Browsing by Author "Parlak, Ayse"

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    The effect of azygos vein preservation on postoperative complications after esophageal atresia repair: Results from the turkish esophageal atresia registry
    (W B Saunders Co-elsevier Inc, 2021-10-24) Soyer, Tutku; Oztorun, Can Ihsan; Firinci, Binali; Durakbasa, Cigdem Ulukaya; Bahadir, Gulnur Gollu; Karaman, Ayse; Dokumcu, Zafer; Akkoyun, Ibrahim; Demirel, Berat Dilek; Oztan, Mustafa Onur; Ciftci, Ilhan; Ilhan, Huseyin; Yalcin, Sonay; Ozden, Onder; Tekant, Gonca Topuzlu; Kiyan, Gursu; Oral, Akgun; Guvenc, Unal; Erginel, Basak; Yildiz, Abdullah; Erdem, Ali Onur; Uzunlu, Osman; Erturk, Nazile; Aydin, Emrah; Samsum, Hakan; Arslan, Umut Ece; Parlak, Ayse; PARLAK, AYŞE; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Pediatri Anabilim Dalı.; 0000-0001-7686-2561; AAH-6766-2021
    Aim: Preservation of the azygos vein (AV) maintains normal venous drainage of the mediastinum and decreases postoperative congestion. The modification of esophageal atresia (EA) repair by preserving AV may prevent postoperative complications and may lead to better outcomes. The data from the Turkish Esophageal Atresia Registry (TEAR) were evaluated to define the effect of AV preservation on postoperative complications of patients with EA. Methods: Data from TEAR for a period of five years were evaluated. Patients were enrolled into two groups according to the preservation of AV. Patients with divided (DAV) and preserved AV (PAV) were evaluated for demographic and operative features and postoperative complications for the first year of life. The DAV and PAV groups were compared according to the postoperative complications, such as fis-tula recanalization, symptomatic strictures, anastomotic leaks, total number of esophageal dilatations, and anti-reflux surgery. In addition, respiratory problems, which required treatment, were compared between groups. Results: Among 502 registered patients; the data from 315 patients with the information of AV ligation were included. The male female ratio of DAV (n = 271) and PAV (n = 44) groups were 150:121 and 21:23, respectively (p > 0.05). The mean body weight, height, gestational age, and associated anomalies were similar in both groups (p > 0.05). The esophageal repair with thoracotomy was significantly higher in DAV group, when compared to the PAV group (p < 0.05). The rates of primary anastomosis and ten-sioned anastomosis were similar in both groups (p > 0.05). There was no difference between DAV and PAV groups for anastomotic leaks, symptomatic anastomotic strictures, fistula recanalization, and the re-quirement for anti-reflux surgery (p > 0.05). The rate of respiratory problems, which required treatment, was significantly higher in the DAV group (p < 0.05) Conclusion: The data in the TEAR demonstrated that preserving the AV during EA repair led to no sig-nificant advantage on postoperative complications, with exception of respiratory problems. AV should be preserved as much as possible to maintain a normal mediastinal anatomy and to avoid respiratory com-plications. (c) 2020 Elsevier Inc. All rights reserved.
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    Publication
    The evaluation of central venous catheter-related complications in pediatric acute leukemia patients: Single center experience
    (Lippincott Williams & Wilkins, 2023-01-01) Evim, Melike Sezgin; SEZGİN EVİM, MELİKE; Yörük, Gülce; Parlak, Ayse; YÖRÜK, GÜLCE; PARLAK, AYŞE; GÜLER, SALİH; Çelik, Fatih; ÇELİK, FATİH; Çelebi, Solmaz; ÇELEBİ, SOLMAZ; Hacımustafaoğlu, Mustafa; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; Baytan, Birol; Güneş, Adalet Meral; MERAL GÜNEŞ, ADALET; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Pediatri Anabilim Dalı.; 0000-0002-1266-4897; 0000-0001-7686-2561; 0000-0002-9375-2855; 0000-0003-4646-660X; AAI-3665-2021; AAH-6766-2021
    Central venous catheters (CVCs) are important for maintenance of childhood leukemia treatment but CVCs may develop complications. The aim of this study was to retrospectively evaluate the CVC-related complication rate, complication types, and outcome in children with acute leukemia. Complications developing in 310 CVCs (ports n=250, Hickman catheters n=60) inserted in 262 patients were evaluated. A total of 225,296 catheter days were screened. Median (range) CVC in-dwelling time was 661.5 (1 to 2636) days. In total, 157 complications developed of which 91 (58%) were infectious complications, 35 (22.3%) were vascular, 19 (12.1%) were surgical, and 12 (7.6%) were mechanical. Hickman catheters had a higher complication rate and were more prone to mechanical complications (P<0.01) but there was no difference for other complications. A lower absolute neutrophil count at insertion was observed in children with infectious complications (P<0.01). Seventy-eight of 136 catheters (57.3%) had to be removed prematurely. The overall complication rate was 0.65 per 1000 catheter days. In multivariate analysis, relapse leukemia, Hickman catheter and low absolute neutrophil count increased complication risk by 4.00, 1.97, and 1.92 times, respectively. Five (1.9%) deaths occurred because of catheter complications. Safe use of CVCs can be improved by early detection of complications and an experienced catheter care team.