Person: GÜNSEREN, KADİR ÖMÜR
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GÜNSEREN
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KADİR ÖMÜR
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Publication A cut-off value for the operation time and other risk factors in terms of the infection risk for flexible ureterorenoscopy(Wiley, 2020-12-01) Demir, Aslan; Celen, Sinan; Gunseren, Kadir Omur; GÜNSEREN, KADİR ÖMÜR; Cicek, Mehmet Cagatay; ÇİÇEK, MEHMET ÇAĞATAY; Kilicarslan, Hakan; KILIÇARSLAN, HAKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı.; 0000-0001-8673-3093; 0000-0002-0471-5404; AAO-8934-2021; ABC-9924-2020Objectives To investigate the operation time (OT) and ureteral access sheath (UAS) usage with the infection rates and to determine a cut-off value for OT.Methods We retrospectively analysed the data of the patients who underwent flexible ureterorenoscopy (FURS) for renal stones larger than 20 mm between 2010 and 2019. The investigated parameters were OT, UAS using, and infection status. The data were analysed by forming two groups according to whether the OT was less than 60 minutes and more, whether the UAS was used and whether an infection occurred. In addition, independent risk factors that may affect postoperative urinary infection development were also investigated by logistic regression analysis. And, a Receiver Operating Characteristic (ROC) curve analysis was applied to determine a cut-off value in OT terms, where infection rates increase more.Results A total of 575 patients were enrolled in the study. The rates of the usage of UAS and infection were greater statistically in the group for longer than 60 minutes. OT was longer statistically in the infection group than in the group without infection (94.1 +/- 14.2 and 68.01 +/- 23.1, for groups 1 and 2, respectively, P < .05, Table 2). OT was statistically longer in the UAS group than the unused one (79.3 +/- 24.4 and 66.7 +/- 22.4, for groups 1 and 2, respectively, P < .05, Table 3). ROC analyses revealed a cut-off point of 87.5 min for OT in terms of infection rate.Conclusion While the infection risk increases when OT exceeds 60 minutes, FURS can be safely performed up to 87.5 minutes with 89% sensitivity and 69% specificity infection risk.Publication Comparison of laparoscopic pyelolithotomy and retrograde intrarenal surgery in the management of large renal pelvic stones(Wiley, 2021-03-02) Çiçek, Mehmet Çağatay; Asi, Tariq; Günseren, Kadir Ömür; Kılıçarslan, Hakan; ÇİÇEK, MEHMET ÇAĞATAY; GÜNSEREN, KADİR ÖMÜR; KILIÇARSLAN, HAKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı; 0000-0002-0471-5404; 0000-0001-8673-3093; ABC-9924-2020; HGM-5995-2022; FGY-3115-2022Background To compare the clinical outcomes of laparoscopic pyelolithotomy (LP) and retrograde intrarenal surgery (RIRS) in the management of large renal pelvic stones.Patients and methods This study included patients who presented with a single renal pelvic stone sized >= 20 mm and who were treated primarily by LP or RIRS. The patients were grouped based on the surgical procedure they underwent. We retrospectively examined and compared the age, the longest axis, and the surface area of the stone, operation time, hospitalization time, complications, and stone-free rates of the two groups.Results Of the 156 patients included in the study, 44 had LP, and 112 had RIRS. Patients who received LP (13 males, 31 females) had a median age of 54 (18-79) years, while those who underwent RIRS (46 males, 66 females) had a median age of 54.5 (18-79). Patients who received LP were found to have larger median stone size (30 mm vs 24 mm, P = .003), longer operation time (100 minutes vs 70 minutes, P = .007), lower complication rate (2% vs 8.9%, P = .063), longer median hospital stay (3 days vs 1 day, P < .001) and better stone-free rate at the third month (90.9% vs 67.9%, P < .001).Conclusion LP is a safe and efficient procedure that could be used as an alternative to RIRS in managing large renal pelvic stones.Publication Evaluation of one year, five years and ten years life time of patients with kidney transplant: Single-center experience(Lippincott Williams & Wilkins, 2020-09-01) Elgin, Ersin; Aydın, Mehmet Fethullah; Ünsal, Oktay; Yıldız, Abdulmecid; Oruç, Ayşegül; Günseren, Kadir Ömur; Çiçek, Mehmet Çağatay; Budak, Ferah; Oral, H. Barbaros; Ersoy, Alparlan; Elgin, Ersin; Aydın, Mehmet Fethullah; Unsal, Oktay; Yıldız, Abdulmecid; ORUÇ, AYŞEGÜL; GÜNSEREN, KADİR ÖMÜR; ÇİÇEK, MEHMET ÇAĞATAY; BUDAK, FERAH; ORAL, HALUK BARBAROS; Ersoy, Alparlan; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Bursa Bölge Koordinasyon Merkezi.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İmmünoloji Anabilim Dalı.; 0000-0002-9509-5799; 0000-0002-5665-7402; 0000-0002-0342-9692; 0000-0001-7625-9148; 0000-0003-0463-6818; F-4657-2014; K-7285-2012; AAH-4002-2021; AAJ-8220-2020; IZP-9398-2023; DXA-2790-2022; JKA-8956-2023; JJY-8484-2023; EIF-8983-2022; JJO-6552-2023; CNT-9025-2022Publication 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 The effects of laparoscopic urologic surgery on cardiac functions: A pulse wave velocity study(Aves, 2020-07-01) Çiçek, Mehmet Çağatay; Kaynak, Yurdaer; Gunseren, Kadir Ömur; Kaygısız, Onur; Vuruşkan, Hakan; ÇİÇEK, MEHMET ÇAĞATAY; GÜNSEREN, KADİR ÖMÜR; KAYGISIZ, ONUR; VURUŞKAN, HAKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı.; 0000-0002-0471-5404; 0000-0001-8673-3093; 0000-0002-9790-7295; ABC-9924-2020; L-9439-2019; HGM-5995-2022 ; EFH-9523-2022Objective: The aim of this study is to evaluate the effects of laparoscopic urologic surgery on cardiac functions by the parameter pulse wave velocity (PWV), a noninvasive method.Material and methods: Between July 2012 and February 2013, a total of 47 patients were included in this prospective controlled study. Patients who have been scheduled for laparoscopic surgery (LS) (n=30) and open surgery (n=17) were enrolled in the study. Preoperative, perioperative, and postoperative cardiovascular parameters were measured by a PWV instrument, and the results were compared between laparoscopic (L) group and open (C) group.Results: In the L group, compared to preoperative values, perioperative systolic arterial pressure, diastolic arterial pressure, and mean arterial pressure increased considerably, by 2.6%, 7.9%, and 4.7%, respectively. This was in contrary to reductions in these parameters by 9.5%, 5.7%, and 10%, respectively, in the C group. For the I. group, cardiac output (CO) and cardiac index (CI) were increased in the perioperative period and decreased in the postoperative period. For the C group, there were no changes in measurements of perioperative and postoperative CO and CI. However, these changes in CO and CI were not significantly different between the L and C groups. Postoperative large artery elasticity index decreased in both groups. However, these changes did not represent significant difference between groups.Conclusion: Compared to open surgery, LS may cause increases in perioperative blood pressures. In addition, increased blood pressures may last even on the first postoperative day. These effects may be more important for patients with high cardiovascular risk.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.