Browsing by Author "Sencan A."
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Item Primary Duhamel-Martin operations in neonates and infants(2001) Mir E.; Karaca I.; Günsar C.; Sencan A.; Fesçekoǧlu O.Background: With advances in neonatal anesthetic and surgical care, a safe, one stage, definitive procedure has been possible in Hirschsprung's disease. Since 1996, we have performed this type of operation in the neonatal and early infancy period. We aimed to review our data to state the feasibility of this operation in these age groups. Methods: At Dr Behçet Uz Children's Hospital, we treated 10 patients with a single stage Duhamel-Martin operation between 1996 and 2000. Of the 10 patients, seven were boys. Six patients were diagnosed in the first week of the neonatal period. We evaluated these 10 patients by means of age, sex, age at diagnoses, operational age, diagnostic tools, properties of operation, complications and results. Results: The patients were all full-term delivery and had a mean birthweight of 3 kg. The presenting clinical features were abdominal distention (100%), constipation (100%) and vomiting (70%). One patient was a Down syndrome patient, while another patient showed familial Hirschsprung's disease. Contrast enemas gave positive results in eight patients. Definitive diagnoses were performed with rectal biopsy specimens. The extension of the disease was rectosigmoid in nine patients and descending colon in one patient. Five patients were in the newborn period at the time of the operation, while the oldest one was 7 months old. In the postoperative period, two children were treated because of early abdominal eventration and evisceration of the wound. Postoperative enterocolitis occurred in two patients. These 10 patients have been followed-up for a period of 3 years, and spontaneous defecation and weight gain was observed in all of the patients. Conclusions: Our study confirmed the published data that this operation could be performed as an easy and safe procedure in the neonatal and early infancy period.Item Pyloric atresia associated with multiple intestinal atresias and pylorocholedochal fistula(W.B. Saunders, 2002) Sencan A.; Mir E.; Karaca I.; Gunsar C.; Sencan A.; Topcu K.Although congenital pyloric atresia commonly occurs in isolation, it has rarely been reported in association with other alimentary tract atresias. This is a report of a newborn with congenital pyloric atresia associated with duodenal atresia, jejunal atresia, apple-peel ileal atresia, and pylorocholedochal fistula. Preoperative diagnosis was duodenal atresia because of bilious vomiting, and erect radiogram showed double bubble sign. The presented case is the first report of such an association. Copyright 2002, Elsevier Science (USA). All rights reserved.Item Isolated esophageal atresia with spontaneous recanalization: Case report(W.B. Saunders, 2002) Gunsar C.; Sencan A.; Karaca I.; Mir E.Isolated esophageal atresia is characterized by a long segment between the 2 esophageal pouches. The authors describe a case of pure esophageal atresia that showed spontaneous recanalization in the waiting period for primary esophageal anastomosis. Regurgitation of gastrostomy formula surprisingly was seen in her mouth. The patency of the esophagus was confirmed with thoracic computed tomography (CT) and an esophagogram. A strictured area in the proximal upper third of the esophagus was managed with baloon dilatation. She was discharged in normal condition, feeding by mouth, and with a normal esophagogram. This interesting event led us to speculate about a different type of pure esophageal atresia with the feasibility of the ends recanalizing after some events such as inflammation. This could be the subtype 115 of type 2 in Kluth's atlas of esophageal atresia in which they described 2 blind esophageal ends and a cyst occupying the intervening space. Another speculation about this subject is the presence of double membranes associated with esophageal atresia with a normal outer appearance of the esophagus as was first described by A. F. van Loosbroek. Copyright 2002, Elsevier Science (USA). All rights reserved.Item Blunt renal injuries in Turkish children: A review of 205 cases(2003) Ceylan H.; Gunsar C.; Etensel B.; Sencan A.; Karaca I.; Mir E.A retrospective analysis of the medical records of 205 children with renal injuries secondary to blunt abdominal trauma is used to make recommendations regarding the initial diagnostic and therapeutic approaches in this type of patient. It was found that the absence of hematuria on initial urinalysis does not exclude a serious renal injury. Thus, following blunt abdominal trauma, all children should undergo imaging procedures to exclude renal injury, whether they have hematuria or not. Ultrasound is a good initial screening procedure in all patients. Computed tomography is recommended for the definitive evaluation of suspected major renal injuries. Since even major renal injuries may heal without surgical intervention, conservative management is the recommended initial treatment of choice. Surgery is reserved for those children who are hemodynamically unstable and those that develop complications.Item Modification of meatal advancement and glanuloplasty for correction of distal hypospadias(2004) Taneli C.; Genç A.; Günsar C.; Sencan A.; Arslan O.A.; Daglar Z.; Mir E.Objective: The meatal advancement and glanuloplasty (MAGPI) technique is still successfully used for the repair of distal hypospadias. The technique has been modified considerably since it was first described in 1981. The primary drawbacks of the procedure are the complications of meatal regression and meatal stenosis. The aim of this study was to present a modification of MAGPI for correction of distal hypospadias. Material and Methods: Ten cases with distal hypospadias were operated on using our modified MAGPI procedure. The modification involves excision of a pull-out, tag-shaped piece of glanular tissue through the vertical incision in the meatoplasty section of the original operation. By means of this excision, burying of the meatus into the glans was eased without inducing extra mobilization of the glans wings. As less glans tissue was left at the dorsal urethra the urethral meatus could be replaced in the center of the glans and better anatomic reconstruction could be attained. Results: After 1-3 years of follow-up, all the operated cases showed functionally and cosmetically satisfactory results. The cosmetic appearance achieved with our modified technique was better than that obtained with the classical MAGPI procedure. Conclusions: Using our MAGPI modification, the urethra was localized deeper in the glans and an elliptical (slit-like), wide meatus was obtained, the cosmetic appearance of which was more acceptable than that achieved with classical MAGPI.Item Effect of adhesion barrier (Interceed TC7) on two-stage orchidopexy operation(2004) Genc A.; Taneli F.; Yilmaz O.; Turkdogan P.; Arslan O.A.; Sencan A.; Taneli C.Objective: In two-stage orchidopexy, adhesions formed after the first stage usually cause difficulty during the second operation and may even lead to injury to the testis itself or to the spermatic cord. We investigated whether the use of adhesion-preventing barriers in the abdominal or pelvic region during surgery could lessen adhesions formed during two-stage orchidopexy and thus ease dissection. Material and Methods: The study subjects comprised 21 male, albino, 30-day-old Wistar rats that were divided into three equal groups. In Group 1, the right testes were enveloped in adhesion barriers after dissection and sutured to the inguinal canal. In Group 2, the right testes were sutured to the inguinal canal without the barriers. In Group 3 (sham-operated group), all testes were dissected but no suturing was performed. Rats were sacrificed after 21 days and the ipsilateral testes were harvested. Results: Dissection of barrier-enveloped testes was relatively easy; however, no significant (p < 0.535) difference was seen in adhesion scores between Groups 1 and 2. Total tissue collagen was estimated by means of the hydroxyproline content. Tissue hydroxyproline levels were 16.04 ± 8.58, 13.20 ± 6.34 and 14.71 ± 5.51 μg/mg wet tissue in Groups 1-3, respectively and these differences were not significant. The histopathologic evaluation revealed significant differences only in the thickness of the tunica albuginea in Groups 1 and 2 (110.0 ± 30.0 vs 77.1 ± 21.3 μm, respectively; p < 0.038). Conclusion: The adhesion scores and the biochemical and histopathological examinations showed that an adhesion barrier is not beneficial in two-stage orchidopexy.Item Effect of alarm treatment on bladder storage capacities in monosymptomatic nocturnal enuresis(2004) Taneli C.; Ertan P.; Taneli F.; Genç A.; Günsar C.; Sencan A.; Mir E.; Onag A.Objective: Despite a great number of studies, very little is known about the mechanism of action of enuresis alarm systems. Nevertheless, as a result of this treatment many children are able firstly to wake up before urination occurs and then, in time, to sleep through the night without voiding. The aim of this study was to investigate the effect of enuresis alarms on bladder storage capacities. Material and Methods: A total of 28 children aged >7 years who were not polyuric but who voided once every night, slept alone in their own bedroom and who were willing, along with their family members, to cooperate were recruited. Patients were asked to record their urine output using a frequency/volume chart for two consecutive days. After these records and the results of physical and laboratory examinations were taken into consideration, treatment was instituted with the bell-and-pad (alarm) system for a period of 12 weeks. At the end of this period, patients were asked to complete another frequency/volume chart. Results: The pre- and post-treatment maximum functional bladder capacity was 178.35 ± 87.86 ml and 243.03 ± 102.84 ml, respectively and the pre- and post-treatment mean day-time bladder capacity was 111.11 ± 45.87 and 148.445 ± 7.68 ml. Both of these differences were statistically significant (p < 0.0001 and <0.0001, respectively). The maximum nocturnal bladder capacity was found to be increased from 177.85 ± 84.95 to 255.25 ± 124.52 ml after treatment (p < 0.0001). Conclusion: Treatment with the alarm system for a period of 12 weeks was seen to be associated with a significant increase in bladder storage capacities (maximum nocturnal bladder capacity, maximum functional bladder capacity and mean day-time bladder capacity).Item Treatment and prophylaxis with sucralfate ameliorates hypoxia/ reoxygenation-induced intestinal injury in pup rats(2005) Sencan A.B.; Sencan A.; Aktas S.; Habif S.; Kabaroglu C.; Parildar Z.; Karaca I.Background: Sucralfate is widely used as a cytoprotective agent in patients with peptic ulcer and other intestinal mucosal injury. The aim of this study is to investigate whether sucralfate has any effect on the prevention and treatment of hypoxia/reoxygenation-induced intestinal injury. Material/Methods: Four groups of 10 1-day-old rat pups were studied. Hypoxia/reoxygenation (H/O)-induced intestinal injury was created. Group 1 was subjected to H/O just after birth and sacrificed at the end of the third day (Treatment Control). Group 2 was subjected to H/O just after birth and treated with sucralfate for 3 days. They were sacrificed at the end of the third day (Treatment). Group 3 was subjected to H/O on the third day after birth and then sacrificed (Prophylaxis Control). Group 4 was treated with sucralfate for the first 3 days, then H/O was created. Just after H/O, the pups were sacrificed (Prophylaxis). The intestinal tissues were harvested for histopathological investigation. Malondialdehyde (MDA) levels in the intestinal tissues were determined. Results: The mucosal injury grades of the treatment and prophylaxis groups were significantly lower than those of control groups (p<0.05). The mean MDA level in the treatment and prophylaxis groups were 0.42±0.17 and 0.21±0.23 nmol/mg respectively. The MDA levels of both groups were significantly lower than in the control groups (p<0.05). Conclusions: The present study shows that sucralfate has beneficial effects in an experimental model of hypoxia/reoxygenation-induced intestinal injury. © Med Sci Monit, 2005.Item Long-term effect of pentoxifylline and NG-nitro-L-arginine methyl ester on testicular function in spermatic artery ligation(2006) Yilmaz O.; Genc A.; Taneli F.; Demireli P.; Kocakoc I.D.; Sencan A.; Gunsar C.; Mir E.; Taneli C.Objective. To investigate long-term testicular function in pentoxifylline- and NG-nitro-L-arginine methyl ester (L-NAME)-treated rats prior to spermatic artery ligation by assessing serum inhibin B concentration, a reliable endocrine marker of spermatogenesis. Material and methods. Forty prepubertal rats were randomly divided into four equal groups. Right orchiectomy was performed in all rats. Intraperitoneal pentoxifylline and L-NAME were administered to Groups 1 and 2, respectively. Rats in Group 3 did not receive any medication. The spermatic arteries of the left testes were ligated in all groups with the exception of the sham controls (Group 4). One month postoperatively, a histopathologic evaluation was performed and serum inhibin B concentrations were assessed in all groups. Results. There were no statistically significant differences in testis size or serum inhibin B concentration between Groups 1, 2 and 3. However, the testes were significantly smaller (p1=0.01, p2=0.01, p3 =0.01) and serum inhibin B levels were significantly decreased (p1=0.01, p2 =0.01, p3 =0.01) when Groups 1-3 were compared with Group 4. Histopathological evaluations revealed necrosis and calcification in all specimens with the exception of the sham-operated group. Conclusions. The long-term outcomes of spermatic artery ligation were poor and testicular atrophy developed in rat testes in all study groups. Testicular atrophy could not be reversed by preoperative administration of pentoxifylline and L-NAME. © 2006 Taylor & Francis.Item A rare cause of glans penis masses in childhood: Fibroepithelial polyp(Medknow Publications, 2014) Sencan A.; Sencan A.; Gunsar C.; Cayirli H.; Nese N.Fibroepithelial polyps of glans penis are very rarely seen in childhood. A 6-month-old male admitted to our institution with a slowly enlarging glans penis mass on the ventral side of the glans penis. The mass was totally excised, and hystopathological diagnosis was a fibroepithelial polyp. All of the reported cases published previously, except one, are of adult age and all of them have been associated with the history of long-term condom catheter use. The presence of the case in childhood; however, suggests that the pathology might be congenital. This is the second pediatric case presented in the English literature.Item The radiologic evaluation of pediatric acute abdomen; results of tertiary referral center(ARSMB-KVBMG, 2015) Yilmaz G.; Pekindil G.; Akpinar S.; Sencan A.; Günsar C.; Mir E.; Özkol M.Purpose: In this study we aimed to evaluate the radiological examinations of the pediatric patients who were operated with initial diagnosis of acute abdomen. Methods: We retrospectively reviewed the clinical records and imaging findings of 252 children. All patients were evaluated by plain abdominal radiographs (PAX) and ultrasonography (US). Only 10 patients were examined using computed tomography (CT). The findings of the PAX, US and CT of each patient were determined from their detailed archive records according to their clinical diagnosis. Results: The most frequent pathology was appendicitis in our study whereas the other pathologies were invagination, ovarian torsion, the complications of Meckel's diverticulum, gastrointestinal obstruction and tuboovarian abscess in decreasing frequency. PAXs were valuable in diagnosis of the patients with ileus. It has been showed that US was the most useful for patients with appendicitis and invagination. CT was performed only in 4% of our cases as an advanced diagnostic method. Conclusion: The pediatric patients with acute abdomen have been evaluated radiologically by PAX and US routinely and frequently. CT was performed as an advanced diagnostic method very rarely. CT would be utilized to a lower extent as a more advanced method of imaging in unsolved patient group, as US and PAX solve the pediatric acute abdominal pathologies in high percentages. © 2015 The Author(s).Item Comparison of the learning curves and frustration level in performing laparoscopic and robotic training skills by experts and novices(Kluwer Academic Publishers, 2015) Passerotti C.C.; Franco F.; Bissoli J.C.C.; Tiseo B.; Oliveira C.M.; Buchalla C.A.O.; Inoue G.N.C.; Sencan A.; Sencan A.; do Pardo R.R.; Nguyen H.T.Introduction: Robotic assistance may provide for distinct technical advantages over conventional laparoscopic technique. The goals of this study were (1) to objectively evaluate the difference in the learning curves by novice and expert surgeons in performing fundamental laparoscopic skills using conventional laparoscopic surgery (CLS) and robotic-assisted laparoscopic surgery (RALS) and (2) to evaluate the surgeons’ frustration level in performing these tasks. Methods: Twelve experienced and 31 novices in laparoscopy were prospectively evaluated in performing three standardized laparoscopic tasks in five consecutive, weekly training sessions. Analysis of the learning curves was based on the magnitude, rate, and quickness in performance improvement. The participant’s frustration and mood were also evaluated during and after every session. Results: For the novice participants, RALS allowed for shorter time to task completion and greater accuracy. However, significant and rapid improvement in performance as measured by magnitude, rate, and quickness at each session was also seen with CLS. For the experienced surgeons, RALS only provided a slight improvement in performance. For all participants, the use of RALS was associated with less number of sessions in which they felt frustrated, less number of frustration episodes during a session, lower frustration score during and after the session, and higher good mood score. Conclusion: The advantages of RALS may be of most benefit when doing more complex tasks and by less experienced surgeons. RALS should not be used as a replacement for CLS but rather in specific situations in which it has the greatest advantages. © 2015, Springer Science+Business Media Dordrecht.Item The role of CAPE in PI3K/AKT/mTOR activation and oxidative stress on testis torsion(Elsevier GmbH, 2016) Dilber Y.; Inan S.; Ercan G.A.; Sencan A.Ischemia reperfusion injury arises from testicular torsion resulting in a loss of spermatogenesis and significant germ cell apoptosis. This study evaluates the prooxidant/antioxidant effects of caffeic acid phenethyl ester (CAPE) through PI3K/AKT/mTOR signal pathways on testis torsion. A total of (28) male Wistar rats were divided randomly into 4 groups (n= 7 for each group):group A (sham) group,group B torsion/detorsion group, group C (saturation group, during four days of CAPE, one dose (10. μmol/kg, i.p)) and group D (a single dose of CAPE 2 h after torsion and before detorsion). At the end of the study, unilateral orchiectomies were performed for measurements of MDA and 8OHdG levels, histopathologic and immunohistochemical and TUNEL apoptotic cell examination. Testicular torsion-detorsion led to a significant decrease in the mean values of the Johnsen's scores and a significant increase in the apoptotic cell values of group B. There were no significant differences between group D and group A. In addition, the MDA and 8OHdG levels increased significantly in group B. The MDA and 8OHdG values were lower in group D. However, the 8OHdG levels were higher in group C than the groups A and D. On the other hand, CAPE suppresses mTOR activation and reduces the apoptosis on ischemia/reperfusion damage in rat testis. These results demonstrate that CAPE suppresses mTOR activation and reduces the apoptosis on ischemia/reperfusion damage in rat testis. © 2015 Elsevier GmbH.Item Sonic hedgehog, TBX18, and TSHZ3 proteins involved in pyeloureteral motility development are overexpressed in ureteropelvic junction obstruction: An immunohistochemical, histopathological, and clinical comparative study(Saudi Arabian Armed Forces Hospital, 2016) Yilmaz O.; Nese N.; Dalgic M.; Kesici G.P.; Genc A.; Taneli C.; Gunsar C.; Sencan A.; Cayirli H.; Isisag A.Objectives: To compare pathological samples obtained from cases that underwent surgery for ureteropelvic junction (UPJ) obstruction with samples obtained during autopsies of subjects. Methods: Retrospectively, 42 patients who had undergone surgery due to UPJ obstruction (group 1) were included in the study. Histopathological and immunohistochemical features for sonic hedgehog (SHH), TBX18, and TSHZ3 of UPJ were evaluated and findings were compared with 20 autopsy cases (group 2). Original Articles Results: In group 1, the scores were statistically significantly higher in terms of cytoplasmic SHH, nuclear TBX18, cytoplasmic and nuclear TSHZ3 staining. Statistically, no correlation was found between age and the staining scores belonging to these 3 antibodies in group 1 and group 2. Intense inflammation was found to be related with nuclear staining for TBX18. Conclusion: Gene product expressions of SHH, TBX18 and TSHZ3 are statistically higher in patients with UPJ obstruction, when compared with control group. The explanation may be the reactivation of the processes, which had shown their effects in the embryological period, due to the chronic inflammation and long-term micro-trauma created by the disease. © 2016, Saudi Arabian Armed Forces Hospital. All rights reserved.Item A new surgical technique and intraoperative flourescent molecular imaging for biliary reconstruction(Ondokuz Mayis Universitesi, 2016) Sencan A.; Gridley C.; Nguyen H.T.; Sencan A.Up to date, many surgical techniques have been described for biliary reconstruction. The aim of this study is to try a new surgical technique for biliary reconstruction and also to show whether intraoperative fluorescent molecular imaging (IFMI) is effective to evaluate the perfusion of the new biliary conduit. Two adult pigs were operated. Cholecystectomy and removal of the extrahepatic biliary tract were performed by robotic surgery. A duodenal conduit was created from the duodenum by open surgery. The distal end of the conduit was sutured to portohepatis by end-to-end anastomosis. The perfusion of the conduit was evaluated by photo-dynamic eye. Although the viability of both of the duodenal conduits were macroscopically evaluated as normal, it was screened by IFMI that the middle and distal parts of the conduit were not well-vascularized and that only the base portion of the conduit had sufficient blood supply. As a result, IFMI is a good intraoperative diagnostic tool for showing tissue viability. This new technique may not be used for biliary reconstruction as described here. However, the development of alternative techniques to increase the viability of the conduit may enable the use of this technique successfully. © 2016 OMU.Item The Effect of Tunica Albuginea Incision on Testicular Tissue After Detorsion in the Experimental Model of Testicular Torsion(Urology and Nephrology Research Centre, 2018) Gultekin A.; Tanriverdi H.I.; Inan S.; Yilmaz O.; Gunsar C.; Sencan A.Purpose: Testis torsion is a surgical emergency, and sometimes we cannot sufficiently prevent injury even surgical detorsion of the testis is performed in the appropriate time period due to some reasons such as tissue edema. In this experimental study, we investigated the effect of tunica albuginea incision (TAI) on testicular torsion-detorsion model (TDM). Materials and Methods: Twenty four male rats were used. The rats were randomly divided into three groups. In Group I, testicular torsion (TT) of 720° was created. After 4 hours of torsion period, the testis was detorsioned. Then three longitudinal incisions were made on tunica albuginea of the testis. In Group II, torsion and detorsion was created by the same way as in Group I, but TAI was not added to the procedure. Group III was Sham group. At the end of the first week, rats in the experimental groups were sacrificed and the testes were harvested for histological, immunohistological examinations and for the assessment of apoptotic activity. Results: In Group I, the procedures led to partial improvement in color of the testes. Modified Johnsen Scores in Groups I, II and III were detected as 7.8, 4.3 and 9.6 respectively (P =.001). In Group I, immunoreactivity of anti-APAF-1 was moderate in 7 rats, and strong in 1 rat. Immunoreactivity of anti-cytochrome C and anti-caspase 3 were moderate in 6 rats, and strong in 2 rats. Immunoreactivity of anti-caspase 8 and 9 were moderate in 5 rats, and strong in 3 rats. The differences of immunoreactivity between the groups were statistically significant. TUNEL percentages were detected as 40, 62% in Group I, 60% in Group II and 11,75% in Group III respectively (P =.001). Conclusion: As a result, multiple incisions made on tunica albuginea after detorsion in the TDM in rats, decrease the amount of ischemia- reperfusion injury. This effect might be related with the decrease in testicular edema and free oxygen radicals together with increase in tissue perfusion. Moreover, the decreased apoptotic activity seems to play a role in the decrease in inflammatory response and preservation of tissue parenchyma consequently. © 2018. All Rights Reserved.Item The effect of tunica albuginea incision on testicular tissue after detorsion in the experimental model of testicular torsion(Urology and Nephrology Research Centre, 2018) Gultekin A.; Tanriverdi H.I.; Inan S.; Yilmaz O.; Gunsar C.; Sencan A.Purpose: Testis torsion is a surgical emergency, and sometimes we cannot sufficiently prevent injury even surgical detorsion of the testis is performed in the appropriate time period due to some reasons such as tissue edema. In this experimental study, we investigated the effect of tunica albuginea incision (TAI) on testicular torsion-detorsion model (TDM). Materials and Methods: Twenty four male rats were used. The rats were randomly divided into three groups. In Group I, testicular torsion (TT) of 720° was created. After 4 hours of torsion period, the testis was detorsioned. Then three longitudinal incisions were made on tunica albuginea of the testis. In Group II, torsion and detorsion was created by the same way as in Group I, but TAI was not added to the procedure. Group III was Sham group. At the end of the first week, rats in the experimental groups were sacrificed and the testes were harvested for histological, immunohistological examinations and for the assessment of apoptotic activity. Results: In Group I, the procedures led to partial improvement in color of the testes. Modified Johnsen Scores in Groups I, II and III were detected as 7.8, 4.3 and 9.6 respectively (P = .001). In Group I, immunoreactivity of anti-APAF-1 was moderate in 7 rats, and strong in 1 rat. Immunoreactivity of anti-cytochrome C and anti-caspase 3 were moderate in 6 rats, and strong in 2 rats. Immunoreactivity of anti-caspase 8 and 9 were moderate in 5 rats, and strong in 3 rats. The differences of immunoreactivity between the groups were statistically significant. TUNEL percentages were detected as 40, 62% in Group I, 60% in Group II and 11,75% in Group III respectively (P = .001). Conclusion: As a result, multiple incisions made on tunica albuginea after detorsion in the TDM in rats, decrease the amount of ischemia- reperfusion injury. This effect might be related with the decrease in testicular edema and free oxygen radicals together with increase in tissue perfusion. Moreover, the decreased apoptotic activity seems to play a role in the decrease in inflammatory response and preservation of tissue parenchyma consequently.Item Successful outcomes in laparoscopic pyeloplasty using knotless self-anchoring barbed suture in children(Elsevier Ltd, 2019) Yilmaz O.; Tanriverdi H.I.; Cayirli H.; Ertan P.; Sencan A.; Genc A.; Taneli C.Introduction: Laparoscopic pyeloplasty for ureteropelvic junction obstruction in children has gained increasing importance over the last decade. Intracorporeal knot tying still remains a technical challenge for the surgeon. Self-anchoring suture incorporates a new concept for tissue approximation and reduces intracorporeal knot tying problems. There are very few reports on self-anchoring knotless suture and its application for laparoscopic pyeloplasty in children. We present our results of a series of consecutive children undergoing laparoscopic pyeloplasty with knotless barbed sutures. Material and method: We prospectively evaluate 15 consecutive patients who underwent laparoscopic pyeloplasty with knotless barbed sutures (V-LocTM, Covidien) for ureteropelvic anastomosis. The decision of the operation was given by pediatric nephrology-urology-radiologic imaging diagnostic team, and all patients were operated by a single surgeon. Pyeloplasty was performed without pelvic reduction, and the anastomosis was made by barbed sutures using running fashion. Results: The mean age of the patients were 5.39 (3 months-17 years). Two cases had undergone a right-sided pyeloplasty, and thirteen had undergone a left-sided pyeloplasty. The duration of the operative procedure was 60–110 min. Neither intraoperative nor postoperative complication was encountered in any of the cases. Patients were followed by ultrasonographic evaluation. The anteroposterior diameter (AP) diameter of renal pelvis and hydronephrosis grade Society for Fetal Urology (SFU) are significantly different when compared with pre-operative and postoperative period (p = 0.001 and p = 0.001, respectively). Owing to the renal parenchymal thickness change by age pre-operative and postoperative thickness comparison is adjusted by age, because age is considered as a covariate (confounder variable). We observed statistically significant (p = 0.003) difference in parenchymal thickness in all cases. Follow-up periods of the 15 consecutive pediatric pyeloplasty cases were 6–54 months. Conclusion: In the present study, successful outcome of the laparoscopic pyeloplasty using barbed suture was shown for the first time in children in literature. We believe that successful outcome of laparoscopic pyeloplasty could be achieved by eliminating knots and less manipulation on the wound edge also minimizes tissue injury during the procedure.[Formula presented] [Table presented] © 2019 Journal of Pediatric Urology CompanyItem Author Reply(Elsevier Inc., 2021) Taneli C.; Tanriverdi H.I.; Genc A.; Sencan A.; Gunsar C.; Yilmaz O.[No abstract available]Item Tubularized Reconstructed Plate Urethroplasty: An Alternative Technique for Distal Hypospadias Repair(Elsevier Inc., 2021) Taneli C.; Tanriverdi H.I.; Genc A.; Sencan A.; Gunsar C.; Yilmaz O.OBJECTIVE: To report current results of a new surgical technique, tubularized reconstructed plate urethroplasty (TRPU) in distal hypospadias repair which allows the tubularization of urethral plate without incision or grafting. METHODS: This study is a prospective single surgeon series. Between January 2019 and March 2020, total of 158 patients underwent hypospadias repair, and 29 selected patients had TRPU procedure. Demographic data, duration of follow-up, complications were recorded. A vertical incision is made starting from halfway up the glans. This incision creates a diamond like defect which enables wedge removal of a segment of spongiosum tissue from the base of urethral plate extending to the hypospadiac meatus. Vertical incision is closed horizontally. The urethral plate is stretched and loosened from the base and re-secured into its bed using quilting stitches. Reconstructed urethral plate ensures the required width to allow the formation of neourethra of adequate circumference, followed by a formal glansplasty. RESULTS: Preoperative glans width was 13.4 ± 0.9 mm, urethral plate width was 6.1 ± 0.9 mm. Mean postoperative follow-up period was 13.6 months. All patients had successful functional outcome and cosmetically satisfying appearance. None of the patients required meatal calibration. The total complication rate was 3.4%. CONCLUSION: Native urethral plate itself is used as a natural flap to increase the surface area of the urethral plate in this new perspective of urethroplasty method. We believe that TRPU procedure provides an alternative approach for the formation of neourethra and it is a successful and relatively simple procedure with low complication rates, good cosmetic results and promising successful functional short-term outcome. © 2020 Elsevier Inc.