Yazar "Karakoyunlu, Ahmet Nihat" seçeneğine göre listele

Listeleniyor 1 - 3 / 3
  • Küçük Resim
    Öğe
    External validation and comparison of current scoring systems in retrograde intrarenal surgery: Multi-institutional study with 949 patients
    (Wiley, 2021) Bozkurt, Ibrahim Halil; Karakoyunlu, Ahmet Nihat; Koras, Omer; Celik, Serdar; Sefik, Ertugrul; Cakici, Mehmet Caglar; Degirmenci, Tansu
    Objectives To externally validate and compare Resorlu-Unsal stone score (RUSS), modified Seoul National University Renal Stone Complexity Score(S-ReSC), Ito's nomogram, and Retrograde Intra-Renal Surgery (R.I.R.S.) scoring systems for predicting capabilities of both the stone-free status and complications in a multi-institutional study. Materials and Methods We performed a retrospective analysis of 949 patients who underwent flexible ureterorenoscopy (f-URS) and laser lithotripsy for renal stones in two institutions between March-2015 and June-2020. The RUSS, modified S-ReSC, Ito's nomogram, and R.I.R.S. scores were calculated for each patient by the same surgeon on imaging methods. Results were compared for their predictive capability of stone-free status and complications. Results Of 949 patients 603 were male and 346 were female with a mean age of 47.2 +/- 14.3 (range 2-84 years). Mean stone burden was 102.6 +/- 42.2 (48-270 mm(2)). All nomograms predicted stone-free status (Area Under Curve (AUC) were 0.689, 0.657, 0.303, and 0.690, respectively). All four scoring systems predicted complications with AUC values of 0.689, 0.646, 0.286, and 0.664 for RUSS, modified S-ReSC, Ito's nomogram, and R.I.R.S., respectively. Although all scoring systems were able to predict complications only Ito's nomogram was able to predict Clavien >= 2 complications. Conclusion All four scoring systems (RUSS, modified S-ReSC, Ito's nomogram, and R.I.R.S.) could predict stone-free status after f-URS, however, the AUC values are not satisfactory in our large patient cohort. Although these scoring systems were not developed for predicting post-operative complications, they were associated with complications in our study. However, these four scoring systems have some significant limitations. The ideal scoring system is yet to be developed.
  • [ N/A ]
    Öğe
    Retrospective Analysis of the Factors Affecting Intraoperative and Immediate Postoperative Complications of Retrograde Intrarenal Surgery Classified by the Clavien and Satava Grading Systems
    (Mary Ann Liebert, Inc, 2021) Koras, Omer; Bozkurt, Ibrahim Halil; Karakoyunlu, Ahmet Nihat; Celik, Serdar; Sefik, Ertugrul; Yarimoglu, Serkan; Polat, Salih
    Background: To classify intraoperative and postoperative complications using the modified Clavien classification system (MCCS) and modified Satava classification system (SCS) and to evaluate the parameters associated with complications in patients undergoing retrograde intrarenal surgery (RIRS) for renal and proximal ureteral stones. Materials and Methods: We performed a retrospective analysis of 949 patients who underwent RIRS for renal stones and proximal ureteral stones at two institutions between March 2015 and June 2020. Intraoperative complications were assessed using the SCS, and postoperative complications were graded according to the MCCS. Univariate and multivariate analyses were undertaken to determine predictive factors affecting complication rates. Results: The median stone size was determined as 13mm (range 10-20mm). The stone-free rate was 83.6% after the first intervention. Reprocedure was applied to 89 of the patients with residual stones and the final stone-free rate was 94.4% after reprocedure. According to SCS, the number of intraoperative events and complication incidences was 153 (16.1%). MCCS revealed postoperative complications in 121 (12.8%) patients. Major complications were observed in 18 (1.9%) patients. The rate of complications was higher in patients with renal anomalies (9.9% vs 3.4%, p=0.001). Stone location, stone size, stone burden, stone number, stone density, and residual fragments were determined to be associated with the development of complications (p<0.001, p<0.001, p<0.001, p<0.001, p=0.002, and p<0.001, respectively). In addition, the multivariate analysis revealed that only the presence of residual fragments was a significant predictor of complication development for the patients with Grade 3 complications according to MCCS (p=0.032). However, significant predictors were stone burden (p<0.001), stone density (p=0.002), and fluoroscopy time (p<0.001) for those with Grade >= 2b complications according to SCS. Conclusion: This study showed that abnormal kidney anatomy, operation time, stone burden, and residual fragments were reliable predictors of complication development during and after RIRS. Appropriate preoperative management should be planned according to these predictors to prevent intraoperative and postoperative complications.
  • [ N/A ]
    Öğe
    Safety and Efficacy of Flexible Ureterorenoscopy Surgery in Different Age Groups
    (Coll Physicians & Surgeons Pakistan, 2021) Koras, Omer; Bozkurt, Ibrahim Halil; Karakoyunlu, Ahmet Nihat; Polat, Salih; Yarimoglu, Serkan; Degirmenci, Tansu
    Objective: To comparatively investigate the efficacy, safety and complications of flexible ureterorenoscopy (f-URS) in the treat-ment of patients of different age groups ( 60, 60-74 and 60 years (Group 1), 60-74 years (Group 2) and _75 year (Group 3). The patients' American Society of Anesthesiologists (ASA) score, Charlson Comorbidity Index (CCI), anticoagulant use, stone-free rates and surgical and medical complication rates were examined for each group. Results: There were 688 patients in Group 1, 230 in Group 2, and 38 in Group 3. A significant difference was observed between the age groups in terms of CCI and anticoagulant use (p<0.001 for both). The highest rate of medical complications was observed in Group 3 at 42.1%, followed by Group 2 at 17.8%, while the lowest rate was observed in Group 1 at 2.3% (p<0.001). As a result of the multivariate analysis, receiving anticoagulant treatment (p=0.002) and having a high CCI (p=0.005) were independent predictors of medical complication development. Conclusion: It was clearly demonstrated that f-URS could be used as a safe and effective alternative for the treatment moderate-size kidney stones in all age groups.