Browsing by Author "Günşar C."
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Item Histopathological evaluation of the urethra after the Snodgrass operation: An experimental study in rabbits(2002) Genç A.; Taneli C.; Günşar C.; Türkdoǧan P.; Yilmaz O.; Arslan O.A.; Mir E.Objective: To investigate the histopathological outcome of the incised urethral plate after tubularized incised-plate urethroplasty (the Snodgrass procedure to repair hypospadias) in a hypospadiac rabbit model, as it can produce meatal and neourethral strictures, and healing with scarring. Materials and methods: The study comprised 10 male New Zealand White rabbits (2.2-2.4 kg); under general anaesthesia the ventral urethra was completely excised 1 cm from the meatus proximally and a model of hypospadias formed. A full-thickness incision was then made in the distal dorsal urethra and the two sides of the incision marked by Indian ink tattooing. After placing a feeding tube (5 F) as a urethral catheter, both urethral wings were sutured ventrally by a 7/0 polydioxanone running suture, and the penile skin approximated by 5/0 chromic catgut. At 21 days and 3 months after surgery the penises were harvested. assessed histopathologically, and compared with those from control untreated rabbits of the same age and weight. Results: In the study group the incised area of the dorsal urethra was re-epithelialized; the regional tissue and vascularity were normal. Conclusion: In this rabbit model the dorsal urethral incisions healed with no scar tissue: only the ventral suture lines had minimal fibrosis and inflammatory reaction.Item Meckel's diverticulum: Incidence and complications in childhood; [Meckel divertikülü: Siklik ve çocukluk çaǧindaki komplikasyonlar](2003) Günşar C.; Ceylan H.; Munis N.; Karaca I.; Mir E.Aim: Meckel's diverticulum is the most commonly seen congenital anomaly of the gastrointestinal system. Many complications related with this diverticulum could be seen in childhood. The aim of this study is to investigate the incidence of Meckel's diverticulum in our population and to evaluate the features of the complications originating from it. Method: The data about 1685 patients who underwent laparotomy in İzmir Behcet Uz Children's Hospital between 1990-1996 were investigated. The patients with Meckel's diverticula were classified as symptomatic or asymptomatic. The parameters evaluated were age, sex, clinical presentation, associated anomalies, type of complications related with Meckel's diverticulum, ectopic mucosa, surgical treatment and complications. Results: 25 patients were classified as asymptomatic whereas 35 were classified as symptomatic in a group of 60 patients with Meckel's diverticulitis. The average age was 4.7 years. The incidence was calculated as 1.51 %. The male female ratio (m/f) was 2.5/l and 2.6/l for symptomatic and for asymptomatic patients respectively. Intestinal obstruction (18 cases) was the most common clinical finding presented with vomiting and abdominal pain which were the primary symptoms. Fifteen diverticulum in the asymptomatic group, and all of them in the symptomatic group were excised. The ratio of ectopic mucosa was found as 16 % for the asymptomatic, and 51 % for the symptomatic cases. Symptomatic group had a 16 % complication rate. Conclusion: Meckel's diverticulum is a congenital structure, which is frequently encountered with the clinical presentation of intestinal obstruction in childhood causing life-threatening complications it should be investigated in the laparotomies performed for acute abdomen and where appendices were found innocent.Item MURCS association and rectovestibular fistula: Case report of a patient treated with one-stage posterior sagittal anorectoplasty and sigmoid loop vaginoplasty(W.B. Saunders, 2003) Günşar C.; Genç A.; Şencan A.; Daǧlar Z.; Alparslan O.; Mir E.MURCS association is rare, first described by Duncan in 1979, including nonrandom association of Mullerian duct aplasia or hypoplasia (MU), renal agenesis or ectopy (R), and cervicothoracic somite dysplasia. A 5-year-old girl was admitted to the clinic with a complaint of anteriorly located anus. Physical and radiologic examination of the patient found MURCS association with anorectal malformation (ARM) of rectovestibular-type fistula. She had multiple vertebral anomalies, left renal agenesis, vaginal and uterine agenesia, with a normal female 46,XX karyotype. Posterior sagittal anorectoplasty (PSARP) and sigmoid loop vaginal reconstruction was performed as a one-stage operation for the treatment of vaginal agenesis and ARM, There were no complications in the postoperative period. This combined one-stage operation can be used easily in the treatment of some components of the MURCS association such as vaginal agenesis and ARM as an associated anomaly. Copyright 2003, Elsevier Science (USA). All rights reserved.Item Foreign body extraction with endoscopy assisted tracheotomy: Case report; [Endoskopi yardimiyla trakeotomi ile yabanci cisim çikarilmasi: Olgu sunumu](2003) Günşar C.; Genç A.; Şencan A.; Taneli C.; Mir E.The authors present a rare case of foreign body aspiration treated with a recently defined technique. Endoscopy assisted tracheotomy was used for the removal of a broken plastic pen top from a child and the surgical methods used in the treatment of tracheobronchial foreign body aspiration are discussed.Item Does sucralfate prevent apoptosis occurring in the ischemia/reperfusion-induced intestinal injury?(2003) Şencan A.; Yilmaz Ö.; Özer E.; Günşar C.; Genç K.; Ulukuş Ç.; Taneli C.; Mir E.Background/Purpose: We have shown in a previous study that sucralfate is beneficial in the prophylaxis and treatment of hypoxia/reoxygenation-induced intestinal injury. The aim of this study is to investigate whether sucralfate has any effect on the prevention of apoptosis in the ischemia/reperfusion (I/R)-induced intestinal injury. Methods: Rats were randomized into three groups. Group 1 and 2 were subjected to I/R. Group 1 (treatment group) received sucralfate while group 2 (treatment control group) did not. Group 3 served as a normal control group (sham group). The terminal ileum was harvested for histopathologic investigation by light microscopy. The presence of apoptotic enterocytes (DNA fragmentation in cell nuclei) was detected by terminal deoxynucleotidyl transferase (TdT)-mediated dUTP nick-end-labeling (TUNEL) reaction. Results: In treatment control group, 3 of 7 rats had severe inflammation. None of the sucralfate-treated rats showed severe inflammation, 6 of them only showed mild inflammatory changes (p < 0.05). The apoptotic percentage was found to be 37.1 ± 9.4 in the sucralfate-treated group (group 1), whereas it was 45.4 ± 3.9 in the untreated group (group 2) (p < 0.05). The sham group had a completely normal intestinal architecture. Conclusions: The present study shows that 1) the experimental model of I/R-induced intestinal injury induces enterocyte apoptosis; 2) sucralfate decreases enterocyte apoptosis in the experimental model of I/R-induced intestinal injury which may play a key role in the pathophysiological events leading to failure of the intrinsic gut barrier defense mechanisms.Item Paraesophageal hiatal hernias in children(2003) Yazici M.; Karaca I.; Temir G.; Etensel B.; Günşar C.; Güçlü C.; Mutaf O.Hiatal hernia is a rare condition, which may be a cause of important clinical problems either as a mediastinal mass or as a cause of failure of the antireflux mechanism. Nineteen patients treated for paraesophageal hiatal hernias were included in the study. We investigated demographic data, diagnostic studies and symptoms of the patients together with the type of operation and outcome. Respiratory and gastrointestinal complaints were the prominent symptoms in most patients. Plain X-ray, contrast radiological study and esophagoscopy were used in the diagnostic workup. Surgical repair was performed via thoracic, abdominal or thoraco-abdominal approaches. Concomitant antireflux procedures were performed in 13 patients. Hiatal hernias in children may be asymptomatic or may present with a variety of symptoms or dramatic complications. Because of the risk of complications, surgical treatment is necessary shortly after diagnosis. Repair of the hiatus combined with antireflux surgery seems to yield satisfactory results.Item The effect of circumcision status on periurethral and glanular bacterial flora(2004) Günşar C.; Kurutepe S.; Alparslan O.; Yilmaz Ö.; Daǧlar Z.; Şencan A.; Genç A.; Taneli C.; Mir E.Introduction: Circumcision is a historical operation which is still performed for different purposes. The aim of this study is to investigate the changes in periurethral and glanular sulcus flora due to circumcision to determine the role of circumcision on urinary tract infections (UTIs). Patients and Methods: Fifty patients who were circumcised for social-religious reasons between January 2000 and January 2001 were evaluated in this prospective study. Two swabs were taken from the periurethral and glanular sulcus regions both just before circumcision and 4 weeks after, and the bacteria cultured were recorded. Results: We isolated pathogenic bacteria in the periurethral region of 32 (64%) patients (enterococci in 14 cases; Escherichia coli in 12 cases) before circumcision, and this number decreased to 5 (10%) after circumcision. Similarly, pathogenic bacteria were cultured from the glanular sulcus swabs of 33 (68%) patients (enterococci in 14 cases; E. coli in 10 cases), as well as coagulase-negative staphylococci in another 15 patients before circumcision. Following circumcision, we detected pathogenic bacteria in the glanular cultures of only 4 cases, whereas 40 children had non-pathogenic skin flora. Only 1 of 5 children with history of UTIs (n = 1) and retractable phimosis (n = 4) had periurethral pathogenic bacteria (Proteus spp.) in the post-circumcision period. The differences between pre- and post-circumcision values of the pathogenic bacterial colonizations were statistically significant in both groups sampled (p < 0.05). Conclusion: Non-circumcised patients have similar pathogenic bacterial colonizations in the periurethral and the inner preputial regions, although they have no phimosis. The origin of periurethral flora should be the deeper preputial regions. The flora greatly changed with skin commensals after circumcision. Circumcision might be beneficial from this point of view. Copyright © 2004 S. Karger AG, Basel.Item Testis-fixation in prepubertal rats: Fibrin glue versus transparenchymal sutures reduces testicular damage(2004) Şencan A.; Genç A.; Günşar C.; Daǧlar Z.; Yilmaz Ö.; Ulukuş Ç.; Özer E.; Taneli C.; Mir E.Experimental studies have shown that different suture materials used in testis fixation cause some degree of inflammation in the testis. This study was planned to compare the histological changes that were caused by fibrin glue which is a tissue sealant and by silk and polypropylene for transparenchymal testis fixation. 28 prepubertal rats were divided into 4 groups. Testis was fixed to the tunica vaginalis by fibrin glue in group 1, by silk in group 2 and by polypropylene in group 3. Group 4 was planned as a control. Testicular inflammation and seminiferous tubular diameter were evaluated for histological changes. The least inflammation was observed in the fibrin glue group, while the most inflammation occurred in the silk group. Seminiferous tubular diameter was 241.55 ± 45.90 in the fibrin glue group, 151.90 ± 8.34 in the silk group and 161.36 ± 9.96 in the polypropylene group. In conclusion, fibrin glue, when used for testis fixation, causes less inflammation and less destruction of seminiferous tubular diameter compared with silk and polypropylene.Item The maturity of intestinal neomucosa: Integrin expression and ultrastructural aspects(2004) Günşar C.; Vatansever H.S.; Arslan O.A.; Şencan A.; Müftüoǧlu S.; Özbilgin K.; Kaymaz F.; Mir E.Background/purpose The maturity of neomucosa growing on a serosal surface for the treatment of short bowel syndrome still is questionable. The aim of this study was to evaluate the intestinal neomucosa to assess its histologic maturity. Methods A 6-cm-long isolated ileal segment (IS) was prepared in 8 Wistar albino-type rats. The IS was divided from the antimesenteric side, and 2 intestinal tubes were established, which shared a common wall and a common pedicle. After ileal biopsy sampling for the control group (CG), the IS was fashioned into a mucous fistula. Eight weeks later, all the rats were killed, and the ISs were investigated for neomucosal growth. Sections were prepared with periodic acid shift (PAS) and H & E staining for light microscopy. They also were evaluated by transmission electron microscopy. The microscopic morphology of the 2 groups was evaluated. Immunohistochemical staining was performed to show the expression of the tissue β1, α3 and α2β1 integrin subunits of both the neomucosa (NS) and control group (CG) segments. Results Sections of the NS showed a well-arranged columnar epithelial cell layer with goblet cells that were generally located superficially and with a complete basement membrane. Under the electron microscope, the sections from the NS group showed an epithelial cell layer with proper microvilli of the same height, although they were shorter than those of the CG, and tight intercellular junctions between the epithelial cells. Significant differences between the NS and CG groups were found in the measurements of villus width at base, microvillus surface, and microvillus height. The lamina propria consisted of rich collagen fibers and active fibroblasts in the NS group. In the immunohistochemical staining, although β1 integrine showed a dense distribution (+++) in the lamina propria, particularly localizing at the depth of the tunica mucosa layer, α3 integrin was observed to have a less dense immunoreactivity (++) in both groups. The expression of α2β1 integrin showed slight and dispersed (+) staining. Conclusions The NS showed histologic maturity and ultimate structural similarity with the native small bowel mucosa, which provides strong indirect evidence for the proper functioning of the neomucosa. © 2004 Elsevier Inc. All rights reserved.Item Intrascrotal paratesticular lymphangioma; [Skrotum içi testis dişi lenfanjiom](2004) Günşar C.; Şencan A.; Demir M.A.; Genç A.; Küçükoǧlu T.; Taneli C.; Mir E.We present a case of cystic scratal lymphangioma who showed three different clinical presentations in fourty days. At his first admission, he had a soft, painless, transilluminating, scrotal mass which progressed to an acute scrotum like disease after inadequate excision. Following total excision of the mass, he had a local celhditis attack on the scrotal skin. His lesions healed without any sequela. For histopathological differential diagnosis we performed some immunohisiochcmical dyeing methods in addition to the classical hematoxylene-eosine stained sections. Scrotal lymphangioma should be kepi in mind for the differential diagnosis of inguinoscrotal lesions and with adequate, surgical interventions, the recurrences could be prevented.Item CHARGE association: Case report; [CHARGE birlikteliǧi: Olgu sunumu](2005) Yilmaz Ö.; Arslan O.A.; Genç A.; Kücükoǧlu T.; Günşar C.; Şencan A.; Mir E.; Taneli C.CHARGE association is a combination of a number of related birth defects and acronyme of the first letter of each defect. A 5-year-old male admitted to our hospital with complaint of passing urine through a stenotic hypospadic meatus. Physical examination showed that his weight was 10-20th percentiles and his height was 10-20th percentiles. He had a left sided bad ear. Ophthalmologic examination revealed microphthalmia, iris coloboma, choroid coloboma and lens coloboma of both eyes. External genital examination revealed a coronal hypospadias and a ventral chordee. His mental development was found 3.5 years in social, 4 years in motor skills. An urethroplasty was performed by the Snodgrass technique. Four of the 7 components of the CHARGE association were present in present case.Item The effects of transparenchymal suture material and fibrine-a tissue adhesive-on the contralateral testis(Turkiye Klinikleri, 2008) Dilşen Ç.; Şencan A.; Neşe N.; Kandiloǧlu A.R.; Yilmaz Ö.; Günşar C.; Genç A.; Taneli C.; Mir E.Objective: Experimental studies showed that fibrin glue (FG) which was used in orchidopexy and testicular torsion caused less tissue damage in the ipsilateral testis when compared with the transparenchymal suture materials. However, whether the usage of the FG in testis fixation causes any histological changes in the contralateral testis is not known. The aim of this study was to compare the effects of FG and other suture materials on the contralateral testis where no surgical procedure is performed. Material and Methods: Fifty prepubertal rats were randomly divided into 5 groups and the tunica vaginalis of all the right testes were longitudinally incised. In group 1, the incision line was closed with FG, whereas silk, catgut and polypropylene were used respectively in the groups 2, 3 and 4. Group 5 was the control group and no surgical procedure was performed on the left testes. The rats were sacrificed 3 weeks later and the diameters of the right and left testes were measured. Testes were evaluated by means of inflammation, seminiferous tubular diameter (STD), spermatogenetic activity and epididymal inflammation. Result: In group 2, 3 and 4, spermatogenetic activity, STD and the testis diameter of the ipsilateral testes decreased, whereas testicular and epidydimal inflammation increased. When the contralateral testis was evaluated, STD of the FG group decreased and FG had no extra benefit on testicular histology when compared to other suture materials. Conclusion: Surgical procedures performed on the ipsilateral testis cause only a decrease in the contralateral STD, which is observed by light microscope, but this decrease seems to have no effect on the spermatogenetic activity. Besides, the usage of FG instead of other materials in testis fixation has no extra benefit. However, it must be kept in mind that these results might vary when ultrastructural and immunological evaluations are performed. Copyright © 2008 by Türkiye Klinikleri.Item The effects of diclofenac on experimental testis torsion; [Diklofenak'in deneysel testis torsiyonundaki etkileri](2009) Daǧlar Z.; Günşar C.; Neşe N.; Şencan A.; Yilmaz Ö.; Genç A.; Taneli C.; Mir E.Aim: To investigate the late testicular effects of spermatic cord torsion and role of diclofenac on testicular injury. Material and Methods: In the first group (G1) of rats detorsion followed 4 hours of left testis torsion. For the second group (G2), detorsion followed 4 hours of torsion and diclofenac (2,5 mg/kg IM) administration. For the last group (G3), detorsion was performed after 4 hours of torsion and combined Diclofenac and Verapamil (10 mg/kg/IM) administration. Bilateral orchiectomy was done after 4 weeks. Spermatogenic activity and diameter of seminiferious tubules were evaluated. Results: When testicular weights were evaluated, the most significant increase was detected in the Diclofenac Group, whereas Verapamile group showed significant decrease both in the ipsilateral and contralateral testes. There were significant differences between 'G1 and G2' (p:0,002), 'G1 and G3' (p:0,04) and 'G2 and G3' (p:0,02) by means of seminiferious tubule diameters of torsioned testes. The most prominent increases in diameters were in the Diclofenac Group. We found significant differences for the seminiferious tubule diameters of the contralateral testes in between 'G1 and G3' (p:0,03) and 'G2 and G3' (p:0,003). Significant differences were found by means of spermatogenic activity of the torsioned testes between 'G1 and G2' (p:0.005), 'G1 and G3' (p:0.004), and 'G2 and G3'(p:0.02) groups. For the contralateral testes; the differences between 'G1 and G2'(p:0.003) and 'G1 and G3' (p:0.007)were significant. Conclusion: Unilateral testicular torsion-detorsion causes permanent damage in ipsilateral testes. Diclofenac partially prevented this injury. After sufficient investigations, its use in patients with testicular torsion can be beneficial.Item Pediatric ureteroceles: Diagnosis, management and treatment options(Brieflands, 2010) Günşar C.; Mir E.; Şencan A.; Ertan P.; Özcan C.U.Objective: The aim of the study was to evaluate clinical characteristics of ureteroceles particularly for diagnostic and treatment challenges. Methods: Data about patients treated for ureterocele in the two hospital clinics during 1996- 2009 are retrospectively evaluated. Findings: There were 12 girls and 7 boys. Symptomatic urinary tract infection was found in twelve cases. Ureterocele was associated with duplex systems in eleven cases. Vesicoureteral reflux was detected in 4 patients. Bladder diverticulum complicated with ureterocele in 1 patient. Ultrasonography diagnosed ureterocele in 12 patients. Renal scarring was detected in 6 patients at the side of ureterocele. Fifteen patients showed varying degrees of hydroureteronephrosis. Surgical therapy included upper pole nephrectomy in 3 cases. Bladder level reconstruction was performed in 11 cases. Five patients were treated only by endoscopic incision. In the follow up period 4 patients showed long term urinary tract infections whereas 3 of them were treated endoscopically. Postoperative reflux was still present in two patients who were treated by endoscopic incision. Conclusion: Ureterocele diagnosis and treatment show challenges. Urinary tract infection is important marker for urinary system evaluation. Preoperative management generally depends on a combination of diagnostic methods. Endoscopic incision needs serious follow up for postoperative problems. © 2010 by Pediatrics Center of Excellence.Item Antibiotic treatment is superior to ursodeoxycholic acid on total parenteral nutrition associated hepatic dysfunction(2010) Günşar C.; Vatansever S.; Var A.; Aygören R.; Yilmaz O.; Türköz E.; Şencan A.; Mir E.Purpose This study aimed to investigate the apoptotic mechanisms, oxidative stress, and mechanisms of effect of antibiotics and ursodeoxycholic acid (UDCA) in total parenteral nutrition (TPN)-associated liver injury. Methods Four groups of young rabbits were used in the study as follows: Group 1 (n: 7): TPN + Metronidazole (30 mg/kg IV) + Gentamicin (6 mg/kg IV); Group 2 (n: 7): TPN + UDCA (15 mg/kg per oral); Group 3 (n: 6): TPN only; and Group 4 (n: 7): Control group. After 10 days, the animals were killed and livers were removed. Hepatic apoptosis, apoptotic proteins, malondialdehyde (MDA) and myeloperoxidase (MPO) levels were studied in liver, and direct bilirubin values were assessed in the blood samples. Results Direct bilirubin increased with TPN, and antibiotic combination, as the most effective group, significantly lowered its levels (p<0.01). MDA values also showed significant differences in comparisons between G1 and G3 (p<0.05) and G1-4 (p<0.01). An increased number of apoptotic cells was detected particularly in G2 and G3, whereas the lowest levels, other than in the control group, were found in G1. All TUNEL-positive cell number data were statistically significant except between G2 and G3(p<0.05). Caspase-3 and Bax immunoreactivities were greatest in G2. Significant differences were shown in caspase-3 immunoreactivity between the groups (p<0.01), except between G1 and G3 (p>0.05). All comparisons between the groups were significant for Bax (p<0.01). In contrast, Bcl-2 immunoreactivity was moderate and highest in G1: comparisons between G1 and the other groups demonstrated statistically significant differences (p<0.01). Fas-L immunoreactivity was greatest in G2, and all comparisons between the groups were statistically significant (p<0.01). Conclusions Metronidazole and gentamicin combination is effective on TPN-induced liver injury by the Bcl-2 antiapoptotic pathway, total anti-apoptotic effect and by decreasing bilirubin levels. Oxidative injury in the liver increased with therapy. UDCA seems less effective on TPN-associated liver injury. © Springer-Verlag 2010.Item Tubularised incised plate urethroplasty is an applicable method for the treatment of the hypospadiac type of urethral duplication(Galenos Publishing House, 2011) Yilmaz Ö.; Günşar C.Urethral duplication is a rare congenital anomaly usually seen in males. We present a case of urethral duplication treated by a tubularised incised plate urethroplasty (TIPU) technique. A 5-year-old male boy was admitted to the clinic with the complaints of thin calibrated urinating and diurnal enuresis. We diagnosed distal penile hypospadias. During the operation, another urethral opening was found proximal to the previously seen hypospadiac meatus, localised on the coronary sulcus. We performed the TIPU procedure without excising the duplicated urethra. We only excised the common wall between the two urethras, and used the dorsal urethral plate of the duplicated urethra for tubularisation of the neourethra. The postoperative course was uneventful. A cystoscopy was done for suspected urogenital sinus. There was no further complaint at the third postoperative month. The TIPU technique can be successfully applied in such cases. The dorsal plate of the duplicated urethra can be used to form the neourethra. © Trakya University Faculty of Medicine.Item Antenatally diagnosed epigastric heteropagus twin: Case report; [Antenatal tanılı epigastrik heteropagus ikiz](Turkiye Klinikleri, 2012) Günşar C.; Şencan A.; Baytur Y.; Aşçi A.; MIr E.Conjoined twinning is a rare anomaly with a rate of 1 per 50 000-100 000 live births. Heteropagus twinning (parasitic twinning) is a specific and much rarer form of conjoined twinning. In this anomaly, while one of the twins (host twin) develops completely, the other one develops asymmetrically attached to and dependent upon the host (parasitic twin). Number of conjoined twins antenatally diagnosed as heteropagus is considerably few in the literature. Accurate antenatal diagnosis can be helpful to inform the family in the decision to terminate or continue with pregnancy. Antenatal three-dimensional sonography provides an accurate diagnosis and recognition of the details of the anomaly better. In this paper, a case that was diagnosed with epigastric heteropagus twinning with three-dimensional ultrasonography at 17 weeks of gestation with a successful separation with surgery is presented. © 2012 by Türkiye Klinikleri.Item Our approach to the treatment of pulmonary hydatid cyst; [Akciğer kist hidatiklerinde tedavi yaklaşımımız](Logos Medical Publishing, 2015) Gültekin Uyanik A.; Günşar C.; Genç A.; Taneli C.; Şencan A.; Yilmaz Ö.Parasitic hydatid disease caused by Echinococcus Granulosus is endemic in our country. Different from adults it can localized more frequently in lungs of the children With this article we evaluated our patients so as to present our approach in the treatment of pulmonary echinococcosis. We have investigated, retrospectively clinical sign of the patients with diagnosis of pulmonary cyst hydatid treated in our clinic, our medical and surgical treatment modalities, and their outcomes. The study population consisted of 8 boys and 4 girls, with a mean age of 10.5±3.9 years. Most commonly seen symptoms were cough (n:7), chest pain (n:3) and fever (n:3). In 7 patients disease was localized in right lung. Cysts were most frequently localized in the the upper and middle lobes rather than the lower lobe. In 3 patients additionally hydatic cyst was detected in the liver. Simple and complicated hydatid cysts were also detected in 6 and 4 patients, respectively. All the patients were treated surgically, following preoperative treatment with albendazole for an average of 22.7±9.04 days. Nine patients were treated surgically with standard posterolateral thoracotomy+partial excision, 1 patient with lobectomy,and anolther patient with segmentectomy. As a scolicidal agent we used 20% hypertonic NaCl solution. There were no need for intracavitary capitonnage except for fistulized areas. Postoperatively in 6 patients complications were seen [fistula;n:3, and, pneumothorax, n:3, and pleural effusion (n:3)]. Thoracoscopy+decortication were performed in one patient as a result of postoperative adhesions. Chest tubes of the patients were removed at postoperative 15.09±11.09 days, and mean hospital stay was 26.5±11.8 days. With use of albendazole starting preoperatively till postoperative third month, cyst drainage, and partial excision as surgical treatment without capitonnage it is possible to get preferred results. With this treatment modality we have no recurrences. © Cocuk Cerrahisi Dergisi. All rights reserved.Item Anorectal malformation with H-type fistula: Which surgical technique?; [H-Tipi Fistüllü Anorektal Malformasyon: Hangi Cerrahi Teknik?](Ortadog u Reklam Tanitim Yayincilik Turizm Egitim Insaat Sanayi ve Ticaret A.S., 2018) Tanriverdi H.I.; Günşar C.; Şencan A.H-type fistula is a very rare form of anorectal malformations. There is a fistula between anal canal and vestibulum vagen altough anus is located usual and it has a normal openness. One-years-old girl was hospitalized with the diagnosis of anorectal malformation, because of gaita discharge from vestibulum vagen during defecation. The fistule orifice was determined at the left lateral of vestibulum vagen altough the anus is located usual and had normal openness at the physical examination. The catheter, inserted from fistula orifice at the vestibulum, took out just over the dentat line at the anterior wall of the rectum. The anomaly was considered as anorectal malformation with H-type fistula. The fistula was excised with the anterosagittal approach. Recurrence did not determined at the following period of six mounths. There are various surgical techniques for the anorectal malformation with H-type fistula in the literature. In this article, a girl, who had H-type anorectal fistula corrected with anterosagittal approach, was presented and the surgical techniques in the literature were discussed. Copyright © 2018 by Türkiye Klinikleri.Item Giant congenital scrotal sinus(Elsevier Inc., 2020) Demi̇rtürk H.C.; Günşar C.; Usta İ.B.; Özamrak B.G.Congenital scrotal sinuses are extremely rare midline raphe anomalies in children. Quite few cases are published in the literature up to date. Their etiology is unclear but similar to the perineal midline cystic defects it is believed that during the early phases of embryogenesis they could arise from trapped epithelial cells as a result of incomplate closure of epithelial folds. Diagnosis depends on the physical examination and some radiological investigations such as ultrasonography and contrast studies. The preferred treatment is total excision of the sinus structure both for cosmetic reasons and the prevention of probable future complications. © 2020 The Authors