Person: YAVAŞCAOĞLU, İSMET
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YAVAŞCAOĞLU
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İSMET
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Publication Challenging risk factors for right and left laparoscopic adrenalectomy: A single centre experience with 272 cases(Brazilian Soc Urol, 2019-07-01) Kordan, Yakup; Günseren, Kadir Ömür; GÜNSEREN, KADİR ÖMÜR; Çiçek, Mehmet Cağatay; ÇİÇEK, MEHMET ÇAĞATAY; Vuruşkan, Hakan; VURUŞKAN, HAKAN; Yavaşçaoğlu, İsmet; YAVAŞCAOĞLU, İSMET; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı.; 0000-0001-8673-3093; 0000-0002-0471-5404; 0000-0002-9947-848X; ABC-9924-2020Purpose: This study aimed to compare perioperative and postoperative results of right and left laparoscopic adrenalectomy (LA), and to evaluate the impact of challenging factors on these outcomes.Materials and Methods: A total of 272 patient's medical records that underwent single side LA between October 2006 and September 2017 were retrospectively reviewed. The patients were divided into 2 groups according to operation side. Moreover, pheochromocytoma, metastatic masses and adrenal lesions >5cm in size were considered to be difficult adrenalectomy cases and the outcomes of these cases were compared between two groups.Results: 135 patients (49.6%) underwent right LA and 137 patients (50.4%) underwent left LA. Operation time, estimated blood loss (EBL) and hospitalization time were similar between the groups (p=0.415, p=0.242, p=0.741, respectively). Although EBL was higher on the right side than the left (p=0.038) in the first 20 cases, after this learning period has been completed, there was no significant difference between the groups. In patients with pheochromocytoma, metastatic mass and a mass >5cm in size, despite bleeding complications were clinically higher on the right side, this difference was not statistically significant.Conclusions: During the learning period of LA, EBL is higher on the right side. Due to the greater risk of bleeding complications on the right side even on the hands of experienced surgeons, extra care and preoperative planning are required in patients with pheochromocytoma, metastatic masses and masses >5cm in size.Publication Is laparoscopic adrenalectomy for pheochromocytoma safe and effective in geriatric patients?(Wiley, 2021-06-12) Günseren, Kadir Ömur; Çiçek, Mehmet Çağatay; Bolat, Deniz; Yeni, Sezgin; Vuruşkan, Hakan; Gül, Özen Öz; Yavaşcaoğlu, İsmet; GÜNSEREN, KADİR ÖMÜR; ÇİÇEK, MEHMET ÇAĞATAY; VURUŞKAN, HAKAN; ÖZ GÜL, ÖZEN; YAVAŞCAOĞLU, İSMET; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Anabilim Dalı.; 0000-0001-8673-3093; 0000-0002-0471-5404; 0000-0002-1332-4165; ABC-9924-2020; HGM-5995-2022 ; GFT-1275-2022; EFH-9523-2022; GBT-4320-2022; EIN-0828-2022Objectives The study aimed to assess the haemodynamic changes of laparoscopic adrenalectomy (LA) in geriatric patients with pheochromocytoma (PHEO). To the best of our knowledge, this is the first study to evaluate the haemodynamic outcomes of LA in this patient population.Methods Data of 350 patients who underwent single-side transperitoneal LA between 2000 and 2020 were reviewed retrospectively. Patients with a histopathological diagnosis of PHEO were included in the study and classified into two groups according to their ages at the date of surgery. Patients older than 65 years were accepted as elderly according to the World Health Organisation (WHO) recommendations.Results A total of 54 patients underwent LA for PHEO. Fifteen patients were enrolled in the elderly and 39 in the young groups. There were no significant differences in terms of the operation site (0.564), tumour size (0.878), perioperative results such as mean anaesthesia; operation times, blood loss and haemodynamic changes. There were no significant differences in mean hospitalisation and intensive care unit times. One patient in both groups had grade 1 complication according to Clavien Dindo classification (prolonged ileus, managed with medical treatment and transfusion during surgery, respectively).Conclusion Young and elderly patients had similar outcomes in terms of haemodynamic changes that occurred with LA. LA in elderly patients with PHEO is as safe and effective as in younger patients.Publication Single center experience with laparoscopic adrenalectomy on a large clinical series: Lessons learned from 273 cases: A retrospective cohort study(Kuwait Medical Association, 2022-12) Çelen, Sinan; Günseren, Kadir Ömur; Vuruşkan, Hakan; Acımış, Nurhan Meydan; Kordan, Yakup; Yavaşcaoğlu, İsmet; GÜNSEREN, KADİR ÖMÜR; VURUŞKAN, HAKAN; YAVAŞCAOĞLU, İSMET; Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Bölümü; ITO-9188-2023; EFH-9523-2022; EIN-0828-2022Objectives: We aim to evaluate the risk of laparoscopic adrenalectomy (LA) for large adrenal tumors and the risk of learning curve.Design: Single centre, retrospective studySetting: Uludag University, Bursa, TurkeySubjects: A study in a large patient population (N=273) who underwent LA between 2006 and 2017.Interventions: The patients were divided into two study groups according to tumour size as estimated by pathologic specimen maximum diameter, Group A (less than 5cm) and group B (larger than 5cm). In addition, to evaluate learning curve of LA, the patients were divided into two groups according to time interval: the first period was 2006 to 2011, and the second period 2012-2017.Main outcome measures: To evaluate the risk of learning curve and tumour sizeResults: There was no statistical difference between the two groups for per-operative and postoperative complications according to tumour size <5 or >= 5 cm, and there was statistical difference between the two groups for operation time, length of hospital stay; but no statistical difference for postoperative complications according to time interval.Conclusion: LA in large adrenal masses (5 cm or larger) is not associated with longer operative time, increased blood loss and longer hospital stay, without affecting perioperative morbidity, Hence, the size of an adrenal mass should not be the only factor in determining whether LA or not. Besides, learning curve may affect outcomes of LA.Publication The differences between the right and left side laparoscopic donor nephrectomy outcomes: A comparative analysis of single-center outcomes(Kare, 2021-02-26) Günseren, Kadir Ömür; Çiçek, Mehmet Çağatay; Aydın, Yavuz Mert; Özmerdiven, Çağdaş Gökhun; Yavaşcaoğlu, İsmet; GÜNSEREN, KADİR ÖMÜR; ÇİÇEK, MEHMET ÇAĞATAY; AYDIN, YAVUZ MERT; YAVAŞCAOĞLU, İSMET; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı.; 0000-0001-8673-3093; 0000-0002-0471-5404; 0000-0002-6287-6767; AFP-3055-2022; ABC-9924-2020; HGM-5995-2022; EIN-0828-2022Objective: This study aimed to compare the right and left side laparoscopic donor nephrectomy (LDN) outcomes of a single center.Materials and Methods: The outcomes of patients who underwent LDN in our clinic between 2008 and 2020 were evaluated retrospectively. Two groups were consisted according to the side of the donor kidney. The gender, age, body mass index, duration of operation, amount of bleeding, warm ischemia time, drain removal time, and duration of hospitalization and complications were compared between groups.Results: A total of 314 patients were included in the study. Sixty-six patients underwent right LDN and 248 underwent left LDN. There was no difference between groups in terms of age, duration of operation, amount of bleeding, warm ischemia time, and complications (p>0.05). However, drain removal time and duration of hospitalization were longer in the left LDN group (p<0.05).Conclusions: The right LDN had similar intraoperative outcomes with the left LDN. However, failure on meticulous dissection of the lymphatic structures during left LDN might cause chylous drainage and prolonged hospitalization time.Publication Prognostic value of estrogen receptors in patients who underwent prostatectomy for non-metastatic prostate cancer(Spandidos Publ Ltd, 2023-02-01) Aydın, Yavuz Mert; Şahin, Ahmet Bilgehan; Dölek, Rabia; Vuruşkan, Berna Aytaç; Ocakoğlu, Gökhan; Vuruşkan, Hakan; Yavaşçaoğlu, İsmet; Coşkun, Burhan; AYDIN, YAVUZ MERT; ŞAHİN, AHMET BİLGEHAN; DÖLEK, RABİA; AYTAÇ VURUŞKAN, BERNA; OCAKOĞLU, GÖKHAN; VURUŞKAN, HAKAN; YAVAŞCAOĞLU, İSMET; COŞKUN, BURHAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Onkoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; 0000-0002-6287-6767; 0000-0002-7846-0870; 0000-0002-1114-6051; 0000-0002-8242-9921; AAH-9704-2021; AFP-3055-2022; HSH-9815-2023; JCO-5169-2023; AAH-5180-2021; AAM-4927-2020; EEJ-1452-2022; EFH-9523-2022; EIN-0828-2022Estrogen receptors in prostate cancer (PCa) are a subject of debate. The aim of the present study was to investigate whether estrogen receptor-alpha (ER alpha) and estrogen receptor-beta (ER beta) impact the biochemical recurrence (BCR) of non-metastatic PCa after surgery. Following the application of the exclusion criteria, data from 108 patients who underwent laparoscopic radical prostatectomy between January 2011 and December 2019 were retrospectively evaluated. A total of 36 patients with BCR constituted the BCR group. The control group was formed using the Propensity Score Matching (PSM) method with a 1:2 ratio, including parameters with well-studied effects on BCR. The median follow-up time was 74.3 (range, 30-127.5) months in the BCR group and 66.6 (range, 31.5-130) months in the control group. Pathology specimens from the two groups were immunohistochemically stained with ER alpha and ER beta antibodies. Logistic regression analysis and survival analysis were performed. No differences in clinicopathological characteristics were detected between the two groups. The patients with ER alpha(-)/ER beta(+) staining results had a significantly fewer BCRs than other patients (P=0.024). In the logistic regression analysis, patients with ER alpha(-)/ER beta(+) PCa also had a significantly lower risk of recurrence (P=0.048). In the survival analysis, the 5-year BCR-free survival rate of patients with ER alpha(-)/ER beta(+) PCa was higher than that of other patients (85.7 vs. 66.1%; P=0.031). Excluding the effects of well-studied risk factors for recurrence by the PSM method, the present study showed that ER alpha and ER beta have prognostic value for non-metastatic PCa. The 5-year BCR-free survival rate is significantly higher in patients whose PCa tissue has ER alpha(-)/ER beta(+) staining results.Publication Diode laser in the treatment of benign prostatic enlargement: A preliminary study(Aves, 2011-03-01) Oktay, Bülent; Kılıçarslan, Hakan; Doğan, Hasan Serkan; Kordan, Yakup; Yavaşcaoğlu, İsmet; Vuruşkan, Hakan; Oktay, Bülent; KILIÇARSLAN, HAKAN; Doğan, Hasan Serkan; Kordan, Yakup; YAVAŞCAOĞLU, İSMET; VURUŞKAN, HAKAN; Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı.; 0000-0002-9947-848X; ABH-5513-2020; DKK-2716-2022; JIT-9412-2023; GAF-0095-2022; EIN-0828-2022; EFH-9523-2022Objective: To evaluate the efficacy of a novel treatment diode laser, in treatment of benign prostatic enlargement.Materials and methods: We evaluated the surgical and functional outcomes of 85 patients who underwent diode laser treatment for benign prostatic enlargement between September 2007 and April 2009. Preoperative and postoperative the International Prostate Symptom Score (IPSS), the International Index of Erectile Function (IIEF), maximum flow rate, postvoiding residual urine, and prostate volumes were analyzed.Results: All the patients were considered clinically as having benign prostatic enlargement. Mean age was 70.8 +/- 8.6 years and follow-up period was 12.6 +/- 6 months. In all patients, the power used was 120 W, the mean applied energy was 190 +/- 70 kJ and the total laser time was 21.9 +/- 7.2 min. Improvement in functional outcomes began in the third postoperative month and was sustained through 12 months postoperatively. Compared to preoperative data, at postoperative 12 months, we detected a significant decrease in prostate volumes (55.5 +/- 27.6 mL vs. 42.8 +/- 21.7 mL), IPSS (21.6 +/- 4.75 vs. 4.6 +/- 3.3) and residual urine volume (89.5 +/- 85.6 mL vs. 30.4 +/- 22.4 mL), and a significant increase in maximum flow rates (18.7 +/- 6.9 mL/sec vs. 9.6 +/- 5.6 mL/sec). No difference was detected in IIEF scores (36.8 +/- 21.2 vs. 37.8 +/- 23.7). Re-treatment was required in 5.8% of patients, and retrograde ejaculation was reported in 17% of patients.Conclusion: The early results of diode laser treatment for benign prostatic enlargement were equivalent to other endoscopic and minimally invasive treatments.Publication Detection of vesico-ureteric reflux in renal transplant recipients by colour doppler urosonograpy(Aves, 2005-09-01) Vuruskan, Hakan; VURUŞKAN, HAKAN; Çift, Ali; Oktay, Bülent; Bolca, Naile; BOLCA TOPAL, NAİLE; Kordan, Yakup; Yavasçaoğlu, İsmet; YAVAŞCAOĞLU, İSMET; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0002-9947-848X; AAH-7103-2019Introduction: In this study, we evaluated the vesico-ureteric reflux (VUR) in renal transplant recipients by using color Doppler urosonography (CDU).Materials and Methods: Among 149 renal transplant recipients, 42 (27 men, 15 women) who accepted to take part were included to the study. The mean age and duration of post-transplant follow-up of the patients were 35.1+/-1.39 years (15-55) and 63.6+/-7.2 months (7-170), respectively. In all patients, ureterovesical anastomosis and antireflux submucosal tunnel were performed with Lich-Gregoir technique without using ureteral stent. Urinary system was assessed in all patients with CDU without any contrast enhancing agent by the same radiologist. During CDU, patients were asked to make Valsalva maneuver when their bladders were full with urine and were evaluated for reflux. The patients' ureteric jets were first investigated in transverse and then in longitudinal plane by observing distal ureteric segment and ureteral orifice. The flows coming towards the transducer were coded red in color while those moving away from the transducer were coded blue in color. During observation of the distal ureteric segment; detection of red color was regarded as reflux. The patients, in whom reflux was detected by CDU, were reassessed by voiding cystouretrography (VCUG).Results: Among 42 patients who underwent CDU, 7 patients (16.7%) were diagnosed to have VUR. In all patients, the diagnosis of CDU detected VUR was confirmed by VCUG. In 4 patients (57.2%) low grade and in 3 patients (42.9%) intermediate grade reflux was found by using CDU. None of the patients had high grade reflux. In 3 patients (42.9%) grade 2, in 3 patients (42.9%) grade 3, in 1 patient (14.2%) grade 4 reflux were observed during evaluation of these patients by VCUG. Since VCUG is an invasive procedure and the patients who were determined not to have VUR by CDU had no urinary tract infection history in the follow-up they did not undergo VCUG.Conclusion: CDU is a non-invasive and effective method for the diagnosis and follow-up of VUR in renal transplant recipients.Publication Emphysematous pyelonephritis: Case report(Aves, 2005-09-01) VURUŞKAN, HAKAN; Vuruşkan, Hakan; Çalışkan, Zülküf; Çift, Ali; Kordan, Yakup; Yavaşçaoğlu, İsmet; YAVAŞCAOĞLU, İSMET; Oktay, Bülent; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı.; 0000-0002-9947-848X; AAH-7103-2019Introduction: Emphysematous pyelonephritis (EP) is a lethal infection which is rarely seen and is characterized by gas in intrarenal or perirenal region. The traditional treatment of EP is open surgical flowing and parenteral antibiotherapy or nephrectomy. In this study a 74 years old male patient with EP treated with percutaneous drainage catheter and comprehensive antibiotherapy because of no clinical response to antibiotherapy is presented.Publication Laparoscopic extraperitoneal radical prostatectomy: Our first experiences(Aves, 2005-09-01) Oktay, Bülent; Vuruskan, Hakan; VURUŞKAN, HAKAN; Yavasçaoğlu, İsmet; YAVAŞCAOĞLU, İSMET; Kordan, Yakup; Çalışkan, Zülküf; Öztürk, Murat; ÖZTÜRK, MURAT; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı.; 0000-0002-9947-848X; 0000-0002-0668-8075Introduction: Laparoscopic radical prostatectomy is a relatively new and contemporary approach in the surgical management of localized prostate cancer. We report our preliminary results after 6 procedures.Materials and Methods: We performed laparoscopic extraperitoneal radical prostatectomy (LERP) in 6 patients between January and June in 2004. Clinical stage, serum PSA, Gleason score, operating time, surgical and medical complications, estimated blood loss, transfusion rate, hospital stay and catheterization times were recorded. The pathologic stage (1997 TNM classification), status of surgical margins and continence were noted.Results: There was no conversion and reintervention. The mean operation time was 320 minutes. The mean blood loss was 178.3 ml. The mean hospital stay was 4.5 days. There were no major complications. Subileus occurred in one patient and resolved spontaneously. The mean catheterization time was 13.3 days. 2 of 6 patients had positive surgical margins at the urethra. 4 of 6 patients were continent after a median followup period of 3 months.Conclusion: LERP as a minimally invasive procedure seems to offer the same early oncological and surgical results as conventional open radical prostatectomy. Long and gradual learning curve of this procedure is its main disadvantage.Publication Laparoscopic radical cystectomy: Uludag University experience(Aves, 2009-09-01) Yavaşcaoğlu, İsmet; Gökcen, Kaan; Doğan, Hasan Serkan; Kordan, Yakup; Aytaç, Berna; Vuruşkan, Hakan; Oktay, Bülent; YAVAŞCAOĞLU, İSMET; Gökcen, Kaan; Doğan, Hasan Serkan; Kordan, Yakup; AYTAÇ VURUŞKAN, BERNA; VURUŞKAN, HAKAN; Oktay, Bülent; Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; 0000-0002-9947-848X; ABH-5513-2020; AAH-9746-2021; EIN-0828-2022; JMX-6994-2023; GAF-0095-2022; EFH-9523-2022; DKK-2716-2022Objective: To present the experience of our clinic on laparoscopic radical cystectomy (LRC).Materials and methods: Twenty-three patients who underwent laparoscopic radical cystectomy, lymphadenectomy and urinary diversion between May 2006 and April 2009 were included. Twenty-two patients were male and one was female. Mean age of patients was 61.5 (40-75) years.Results: Mean total operative time was 388 (270-510) minutes, whereas mean time for laparoscopic cystectomy and lymph node dissection was 225 (180-310) minutes. Simultaneous nephroureterectomy was performed in two patients. Ileal conduit was performed in 20 patients as urinary diversion and orthotopic neobladder was constructed in 3. Mean blood loss was 130 mL (40-300) and intraoperative blood transfusion was not necessary in any of the patients. Mean postoperative hospitalization was 11.1 (7-24) days. No intraoperative complication was experienced and conversion to open surgery has never happened. Superficial wound infection and dehiscence have happened in 2 patients and prolonged ileus was encountered in 1 patient. Histological examination revealed organ confined (pT0/pT1/pT2/pT3a) disease in 21 (91.3%), extravesical (pT3b/pT4) disease in 2 (8.7%), and lymph node involvement in 4 (17%) patients. Four patients with lymph node involvement, 1 patient with squamous cell cancer, and 1 patient with neuroendocrin carcinoma received adjuvant chemotherapy. Within a mean time period of 13.1 (1-26) months, 95.6% (22/23) of patients, including patients who were given adjuvant chemotherapy, were alive. No port site metastasis has been reported during the follow-up period.Conclusion: Our clinical experience confirms that LRS can be performed safely without compromising the oncological principles.