preferred because of concerns about weakening the staple line. The aim of this study was to compare the suturing and monopolar cauterization methods for SLBC in LSG. Methods: 212 patients were divided into two groups as cautery and suture groups. Demographic characteristics, intraoperative, and post-operative results were analyzed. Results: Post-operative complications were seen in seven patients, four of them staple line bleeding (three patients were in the cautery group and one patient was in the suture group), and three of them leakage (all patients were in the suture group) from the staple line. There was no significant difference between the groups in terms of staple line bleeding (p = 0.35), staple line leakage (p = 0.09), blood loss (p = 0.12), intraoperative complications (p = 0.16), post-operative hemoglobin decrease (p = 0.63), and length of hospital stay (p = 0.35), but the operation time was longer in the suture group. Conclusion: This is the first study in literature comparing monopolar cauterization with another technique. Monopolar cauterization can be used for SLBC in LSG. It is a safe and efficient method as well as inexpensive.Öğe Outcomes of 6 Human Leukocyte Antigen-Mismatched Living Donor Kidney Transplant: A Study With Biopsy Amendment(Baskent Univ, 2022) Karatas, Murat; Okut, Gokalp; Simsek, Cenk; Dogan, Sait Murat; Tatar, Erhan; Uslu, AdamObjectives: In this study, we examined the graft and patient survival outcomes in patients with end-stage kidney disease who received 6 HLA-mismatched incompatible living donor kidney transplant. Materials and Methods: Patients who underwent living donor kidney transplant between January 2010 and March 2020 were evaluated retrospectively. Group A included kidney transplant recipients with 6 HLA mismatches, and group B included kidney transplant recipients with 0 to 5 HLA mismatches. Patients with <1 year of follow-up were excluded. All rejection episodes were diagnosed via Tru-Cut biopsy and histopathological evaluation. Results: There were 15 patients in group A and 176 patients in group B. The mean follow-up was 54.1 +/- 30 months. The number of patients who underwent pretransplant immune desensitization and received tacrolimus-based triple maintenance immunosuppression therapy was significantly higher in group A. In group A, there were 13 acute rejections seen in 9 patients (81%); in group B, there were 67 acute rejections seen in 51 patients (28.9%; P =.019). No differences were observed between the groups in terms of baseline glomerular filtration rate (60 +/- 16 vs 61.6 +/- 20 mL/min/1.72 m(2); P =.76), final control glomerular filtration rate (60.7 +/- 15 vs 58 +/- 19 mL/ min/1.72 m(2); P =.59), graft loss (0% vs 4%; P =.94), and mortality (6.6% vs 3%; P =.39). Conclusions: The presence of 6 HLA mismatches was associated with higher rates of biopsy-proven acute rejection. However, 6 HLA-mismatched incompatible living donor kidney transplant can be safely performed in centers where posttransplant followup is supported by indication and protocol biopsies and where there is a pathological infrastructure with extensive knowledge and experience.Öğe Pediatric renal transplantation; 10 years experience(2021) Okut, Gokalp; Dogan, Gulec Mert; Doğan, Sait MuratObjective: Although renal transplantation (RT) is the first treatment option for children with end-stage renal failure, the number of transplanted children remains low compared to adults. Experience of the individual pediatric transplant center is very important in the prognosis of pediatric transplant recipients. In this study, our pediatric RT experience was presented. Material and Methods: We retrospectively analyzed the data of 27 patients who had RT in our clinic between April 2009 and April 2019. Results: Fifteen of the patients were males, and mean age of all patients was 12.36 ± 4.18 years (range 4-17 years). The most frequent etiology for endstage renal disease (ESRD) was vesicourethral reflux. Eighteen (66.7%) of the transplanted kidneys came from cadaveric donors and 9 (33.3%) from live donors. One patient had preemptive RT and one patient had a re-RT. Twenty-two patients were on peritoneal dialysis program and four patients were on hemodialysis program. Mean dialysis time before transplantation was 29 (3-104) months. Bleeding was the most common surgical complication. Delayed graft function developed in four patients, and all of their grafts were from cadaveric donors. Rejection developed in 12 of our patients, graft loss was observed in only four of them. Considering all patients, graft survival rates were 100% in the 1st and 3rd years, and 92% in the 5th year. Conclusion: Pediatric RT program is difficult to establish, maintain and develop. Complications after transplantation are not uncommon; therefore, early detection and appropriate management are needed. Strategies are still needed to increase post-transplant success.Öğe Surgical complications after pediatric kidney transplantation; Single center experience(2021) Okut, Gokalp; Gulec, Mert Dogan; Dogan, Sait MuratAbstract: Aim: Kidney transplantation is the most effective treatment for end stage renal disease in all age groups. In this study, we analyzed our surgical complications after pediatric kidney transplantation. Materials and Methods: The data of pediatric patients who underwent kidney transplantation in our center between April 2009 and April 2019 were retrospectively analyzed. We divided the complications of the patients requiring secondary surgery into two groups as early and late according to their appearance in the first week and after. Wound problems, local or systemic infections, incisional hernias were not included in the surgical complication group. Results: Among the 27 pediatric kidney transplant procedures performed in our center, there were 11 surgical complications (6% early and 5 late complications) (40%). 4 of the complications in the early transplant period were due to bleeding, 1 was due to the torsion of the vascular structures belonging to the graft, and 1 was due to lymphocele development. Three of the late complications were ureteral stenosis, and two were due to vesicoreteral reflux to the transplant kidney. In our study group, there was no patient loss due to transplantation. Graft loss was not related to surgical complication in any patient. Conclusion: Pediatric kidney transplantation is a procedure that can be safely performed in our center, by looking at our patient and graft survival results and low surgical complications. Immediate identification and treatment of any complications are critical to the graft and patient survival.Öğe Surgical complications after pediatric kidney transplantation; Single center experience(2021) Okut, Gokalp; Dogan, Gulec Mert; Dogan, MuratAim: Kidney transplantation is the most effective treatment for end stage renal disease in all age groups. In this study, we analyzed our surgical complications after pediatric kidney transplantation. Materials and Methods: The data of pediatric patients who underwent kidney transplantation in our center between April 2009 and April 2019 were retrospectively analyzed. We divided the complications of the patients requiring secondary surgery into two groups as early and late according to their appearance in the first week and after. Wound problems, local or systemic infections, incisional hernias were not included in the surgical complication group. Results: Among the 27 pediatric kidney transplant procedures performed in our center, there were 11 surgical complications (6% early and 5 late complications) (40%). 4 of the complications in the early transplant period were due to bleeding, 1 was due to the torsion of the vascular structures belonging to the graft, and 1 was due to lymphocele development. Three of the late complications were ureteral stenosis, and two were due to vesicoreteral reflux to the transplant kidney. In our study group, there was no patient loss due to transplantation. Graft loss was not related to surgical complication in any patient. Conclusion: Pediatric kidney transplantation is a procedure that can be safely performed in our center, by looking at our patient and graft survival results and low surgical complications. Immediate identification and treatment of any complications are critical to the graft and patient survival.
