Browsing by Author "Sagir, Suleyman"

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Evolving Approach in Nephron-Sparing Surgery: Has Anything Changed From Open Surgery To Laparoscopy
(Iniestares, S.a., 2024) Ergun, Muslum; Sagir, Suleyman; Akyuz, Osman; Akman, Ramazan Yavuz
Objective: This study aimed to provide valuable insights into the comparative efficacy of different surgical approaches fornephron-sparing surgery (NSS) and contribute to the existing literature in this field. Materials and Methods: This study included patients who underwent NSS for small renal masses between January 2016 andMarch 2024. A total of 97 patients (41 in the open approach group, 56 in the laparoscopic approach group) with demographic,radiological, intraoperative, renal functional, and oncological follow-up data were included. Three different anatomical scoringsystems (R.E.N.A.L. nephrometry score, PADUA score and C-index) were utilised to assess tumour location and estimate prox-imity to the hilum and collecting system. Results: In the open nephron-sparing surgery (ONSS) and laparoscopic nephron-sparing surgery (LNSS) groups, the mean kid-ney tumour diameters (SD) were 5.20 +/- 2.30 and 4.90 +/- 2.10, which were similar in both surgical method groups (p= 0.061).However, tumours treated with ONSS had significantly more adverse morphometric features (p<0.05). For ONSS and LNSSgroups, the mean R.E.N.A.L. nephrometry scores (SD) were 6.15 +/- 2.04 and 5.2 +/- 1.4 (p= 0.032), respectively; The mean PADUAscores (SD) were 7.46 +/- 1.14 and 6.8 +/- 1.0 (p= 0.049), respectively; And the mean C-index (SD) scores were 1.39 +/- 0.4 and 1.37 +/- 0.5 (p= 0.062), respectively. No significant differences were found in the mean tumour diameter (cm) (Inter Quantile Range(IQR)) distribution of both groups (p= 0.058). Despite the slight increase in transfusion rate in the LNSS group, estimated bloodloss (EBL), transfusion rates, and length of hospital stay were similar in both groups. Conclusions: Although LNSS does not appear superior in terms of intraoperative blood loss, length of hospital stay and transfu-sion rate, it provides comparable long-term outcomes to ONSS. Our study suggests that when matched with nephrometry scores,LNSS can achieve similar outcomes to ONSS
The Performance of the Inflammatory Indexes in Predicting Double J Catheter Insertion Necessity Among Children and Adult Patients With Ureteral Stone
(Reial Acad Medicina Illes Balears, 2023) Azizoglu, Mustafa; Sagir, Suleyman
Objective: The present study was designed to examine the differences in NLR, PLR, and PNLR between two distinct patient groups, further examining their utility as diagnostic markers.Materials and methods: Patients were then separated into two categories: Group 1 (those not require DJ catheter insertion) and Group 2 (those needed DJ catheter insertion). Factors such as patient age, gender, symptoms, diagnosis, hematological parameters, and some indexes (NLR, PLR, and PNLR) were thoroughly assessed.Results: The research study featured 150 participants, split into two groups of 80 (Group 1) and 70 (Group 2) individuals. Despite average age differences, the distribution of ages was statistically significant. Group 1 had more children, while Group 2 contained more adults. Gender distribution between groups was not significantly different. Group 2 had larger mean stone sizes than Group 1. Stone location showed no significant variation between the groups. WBC and NEU were higher in Group 2, while LYM was higher in Group 1. There was no significant difference in MONO, PLT, and urea levels, but CRE level was higher in Group 2. NLR, PLR, and PNLR were also significantly higher in Group 2. Cut-off values for NLR, PLR, and PNLR had moderate to good predictive abilities. There was a positive correlation between stone size and PNLR index.Conclusions: Our study demonstrates the predictive utility of hematological parameters (NLR, PLR, PNLR) in determining the need for DJ catheter placement in ureteral stone patients.
Prognostic and Predictive Value of Tertiary Lymphoid Structures in Turbt Materials: Should It Be Seated in the Routine Pathological Examination, and Can It Be Used in Deciding on the Treatment Method?
(Elsevier Science inc, 2024) Yilmaz, Fatih; Sagir, Suleyman
Objective: This study aims to reveal the importance of tertiary lymphoid structures (TLS) in transurethral resection of bladder tumor (TURBT) materials with a practical and applicable method in which the effect of a certain threshold value on survival and treatment response can be implicated. Methods: TURBT materials that had not previously received any treatment (chemotherapy, radiotherapy, or immunotherapy) and were diagnosed for the first time at Mardin Training and Research Hospital between 2014 and 2022 were included in the study. The maximum TLS per 4x magnification field (field diameter: 4.5 mm) was recorded. Grouping and statistical analysis of the TLS number were performed using threshold values of ">= 1", ">= 2", and ">= 3". Results: TLSs were more frequently found in high-grade tumors (P = 0.008) and showed a strong association with stage progression (P < 0.001). It was also significantly associated with many adverse histopathological parameters. Conversely, high TLS (>= 1, >= 2, and >= 3) appeared to be associated with fewer recurrences (P = 0.032, P = 0.001, and P = 0.018, respectively), and cases with higher TLS showed longer recurrence-free survival (P = 0.089, P = 0.023, P = 0.037, respectively). TLS >= 3 was found to be an independent parameter that was associated with favorable RFS (P = 0.019, HR = 0.401), and multifocality was found to be an independent risk factor for RFS (P = 0.023, HR = 2.302). Conclusion: This study is the first to demonstrate the relationship between the presence and specific thresholds of TLS in TURBT materials with prognostic parameters. Including this information in the routine pathological examination of TURBT materials will allow a more accurate approach to treatment and follow-up, especially in patients with non-muscle invasive bladder cancer (NMIBC).
Subcutaneous Ring Block and Dorsal Penile Nerve Block Effectiveness in Male Circumcision: a Cross-Sectional Study
(Reial Acad Medicina Illes Balears, 2024) Sagir, Suleyman; Kose, Elif Ozge Cinar
Background: Our aim was to compare the effectiveness and postoperative implications of two regional anesthesia techniques, namely the subcutaneous ring block (SRB) and the dorsal penile nerve block (DPNB), when applied during routine circumcision in children. Patients and methods: This comparative retrospective study was conducted between the years 2021 and 2022. The subjects were patients who underwent circumcision during this period. The techniques compared were the subcutaneous ring block (SRB) (group 1) and the deep dorsal penile nerve block (DPNB) (group 2). Results: We observed that neither group had any instances of comorbidity or infection, rendering these factors statistically identical between the two groups (p=1.000 in both cases). Group 1 showed edema in 4 patients (21.2%) while it was reported in 12 patients (63.2%) in Group 2 (p =0.009). Similarly, bleeding was observed in 4 patients (21.2%) in group 1, but there were no instances of bleeding in group 2 (p =0.034). In terms of postoperative pain, group 1 had a higher average pain score (6.02 +/- 1.33) compared to Group: 2 (4.68 +/- 3.12) (p =0.040). In Group 1, 18 patients (94.7%) required postoperative analgesia, whereas in Group 2, only 3 patients (15.8%) needed it (p <0.001). Conclusions: Our comparative analysis demonstrates that the deep dorsal penile nerve block (DPNB) was associated with fewer postoperative complications, lower pain scores, and less need for postoperative analgesia than the subcutaneous ring block (SRB) in pediatric circumcision