Turk Pediatri Arsivi-turkish Archives of Pediatrics, 2008
Cystic diseases of liver are recognized in infancy and childhood initially Cystic diseases of liv... more Cystic diseases of liver are recognized in infancy and childhood initially Cystic diseases of liver and biliary tract are choledocal cysts autosomal recessive and autosomal dominant polycystic kidney disease congenital hepatic fibrosis and Caroli disease cystic dilatation of intrahepatic bile ducts Choledochal cysts and Caroli disease do not allow biliary flow cause chronic or obstructive cholestasis and progressive liver disease In congenital hepatic fibrosis and polycystic kidney disease there is cystic formations at terminal interlobular bile ducts but cholestasis is not seen They don’t cause liver and biliary tract functional disturbances Turk Arch Ped 2008; 43: 40 5 Key words: Biliary tract cystic diseases liver renal
Tüm olgular ortalama 11 aylıkken (2-35 ay) TERPT yöntemiyle ameliyat edildi ve ortalama 15 cm (8-... more Tüm olgular ortalama 11 aylıkken (2-35 ay) TERPT yöntemiyle ameliyat edildi ve ortalama 15 cm (8-38 cm) barsak bölümü çıkarıldı. TERPT ameliyatına; enterostomi açılmış olan altı hastanın üçünde karın içi yapışıklıkların ameliyatı güçleştirebileceği düşüncesiyle, enterostomisiz hastalardan ise birine uzun segment Hh şüphesiyle laparatomi ile başlandı. Enterostomili iki hasta ile enterostomisiz bir hastada ise ameliyata transanal yoldan başlanmasına karşın tatminkar bir serbestleştirme sağlanamadığından karına dönüldü. Ameliyat sonrası erken dönemde 1 olguda karın kesisinin açılması nedeniyle girişim gerekti, 1 olgumuz ise erken dönemde kaybedildi. Hastalarımızın hastanede kalma süresi ortalama 6 gündü (4-12 gün). On beş olgumuzun ortalama 14 aylık (1-21 ay) takibinde; 3 (%20) olguda anastomoz darlığı nedeniyle genişletme gerekirken, 10 (%66,6) olguda perineal dermatit tablosuyla karşılaşıldı. Bakımlarla iyileşen hastalarımızın günlük kaka yapma sayısı ameliyattan sonraki ilk üç ayda 8-10 kez iken sonrasında günde 1-3'e dek düştüğü gözlendi. Tüm hastalarımızın takibi halen sorunsuz şekilde sürmektedir. Sonuç: Hh tedavisinde kurulduğundan beri Rehbein yöntemini tercih eden kliniğimizin ilk TERPT deneyimlerinden sonra yöntemin güvenilir bir histopatolojik değerlendirme olanağı bulunması koşuluyla, özellikle batın açılmadan tek ameliyat olarak uygulanması durumunda daha yüksek oranda cerrahi ve aile memnuniyeti sağlayacağını düşünmekteyiz.
Turk Pediatri Arsivi-turkish Archives of Pediatrics, Sep 1, 2007
Dogumsal torasik ektopik bobrek bobregin cok nadir gorulen gelisimsel anomalisidir Genellikle kli... more Dogumsal torasik ektopik bobrek bobregin cok nadir gorulen gelisimsel anomalisidir Genellikle klinik belirti vermez ve tani akciger grafisi ile rastlantisal olarak koyulur Sol torasik ektopik bobrek ile birlikte diyafragma “evantrasyonu” iki tarafli pes ekinovarus ve gelisimsel kalca displazisi tespit ettigimiz 2 ay 22 gunluk bir kiz olguyu sunuyoruz Turk Ped Ars 2007; 42: 125 8 Anahtar kelimeler: Diyafragma evantrasyonu dogumsal torasik ektopik bobrek
Although surgical intervention is occasionally required for rectal prolapse (RP), there is both v... more Although surgical intervention is occasionally required for rectal prolapse (RP), there is both vagueness as to the indications for surgery and confusion as to the technique that should be used for children who need surgical treatment. Using Ekehorn's transanal suture rectosacropexy technique, 56 children with RP were treated surgically between 1987 and 1998 at our hospital. There were 36 boys and 20 girls, the average age was 4.5 years, and the duration of the recurrent prolapse prior to admission ranged from 3 to 8 months. The technique consists of simply inserting one``U''-shaped suture through the rectal ampulla and tying the strands of the suture outside at the level of the sacrococcygeal junction. In this series, follow-up periods ranged from 1 to 10 years and there were no recurrences. We believe that surgical indications for RP need to be de®ned more clearly and that Ekehorn's technique oers a simple and eective method for the surgical treatment of complete RP in children.
There are very few reports on the surgical management of presacral masses (PSM) via a posterior s... more There are very few reports on the surgical management of presacral masses (PSM) via a posterior sagittal (PS) approach. Between 1994 and 2000, we followed ®ve girls who had been operated upon for PSMs via a PS approach. The mean age was 28.8 16.6 months (6±48 months). The mean follow-up was 3 1.6 years (1±5 years). Although two patients had yolk-sac tumors, all patients are still alive. We believe that this is a safe and satisfactory method for resection of PSMs.
Purpose Gastric perforation is a rare condition with high mortality rates in preterm infants. The... more Purpose Gastric perforation is a rare condition with high mortality rates in preterm infants. The aim of this retrospective study was to define the risk factors and prognosis in very low birth weight (VLBW) infants with gastric perforations. Methods VLBW infants with a diagnosis of gastric perforation between 2012 and 2016 were included. The data including birth weight, gestational age, gender, risk factors, time and location of the perforation and prognosis were recorded. Results A total of eight infants were identified. The median gestational age and birth weight of the infants were 26 weeks and 860 g, respectively. Five were male and 6 (75%) had a diagnosis of hemodynamically significant patent ductus arteriosus (PDA), early sepsis, persistent hypotension, and drug administration (paracetamol, ibuprofen). The main clinical finding was abdominal distension and pneumoperitoneum was detected in all infants. The median diagnosis was 6 days of life. The median perforation size was 2.5 cm and curvature major and anterior wall were the most common locations. The mortality rate was 62.5%. Conclusion Male gender, chorioamnionitis, early sepsis, asphyxia, hemodynamic PDA, persistent hypotension, ibuprofen and paracetamol usage, and orogastric catheter administration were the main risk factors for gastric perforations in VLBW infants.
Yabancı cisim yutulması, çocukluk çağının sık karşılaşılan bir sorunudur. Bu cisimler bazen çok c... more Yabancı cisim yutulması, çocukluk çağının sık karşılaşılan bir sorunudur. Bu cisimler bazen çok ciddi komplikasyonlara yol açabilmektedir. Makalemizdeki amaç, gastrointestinal sistemde yabancı cisimlerin oluşturduğu cerrahi sorunlarla ilgili klinik deneyimlerimizi literatür eşliğinde tartışmaktır. Gereç ve Yöntem: İki merkezde 1987 ile 2013 yılları arasında yabancı cisim yutulması tanı ve tedavisi yapılan çocukların hastane arşivlerinden ulaşılabilen dosyaları geriye dönük olarak incelendi.
The technique of gonadal biopsy is very important for the diagnosis of the gonadal sex. But there... more The technique of gonadal biopsy is very important for the diagnosis of the gonadal sex. But there is no agreement of the surgeons about gonadal biopsy technique. Testis and gonad biopsies are obtained for a variety of reasons, with changing patterns of medical practice, criteria for biopsy will vary. The aim of this study was determined of using gonadal biopsy technique and to establish a proper protocol for using biopsy technique among the pediatric surgeons in our country. Method: A question-answer form was used to determine that which techniques were prefer to do biopsy of gonad among the pediatric surgeons, and all data were analyzed. Results:The technique of the gonadal biopsy showed differences. The result of this study, The answers of these questions among 86 pediatric surgeons and 14 urologists (n:100) are: What is your technique in testicular biopsy? According to purpose %4, No Biopsy %2, Unipolar %28, Bipolar %10, Bipolar longitudinal wedge %54, Wedge %2. What is your tech...
Objective: The aim of this study is to evaluate the 14 years' clinical experience in children... more Objective: The aim of this study is to evaluate the 14 years' clinical experience in children with acute scrotum and to discuss the role of surgery for acute scrotum in delayed presentation. Methods: Of 156 boys with acute scrotum, 98 (63%) were operated for suspected torsion between 1987 and 2001. Clinical records are evaluated retrospectively regard to surgical indications, findings of operation and outcome. Results: Testicular torsion (n=38, 39%), appendix testis/epididymis torsion (n=21, 22%), epididymoorchitis (n=20, 20%), acute/infected hydrocele (n=12, 12%), and hematocele (n=7, 7%) were diagnosed in 98 children. The mean admission time was found 4.5 days (1-10 days) in testicular torsion group while mean age was biphasic (15 days and 7 years). Only two testes from 38 patients with unilateral testicular torsion saved from being lost to torsion. These two patients had admitted with one and two-day history. Conclusion: Physical examination in cases with acute scrotum is rel...
Çalışmada, Ulusal Çocuk Cerrahisi (ÇC) ve Pediatrik Üroloji (PÜ) kongrelerinde sunulan deneysel ç... more Çalışmada, Ulusal Çocuk Cerrahisi (ÇC) ve Pediatrik Üroloji (PÜ) kongrelerinde sunulan deneysel çalışmalar incelenerek ÇC topluluğunun bu alandaki çalışmalarının genel özelliklerinin belirlenmesi, göze çarpan sorunlar ve olası çözüm yollarının tartışılması amaçlanmıştır.
de çoğunlukla mukozal konjesyon, ödem, kanama ve iskemik değişiklikler bildirildi. Ektopik doku o... more de çoğunlukla mukozal konjesyon, ödem, kanama ve iskemik değişiklikler bildirildi. Ektopik doku olarak 26 olguda (%22) mide mukozası, 1 olguda ise pankreas dokusu varlığı belirlendi. Ameliyat sonrasında olguların 2'si bağırsak yapışıklığı nedeniyle yeniden ameliyat edildi. Üç olgu yaygın/ gecikmiş peritonite bağlı çoklu organ yetersizliği tablosuyla kaybedildi. Rastlantısal saptanıp takibe alınan iki hasta semptomatik hale geldi; 1'i rektal kanama, 1'i invajinasyon nedeniyle opere edildi. Sonuç: Semptomatik olgularda sıklıkla akut karın tablosu ön planda olup, tanıda gecikmeler ölümcül komplikasyonlara neden olabilmektedir. Tanıda zorluk yaşanan olgularda MD'ne bağlı komplikasyonların akılda tutulması gerekmektedir.
Kısa bağırsak sendromu (KBS) bağırsak uzunluğu ve mukoza alanı yetersizliğinden kaynaklanan bir e... more Kısa bağırsak sendromu (KBS) bağırsak uzunluğu ve mukoza alanı yetersizliğinden kaynaklanan bir emilim sorunu olup, ağır enerji, protein, vitamin ve elektrolit bozukluğu ile seyreder. KBS'nin en sık nedenleri, nekrotizan enterekolit, ince bağırsak atrezileri, orta bağırsak volvulusu ve gastroşizisdir. Çalışmamızda Bianchi yöntemi ile bağırsak uzatılması yapılan KBS'li 2 olgu sunulmuş ve literatür taramasıyla ülkemiz çocuk cerrahisi topluluğunun KBS olgularına yaklaşımı özetlenmeye çalışılmıştır.
Aim. Ureteropelvic junction obstruction (UPJO) is rarely associated with a duplex collecting syst... more Aim. Ureteropelvic junction obstruction (UPJO) is rarely associated with a duplex collecting system. We review this unusual anomaly in terms of presentation, diagnostic evaluation, and surgical management.Method. We retrospectively reviewed the medical records of patients diagnosed with a duplex system with UPJO.Result. Sixteen patients (6 girls, 10 boys) with 18 moieties were treated surgically and four patients were treated conservatively. The median age at surgery was two years (range, 2 months to 7 years). The lower pole and upper moiety were affected in 12 and two kidneys, respectively, and both were affected in two patients. The anomaly was right-sided in 12 moieties and left-sided in six. The duplication was incomplete in seven patients and complete in nine. The mean renal pelvis diameter at the time of surgery was 25.6 (range 11–48 mm) mm by USG. The mean renal function of the involved moiety was 28.3% before surgery. Management included pyelopyelostomy or ureteropyelostomy ...
Background: To assess the effectiveness of the current vesicoureteral reflux (VUR) grading system... more Background: To assess the effectiveness of the current vesicoureteral reflux (VUR) grading system according to the international classification of VUR (ICVUR) and to evaluate whether VUR grading accuracy could be improved by renal ultrasonography (RU) according to the Society for Fetal Urology (SFU) grading system. Objectives: Therefore, this study assessed the accuracy of the current VCUG staging system by assessing inter-rater reliability among pediatric radiologists and urologists; it also evaluated whether accuracy is increased by RU without consensus (with respect to VCUG grading). Methods: Four pediatric urologists and four pediatric radiologists independently graded 120 voiding cystourethrograms (VCUGs). Middle VUR grades were divided into the following three groups: VUR consensus grade III (group 1), VUR consensus grade IV (group 3), and VUR non-consensus grades III and IV (group 2). All groups were compared with respect to hydronephrosis grade using RU. Results: The intraclass correlation coefficient (ICC) values ranging from 0.86 to 0.89 reflected good reliability. The lowest agreement was associated with middle grades (III and IV). A marked difference in sensitivity was observed between groups 1 and 3 (35% and 95%, respectively, P < 0.05), indexed by SFU hydronephrosis grade, suggesting that VCUG cases in group 2 (n = 16 at SFU 0 or 1) could be accepted as grade III, and SFU scores of 2, 3, or 4 could be considered grade IV. Conclusions: Inter-rater accuracy could be improved at middle grades using renal ultrasonography (USG), which could promote communication between different specialists.
Turk Pediatri Arsivi-turkish Archives of Pediatrics, 2008
Cystic diseases of liver are recognized in infancy and childhood initially Cystic diseases of liv... more Cystic diseases of liver are recognized in infancy and childhood initially Cystic diseases of liver and biliary tract are choledocal cysts autosomal recessive and autosomal dominant polycystic kidney disease congenital hepatic fibrosis and Caroli disease cystic dilatation of intrahepatic bile ducts Choledochal cysts and Caroli disease do not allow biliary flow cause chronic or obstructive cholestasis and progressive liver disease In congenital hepatic fibrosis and polycystic kidney disease there is cystic formations at terminal interlobular bile ducts but cholestasis is not seen They don’t cause liver and biliary tract functional disturbances Turk Arch Ped 2008; 43: 40 5 Key words: Biliary tract cystic diseases liver renal
Tüm olgular ortalama 11 aylıkken (2-35 ay) TERPT yöntemiyle ameliyat edildi ve ortalama 15 cm (8-... more Tüm olgular ortalama 11 aylıkken (2-35 ay) TERPT yöntemiyle ameliyat edildi ve ortalama 15 cm (8-38 cm) barsak bölümü çıkarıldı. TERPT ameliyatına; enterostomi açılmış olan altı hastanın üçünde karın içi yapışıklıkların ameliyatı güçleştirebileceği düşüncesiyle, enterostomisiz hastalardan ise birine uzun segment Hh şüphesiyle laparatomi ile başlandı. Enterostomili iki hasta ile enterostomisiz bir hastada ise ameliyata transanal yoldan başlanmasına karşın tatminkar bir serbestleştirme sağlanamadığından karına dönüldü. Ameliyat sonrası erken dönemde 1 olguda karın kesisinin açılması nedeniyle girişim gerekti, 1 olgumuz ise erken dönemde kaybedildi. Hastalarımızın hastanede kalma süresi ortalama 6 gündü (4-12 gün). On beş olgumuzun ortalama 14 aylık (1-21 ay) takibinde; 3 (%20) olguda anastomoz darlığı nedeniyle genişletme gerekirken, 10 (%66,6) olguda perineal dermatit tablosuyla karşılaşıldı. Bakımlarla iyileşen hastalarımızın günlük kaka yapma sayısı ameliyattan sonraki ilk üç ayda 8-10 kez iken sonrasında günde 1-3'e dek düştüğü gözlendi. Tüm hastalarımızın takibi halen sorunsuz şekilde sürmektedir. Sonuç: Hh tedavisinde kurulduğundan beri Rehbein yöntemini tercih eden kliniğimizin ilk TERPT deneyimlerinden sonra yöntemin güvenilir bir histopatolojik değerlendirme olanağı bulunması koşuluyla, özellikle batın açılmadan tek ameliyat olarak uygulanması durumunda daha yüksek oranda cerrahi ve aile memnuniyeti sağlayacağını düşünmekteyiz.
Turk Pediatri Arsivi-turkish Archives of Pediatrics, Sep 1, 2007
Dogumsal torasik ektopik bobrek bobregin cok nadir gorulen gelisimsel anomalisidir Genellikle kli... more Dogumsal torasik ektopik bobrek bobregin cok nadir gorulen gelisimsel anomalisidir Genellikle klinik belirti vermez ve tani akciger grafisi ile rastlantisal olarak koyulur Sol torasik ektopik bobrek ile birlikte diyafragma “evantrasyonu” iki tarafli pes ekinovarus ve gelisimsel kalca displazisi tespit ettigimiz 2 ay 22 gunluk bir kiz olguyu sunuyoruz Turk Ped Ars 2007; 42: 125 8 Anahtar kelimeler: Diyafragma evantrasyonu dogumsal torasik ektopik bobrek
Although surgical intervention is occasionally required for rectal prolapse (RP), there is both v... more Although surgical intervention is occasionally required for rectal prolapse (RP), there is both vagueness as to the indications for surgery and confusion as to the technique that should be used for children who need surgical treatment. Using Ekehorn's transanal suture rectosacropexy technique, 56 children with RP were treated surgically between 1987 and 1998 at our hospital. There were 36 boys and 20 girls, the average age was 4.5 years, and the duration of the recurrent prolapse prior to admission ranged from 3 to 8 months. The technique consists of simply inserting one``U''-shaped suture through the rectal ampulla and tying the strands of the suture outside at the level of the sacrococcygeal junction. In this series, follow-up periods ranged from 1 to 10 years and there were no recurrences. We believe that surgical indications for RP need to be de®ned more clearly and that Ekehorn's technique oers a simple and eective method for the surgical treatment of complete RP in children.
There are very few reports on the surgical management of presacral masses (PSM) via a posterior s... more There are very few reports on the surgical management of presacral masses (PSM) via a posterior sagittal (PS) approach. Between 1994 and 2000, we followed ®ve girls who had been operated upon for PSMs via a PS approach. The mean age was 28.8 16.6 months (6±48 months). The mean follow-up was 3 1.6 years (1±5 years). Although two patients had yolk-sac tumors, all patients are still alive. We believe that this is a safe and satisfactory method for resection of PSMs.
Purpose Gastric perforation is a rare condition with high mortality rates in preterm infants. The... more Purpose Gastric perforation is a rare condition with high mortality rates in preterm infants. The aim of this retrospective study was to define the risk factors and prognosis in very low birth weight (VLBW) infants with gastric perforations. Methods VLBW infants with a diagnosis of gastric perforation between 2012 and 2016 were included. The data including birth weight, gestational age, gender, risk factors, time and location of the perforation and prognosis were recorded. Results A total of eight infants were identified. The median gestational age and birth weight of the infants were 26 weeks and 860 g, respectively. Five were male and 6 (75%) had a diagnosis of hemodynamically significant patent ductus arteriosus (PDA), early sepsis, persistent hypotension, and drug administration (paracetamol, ibuprofen). The main clinical finding was abdominal distension and pneumoperitoneum was detected in all infants. The median diagnosis was 6 days of life. The median perforation size was 2.5 cm and curvature major and anterior wall were the most common locations. The mortality rate was 62.5%. Conclusion Male gender, chorioamnionitis, early sepsis, asphyxia, hemodynamic PDA, persistent hypotension, ibuprofen and paracetamol usage, and orogastric catheter administration were the main risk factors for gastric perforations in VLBW infants.
Yabancı cisim yutulması, çocukluk çağının sık karşılaşılan bir sorunudur. Bu cisimler bazen çok c... more Yabancı cisim yutulması, çocukluk çağının sık karşılaşılan bir sorunudur. Bu cisimler bazen çok ciddi komplikasyonlara yol açabilmektedir. Makalemizdeki amaç, gastrointestinal sistemde yabancı cisimlerin oluşturduğu cerrahi sorunlarla ilgili klinik deneyimlerimizi literatür eşliğinde tartışmaktır. Gereç ve Yöntem: İki merkezde 1987 ile 2013 yılları arasında yabancı cisim yutulması tanı ve tedavisi yapılan çocukların hastane arşivlerinden ulaşılabilen dosyaları geriye dönük olarak incelendi.
The technique of gonadal biopsy is very important for the diagnosis of the gonadal sex. But there... more The technique of gonadal biopsy is very important for the diagnosis of the gonadal sex. But there is no agreement of the surgeons about gonadal biopsy technique. Testis and gonad biopsies are obtained for a variety of reasons, with changing patterns of medical practice, criteria for biopsy will vary. The aim of this study was determined of using gonadal biopsy technique and to establish a proper protocol for using biopsy technique among the pediatric surgeons in our country. Method: A question-answer form was used to determine that which techniques were prefer to do biopsy of gonad among the pediatric surgeons, and all data were analyzed. Results:The technique of the gonadal biopsy showed differences. The result of this study, The answers of these questions among 86 pediatric surgeons and 14 urologists (n:100) are: What is your technique in testicular biopsy? According to purpose %4, No Biopsy %2, Unipolar %28, Bipolar %10, Bipolar longitudinal wedge %54, Wedge %2. What is your tech...
Objective: The aim of this study is to evaluate the 14 years' clinical experience in children... more Objective: The aim of this study is to evaluate the 14 years' clinical experience in children with acute scrotum and to discuss the role of surgery for acute scrotum in delayed presentation. Methods: Of 156 boys with acute scrotum, 98 (63%) were operated for suspected torsion between 1987 and 2001. Clinical records are evaluated retrospectively regard to surgical indications, findings of operation and outcome. Results: Testicular torsion (n=38, 39%), appendix testis/epididymis torsion (n=21, 22%), epididymoorchitis (n=20, 20%), acute/infected hydrocele (n=12, 12%), and hematocele (n=7, 7%) were diagnosed in 98 children. The mean admission time was found 4.5 days (1-10 days) in testicular torsion group while mean age was biphasic (15 days and 7 years). Only two testes from 38 patients with unilateral testicular torsion saved from being lost to torsion. These two patients had admitted with one and two-day history. Conclusion: Physical examination in cases with acute scrotum is rel...
Çalışmada, Ulusal Çocuk Cerrahisi (ÇC) ve Pediatrik Üroloji (PÜ) kongrelerinde sunulan deneysel ç... more Çalışmada, Ulusal Çocuk Cerrahisi (ÇC) ve Pediatrik Üroloji (PÜ) kongrelerinde sunulan deneysel çalışmalar incelenerek ÇC topluluğunun bu alandaki çalışmalarının genel özelliklerinin belirlenmesi, göze çarpan sorunlar ve olası çözüm yollarının tartışılması amaçlanmıştır.
de çoğunlukla mukozal konjesyon, ödem, kanama ve iskemik değişiklikler bildirildi. Ektopik doku o... more de çoğunlukla mukozal konjesyon, ödem, kanama ve iskemik değişiklikler bildirildi. Ektopik doku olarak 26 olguda (%22) mide mukozası, 1 olguda ise pankreas dokusu varlığı belirlendi. Ameliyat sonrasında olguların 2'si bağırsak yapışıklığı nedeniyle yeniden ameliyat edildi. Üç olgu yaygın/ gecikmiş peritonite bağlı çoklu organ yetersizliği tablosuyla kaybedildi. Rastlantısal saptanıp takibe alınan iki hasta semptomatik hale geldi; 1'i rektal kanama, 1'i invajinasyon nedeniyle opere edildi. Sonuç: Semptomatik olgularda sıklıkla akut karın tablosu ön planda olup, tanıda gecikmeler ölümcül komplikasyonlara neden olabilmektedir. Tanıda zorluk yaşanan olgularda MD'ne bağlı komplikasyonların akılda tutulması gerekmektedir.
Kısa bağırsak sendromu (KBS) bağırsak uzunluğu ve mukoza alanı yetersizliğinden kaynaklanan bir e... more Kısa bağırsak sendromu (KBS) bağırsak uzunluğu ve mukoza alanı yetersizliğinden kaynaklanan bir emilim sorunu olup, ağır enerji, protein, vitamin ve elektrolit bozukluğu ile seyreder. KBS'nin en sık nedenleri, nekrotizan enterekolit, ince bağırsak atrezileri, orta bağırsak volvulusu ve gastroşizisdir. Çalışmamızda Bianchi yöntemi ile bağırsak uzatılması yapılan KBS'li 2 olgu sunulmuş ve literatür taramasıyla ülkemiz çocuk cerrahisi topluluğunun KBS olgularına yaklaşımı özetlenmeye çalışılmıştır.
Aim. Ureteropelvic junction obstruction (UPJO) is rarely associated with a duplex collecting syst... more Aim. Ureteropelvic junction obstruction (UPJO) is rarely associated with a duplex collecting system. We review this unusual anomaly in terms of presentation, diagnostic evaluation, and surgical management.Method. We retrospectively reviewed the medical records of patients diagnosed with a duplex system with UPJO.Result. Sixteen patients (6 girls, 10 boys) with 18 moieties were treated surgically and four patients were treated conservatively. The median age at surgery was two years (range, 2 months to 7 years). The lower pole and upper moiety were affected in 12 and two kidneys, respectively, and both were affected in two patients. The anomaly was right-sided in 12 moieties and left-sided in six. The duplication was incomplete in seven patients and complete in nine. The mean renal pelvis diameter at the time of surgery was 25.6 (range 11–48 mm) mm by USG. The mean renal function of the involved moiety was 28.3% before surgery. Management included pyelopyelostomy or ureteropyelostomy ...
Background: To assess the effectiveness of the current vesicoureteral reflux (VUR) grading system... more Background: To assess the effectiveness of the current vesicoureteral reflux (VUR) grading system according to the international classification of VUR (ICVUR) and to evaluate whether VUR grading accuracy could be improved by renal ultrasonography (RU) according to the Society for Fetal Urology (SFU) grading system. Objectives: Therefore, this study assessed the accuracy of the current VCUG staging system by assessing inter-rater reliability among pediatric radiologists and urologists; it also evaluated whether accuracy is increased by RU without consensus (with respect to VCUG grading). Methods: Four pediatric urologists and four pediatric radiologists independently graded 120 voiding cystourethrograms (VCUGs). Middle VUR grades were divided into the following three groups: VUR consensus grade III (group 1), VUR consensus grade IV (group 3), and VUR non-consensus grades III and IV (group 2). All groups were compared with respect to hydronephrosis grade using RU. Results: The intraclass correlation coefficient (ICC) values ranging from 0.86 to 0.89 reflected good reliability. The lowest agreement was associated with middle grades (III and IV). A marked difference in sensitivity was observed between groups 1 and 3 (35% and 95%, respectively, P < 0.05), indexed by SFU hydronephrosis grade, suggesting that VCUG cases in group 2 (n = 16 at SFU 0 or 1) could be accepted as grade III, and SFU scores of 2, 3, or 4 could be considered grade IV. Conclusions: Inter-rater accuracy could be improved at middle grades using renal ultrasonography (USG), which could promote communication between different specialists.
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