Suleyman Cuneyt Karakus

The comparison of dextranomer/hyaluronic acid and polyacrylate-polyalcohol copolymers in endoscopic treatment of vesicoureteral reflux

BACKGROUND Dextranomer/hyaluronic acid (Dx/Ha;Dexell®) and polyacrylate-polyalcohol copolymer (PPC;Vantris®) are the popular tissue-augmenting substances using for the endoscopic injections of vesicoureteral reflux (VUR). The aim of the study is to evaluate and compare Dx/Ha and PPC in terms of effectiveness, injection techniques and complications with special emphasis on vesicoureteral junction obstruction (VUJO). METHODS A total of 95 patients who underwent endoscopic VUR treatment between 2009 and 2015 were retrospectively reviewed. The patients were divided into two groups: group 1: Patients underwent endoscopic treatment with PPC (n=50 patients, 70 renal refluxing units) group 2: Patients underwent endoscopic treatment with Dx/Ha (n=45 patients, 74 renal refluxing units). RESULTS The overall resolution rates based on the number of renal refluxing units studied was 88.6% and 70.3% in group 1 and group 2, respectively. Resolution rates were significantly better in group 1 compared to group 2. VUJO requiring ureteral reimplantation or stent insertion developed in 7 patients in group 1. No VUJO was observed in group 2. VUJO in group 1 was markedly higher than that in group 2. CONCLUSIONS Endoscopic treatment of VUR with PPC promises better resolution rates but higher VUJO rates compared to Dx/Ha.

Delayed diagnosis: An important prognostic factor for oesophageal atresia in developing countries.

The aim of this study is to analyse the effect of delayed diagnosis on mortality rates, and evaluate the role of delayed diagnosis as a new prognostic factor in patients with oesophageal atresia (OA), especially in developing countries.

The passage of meconium alone is not a sign of correctly positioned anus

Abstract Objective: The aim of this study is to determine the consequences of delayed presentation of anorectal malformations and emphasize the causes of delayed diagnosis of these malformations. Methods: We retrospectively reviewed 54 neonatal patients with a diagnosis of anorectal malformations. Group 1 consisted of 35 patients diagnosed within the first 48 h of life and Group 2 included 19 patients diagnosed after 48 h of life. Results: Obstructive symptoms at the time of diagnosis, overall complications and the mean postoperative hospitalization period in Group 2 were markedly higher than that of Group 1. A comprehensive neonatal examination within the first 48 h of life was performed in 32 (91.4%) patients in Group 1 and 5 (26.3%) of the patients in Group 2 (p < 0.001). Conclusions: The passage of meconium is not the only sign of correctly positioned anus. A careful physical examination and awareness of this anomaly are of great importance in making a timely diagnosis of anorectal malformations.

A bladder stone within a congenital paraureteral diverticulum: a case report.

Paraureteral diverticula are rare in pediatric population. We here present a bladder stone in the congenital paraureteral diverticulum presenting with vesicoureteral reflux. To the best of our knowledge, stone formation in paraureteral diverticulum has not been reported previously. A 5-year-old boy was admitted with the complaint of dysuria. Abdominal ultrasonography revealed a bladder stone in a diverticulum arising from right posterolateral wall and a small right kidney. Voiding cystourethrogram confirmed large bladder diverticulum with vesicoureteral reflux. Cystoscopy revealed a giant stone in the paraureteral diverticulum. The stone was removed with open diverticulectomy and right Cohen ureteroneocystostomy was performed.

Diseases mimicking intussusception: diagnostic dilemma.

Intussusception is a common abdominal emergency in early childhood. The aim of this study was to describe the diseases mimicking intussusception and to discuss the causes and management of these conditions.

Totally implantable central venous port catheters: a 10- year single-center experience

Totally implantable port catheters facilitate the administration of cytotoxic drugs, antibiotics, blood products and fluids in children with hematologic and oncologic diseases or organ failures. The aim of this study is to evaluate the characteristics of patients and results of port catheter insertions. We retrospectively reviewed demographic and clinical properties of 224 children who underwent implantable port catheter insertions in order to receive long-term intravenous treatment between 2003 and 2013. Port catheters were implanted in 224 patients (124 female and 100 male). The mean age of patients was 5.04±3.75 years (2 months-18 years). The most common oncologic diagnose was acute lymphoblastic leukemia. Seventy-two port catheters were removed due to infection in 40 and completion of treatment in 32 patients. 25 of 152 port catheters inserted via subclavian puncture and 15 of 90 port catheters inserted via jugular cut down were removed due to infection (P=0.965). Port catheters were inserted 3 times in 3 patients and 2 times in 15 patients. The mean duration of usage was 442.5±381.3 days among patients whose catheters were removed due to infection and 964.4±298.8 days among patients whose treatments were completed (P<0.001). Pneumothorax or hemothorax were observed in none of the cases. Four patients needed revision of eroded skin over the chamber. We were not able to remove the catheter from right jugular vein in a patient due to firm adhesion of catheter to the vessel wall. Catheter migration occurred in one patient and removed by endovascular procedure. Implantable