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ÖzetAmaç: Çalışmanın amacı adenotonsiller hipertrofi (ATH) nedeni ile adenoidektomi ve/veya tonsillektomi operasyonlarının Enürezis Noktürna (EN) üzerindeki etkisini araştırmaktır.Gereç ve Yöntemler: Adenoidektomi ve/veya tonsillektomi operasyonu uygulanmış olan 94 hastanın dosyaları retrospektif olarak incelendi. Hastalarda EN sıklığı ve operasyon sonrası düzelip düzelmediği araştırıldı.Bulgular: Ortalama yaş 9.59±2.04 yıl idi. adenoid vegetasyon (AV) sorunu olan grupta EN hasta sayısı fazla idi. Cerrahi öncesi hastaların 73’ünde EN tespit edildi. Operasyon sonrası 63 hastada tam iyileşme,10 hastada kısmi iyileşme söz konusu idi. Gruplar arası EN iyileşmesi ile ilgili istatistiksel açıdan anlamlı farklılık yoktu.Sonuç: Multidisipliner yaklaşım gerektiren EN tedavisinde ATH cerrahi prosedürleri etkin olabilmektedir. Bu nedenle, EN semptomları olan hastalarda üst solunum yolu obstrüksiyonuna ait şikayetlerin sorgulanması ve semptomu olan çocuklara yapılacak doğru cerrahi prosedür tedavini önemli bir basamağı oluşturabilir., Objective: The aim of this study was to investigate the effect of tonsillectomy and adenoidectomy on (Enuresis Nocturna) EN in patients with tonsil hypertrophy and adenoid hypertrophy.Material and Methods: Data of 94 patients was retrospectively valuated. The frequency of EN of the patients and whether they improved after the operation were investigated.Results: The mean age was 9.59±2.04 year. EN patients was higher in the group with adenoid vegetation. EN was detected in 73 of the patients before surgery. There was a complete improvement in 63 patients and partial improvement in 10 patients after the operation. There was no statistically significant difference in EN improvement between the groups.Conclusion: In a multidisciplinary approach, the surgical procedures can be effective in the treatment of EN. Therefore the patients admitting with EN symptoms should be questioned for complaints about upper airway obstruction and the correct surgical procedure for children with symptoms may constitute an important step in their treatment.

Purpose: In this study, we applied platelet rich fibrin (PRF) and pure olive oil on the incision surfaces of rats. We aimed to examine whether PRF may be used safely to prevent peritoneal adhesions.Materials and Methods: Fourty rats were divided into 4 groups (n=8). Eight rats, not included in the study groups, were used to obtain PRF material. Group 1 had no surgical procedure, Group 2 was operated without medication, Group 3 was operated and received 1cc olive oil, Group 4 was operated and received 1 cc PRF. After 21 days, cecum areas were examined histopathologically. Tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), intercellular adhesion molecule-1 (ICAM-1) and platelet-derived growth factor (PDGF) levels were measured in serum by ELISA.Results: The adhesion scores and severity of fibrosis in Group 3 and 4 were significantly lower than Group 2. Plasma TNF-α value was significantly higher in Group 2 than Group 4. Plasma PDGF value was significantly higher in Group 2 than Group 3 and 4.Discussion: PRF reduced intestinal adhesion by inhibiting the proliferation of fibroblasts and inflammatory cells, and promoting the proliferation of mesothelial cells. PRF has anti-inflammatory effect and prevented postop adhesions, based mainly on growth factors and cytokines in its content., Amaç: Bu çalışmada, adhezyon oluşması beklenen alanlara uygulanan trombositten zengin fibrin (PRF) ve saf zeytinyağının etkilerinin incelenmesi amaçlanmıştır. PRF’nin adezyona neden olup olmadığının ve PRF'nin batın içi operasyonlarda güvenle kullanıp kullanamayacağını araştırılmaktadır.Gereç ve Yöntem: Toplamda 4 grup (n=8) olmak üzere 40 adet Wistar albino rat çalışma gruplarında kullanıldı. Çalışma gruplarına dahil edilmeyen 8 rattan PRF eldesi için yararlanıldı. Grup 1’e herhangi bir cerrahi işlem yapılmadı. Adezyon modelin uygulandığı Grup 2’de ilaç kullanılmadı. Adezyon modeli sonrası Grup 3’de 1 cc zeytinyağı ve Grup 4’de 1 cc PRF uygulandı. 21 gün sonra çekum alanları histopatolojik olarak incelendi. Serumda proinflamatuar sitokinlerden tümör nekroz faktör-α (TNF-α), interlökin-6(IL-6), hücreler arası adezyon molekülü-1(ICAM-1) ve platelet-türevli büyüme faktörü(PDGF) düzeyleri ELISA yöntemiyle ölçüldü.Bulgular: Grup 3 ve 4'te adezyon skorları ve fibrozis şiddeti Grup 2'ye göre anlamlı olarak düşüktü. Plazma TNF-α değeri Grup 2'de Grup 4'e göre anlamlı olarak yüksekti. Plazma PDGF değeri Grup 2'de Grup 3 ve 4'e göre anlamlı olarak yüksekti. . Sonuç: PRF, fibroblastların ve inflamatuar hücrelerin çoğalmasını engelleyerek ve mezotelyal hücrelerin çoğalmasını teşvik ederek bağırsak yapışmasını azaltabilir. PRF, içeriğindeki büyüme faktörleri ve sitokinlere bağlı olarak antiinflamatuar etkiye sahiptir ve postop adezyonları önler.

Resumen Introduccion y objetivos Comparar, en terminos de eficacia y seguridad, los resultados del tratamiento endoscopico del reflujo vesicoureteral (RVU) en dos cohortes diferentes de RVU primario tratadas con Dexell y Vantris. Pacientes El estudio incluyo 128 unidades de reflujo renal (URR) en 87 pacientes con RVU primario (64 mujeres, 23 hombres). Se excluyeron los pacientes con RVU secundario y disfuncion vesical e intestinal severa. Un total de 22 ninos mayores ya continentes, con disfuncion vesico-intestinal leve, fueron sometidos a entrenamiento vesico-intestinal previo a la implantacion. Todos los procedimientos se realizaron en presencia de orina esteril mediante la tecnica convencional de inyeccion transuretral subureteral. Resultados No hubo diferencias estadisticamente significativas entre los dos grupos en cuanto a media de edad, sexo, lateralidad de la URR, captacion de 99mTc-DMSA y grado de reflujo. Las tasas de resolucion global con base en el numero de URR con hasta tres tratamientos endoscopicos fueron del 80% (56/70) en el grupo Dexell y del 94,8% (55/58) en el grupo Vantris (p = 0,012). No se observaron recidivas ni obstrucciones de la union vesicoureteral en el postoperatorio en ningun grupo. Conclusiones Dexell y Vantris proporcionaron un tratamiento endoscopico eficaz y seguro en el seguimiento a corto y medio plazo del RVU primario en ninos. Se requieren mas estudios para evaluar la eficacia de estas sustancias, cuyo efecto de volumen depende del tamano de sus particulas, en la resolucion segura del RVU.

INTRODUCTION A simple algorithm for bronchoscopy was prepared in very young children METHODS The patients aged 0-5 years who were applied with bronchoscopy because of suspected foreign body aspiration (FBA) analyzed. RESULTS Evaluations were made of 89 patients, as 55 (61.7%) in the FBA (+) group and 34 (38.3%) in the FBA (-) group. FBA was determined most in the 1-2 years age group (28 patients, 50.9%, p=0.04) due to organic hard foodstuffs (94.5%, pCONCLUSION The presence of a witness, not obtaining unilateral respiratory sounds, and unilateral hyperventilation seen on x-ray are indications for bronchoscopy. In FBA (-) patients applied with bronchoscopy, the complication rate associated with the procedure is low, and the operating time and length of stay in hospital are short.

Objective: In this study, we describe the management and outcome of children with intussusception and analyze the sonographic findings that can be used to differentiate transient, self-limited small bowel intussusception from the cases with an indication for surgery. Material and Methods: We retrospectively reviewed the medical records of pediatric patients with the diagnosis of invagination who had been followed up in the pediatric surgery service between 2012-2017. Results: The median age was 39.5±35.9 (range 2-171) months. Among these patients, 57 (64%) had been followed up without surgery, and the remaining patients (n= 32, 36%) had undergone surgery. The median age of patients who had not undergone surgery was significantly greater than that of the patients who had undergone surgery (52.2±38.4 vs. 16.75±12.6; p

Background and Aims: Foreign body aspiration (FBA) is frequently seen in children, and progresses with symptoms related to airway obstruction, leading to serious complications. The aim of this study was to discuss the diagnosis and treatment principles of patients who underwent bronchoscopy for suspected foreign body aspiration (FBA), and to emphasize its preventability.Method: A retrospective review was made of the records of patients who underwent bronchoscopy for evaluation of FBA in the Pediatric Surgery Clinics of two hospitals where the authors work from January 2017 to February 2020. Age, gender, history of FBA, clinical symptoms, chest radiography findings, bronchoscopy findings, complications, and outcome were recorded for each patient. A history of FBA, physical examination findings, and radiological study results were analyzed statistically to determine the most accurate diagnostic tool to differentiate cases with and without FBA.Results: Bronchoscopy was performed in 102 patients with suspected FBA. A foreign body was detected in 51% (52/102) of the patients. No statistically significant difference was determined in respect of age and gender (p>0.005). There was a statistically significant difference in respect of history and time of presentation, but no difference in terms of physical examination and radiological findings. Of the foreign bodies aspirated, 87% were nuts. No life-threatening complications occurred in any patient due to bronchoscopy. Conclusion: Nuts are the most frequently aspirated foreign bodies in childhood. History, physical examination, and radiological findings may not be available for all patients. Preventive measures are important as FBA can lead to fatal consequences. Careful evaluation of the patient is necessary to reduce the negative bronchoscopy rate., Giriş ve Amaç: Yabancı cisim aspirasyonu çocuklarda sık görülür ve hava yolu obstrüksiyonuna bağlı semptomlarla ilerleyerek ciddi komplikasyonlara yol açar. Bu çalışmanın amacı şüpheli yabancı cisim aspirasyonu nedeniyle bronkoskopi yapılan hastaların uygun tanı araçlarını ve tedavi prensiplerini tartışmak ve önlenebilirliğini vurgulamaktır.Yöntem: Yazarların çalıştığı iki hastanenin Çocuk Cerrahisi Kliniklerinde Ocak 2017'den Şubat 2020 tarihleri arasında, yabancı cisim aspirasyonu değerlendirilmesi için bronkoskopi yapılan hastaların kayıtları geriye dönük olarak incelendi. Yaş, cinsiyet, yabancı cisim aspirasyonu öyküsü, klinik semptomlar, akciğer grafisi bulguları, bronkoskopi bulguları, komplikasyonlar kaydedildi. Yabancı cisim aspirasyonu öyküsü, fizik muayene bulguları ve akciğer grafisi bulguları, yabancı cisim varlığını tespit için bronkoskopi öncesi en uygun tanı aracını bulmak amacıyla istatistiksel olarak incelendi.Bulgular: Yabancı cisim aspirasyonu şüphesi olan 102 hastaya bronkoskopi yapıldı. Hastaların% 51'inde (52/102) yabancı cisim tespit edildi. Yaş ve cinsiyet açısından istatistiksel olarak anlamlı bir fark saptanmadı (p> 0,005). Öykü ve başvuru zamanı açısından istatistiksel olarak anlamlı fark bulunurken, fizik muayene ve radyolojik bulgular açısından fark bulunmadı. Aspire edilen yabancı cisimlerin % 87'si kuruyemiş idi. Bronkoskopiye bağlı hiçbir hastada hayatı tehdit eden bir komplikasyon oluşmadı.Sonuç: Kuruyemişler, çocukluk çağında en sık aspire edilen yabancı cisimlerdir. Hastalarda öykü, fizik muayene ve radyolojik bulguların normal olabileceği unutulmamalıdır. Önleyici tedbirler, ölümcül sonuçlar doğurabilen aspirasyon için hepsinden önemlidir. Negatif bronkoskopi oranını azaltmak için hastanın dikkatli değerlendirilmesi gerekir.

Introduction and Objectives We aimed to point out the ureteral access facility and obstruction removal efficiency of mini-URS in the use of proximal ureteral stone management in children under five-year-old. Patients We retrospectively reviewed the data of 26 children who underwent mini-URS-LL for obstructive stones in proximal ureter between January 2016 and August 2018. The effectiveness of the mini-URS-LL was assessed based on the feasibility, reliability, and success of the technique. Results Mean age was 3 ± 1.3 years, and 11 (42.3%) patients were ≤2 years old, remaining 15 (57.7%) were aged 3−5 years. Mean stone size was 9.11 ± 3.02 mm. A stone-free status was obtained at the end of 31 ureteroscopic procedure in 24 (92.3%) patients. The mean age was found significantly higher in patients who had the procedure without pre-stenting than the others who did (P = .027). No perioperative complication was experienced. Conclusion In preschool-age children, laser lithotripsy with mini-URS may be a safe technique in the hands with advanced endo-urological skills but it has low efficacy with higher rates of prestenting causing additional anesthesia sessions.

Objective: This study aimed to discuss the reasons for conversion in light of the literature and reduce any unnecessary conversion to open procedure, according to our clinic's results during the learning curve. Methods: A retrospective review was performed on 100 patients who had a laparoscopic appendectomy in our clinic between September 2014 and August 2019. The patients who had a laparoscopic appendectomy were evaluated for conversion to open procedure by reviewing the age, gender, white blood cell count (WBC), and surgical findings (location of the appendix, perforation status, peritonitis). Laparoscopy was performed through two ports. Results: The age average of 100 patients, including 63 males who have undergone a laparoscopic appendectomy, was 10.86 ± 3.78 years. The laparoscopic technique was converted to open in nine children. WBC ratio of the patients was significantly higher in converted procedures. Among the procedures converted to open appendectomy, three patients presented retrocecal appendix placement; two patients presented retrocecal placement and perforation and diffuse peritonitis; three patients presented perforation and diffuse peritonitis, and one patient presented uncontrolled bleeding. Conclusion: The use of laparoscopic appendectomy has just increased in Pediatric Surgery clinics along with some factors that affect the conversion to open procedure. WBC ratio was significantly higher in converted procedures. When study results are reviewed from this perspective, perforation, diffuse peritonitis, and the appendix's retrocecal location are the most significant independent indicators for conversion from laparotomic procedure to open procedure.

Background: Many surgical techniques, as well as dressing models, were identified in the treatment of hypospadias. There are many publications in the literature that are the result of the effort to find the ideal dressing after hypospadias surgery. The dressing has some benefits; however, it has some adverse effects. The present study aimed to discuss outcomes of the patients who have been operated through the tubularized incised plate urethroplasty (TIPU) method and followed with and without dressing postoperatively. Methods: Patients operated on through the TIPU method between March 2015 and August 2019 were reviewed retrospectively. The patients were divided into two groups, dressing and undressing. Preoperative hypospadias severity was evaluated according to the Glans-Urethral Meatus-Shaft (GMS) scoring method. The care results of the patients were recorded. Postoperative outcomes were compared according to the Hypospadias Objective Scoring Evaluation (HOSE) scale, and statistical analyses were conducted. The results of both groups were compared statistically. Results: One hundred and nineteen patients were divided into two groups: dressing (n = 56) and nondressing (n = 63). The patients’ average age was 3.54 ± 2.97 years in group 1 and 3.50 ± 3.01 years in group 2 (p = 0.940). There was not any statistically significant difference between the two groups for demographic data. Minimal bleeding had stopped in three patients in the nondressing group spontaneously before discharging. No severe edema or hematoma, which might have concerned the parents, appeared. Two (3.5%) and 3 (4.7%) patients underwent a maximum of three urethral dilation sessions in dressing and nondressing groups, respectively (p = 0.556). We found no significant difference between groups in the comparison of preoperative GMS and postoperative HOSE scoring. Discussion: The most important limitation of the study is that it is retrospective. Pre- and postoperative scoring systems are objective. The data obtained in the literature show that surgeons prefer to apply dressings commonly after the TIPU technique. Advantages and disadvantages of dressing are mentioned in the literature. Even if the paradigm is dressing in hypospadias surgery, according to the results of our study, dressing may not affect the functional and cosmetic results of TIPU repair. Conclusion: Postoperative functional and cosmetic results of TIPU in hypospadias appear to be independent of dressing. However, the results must be supported by further research.

© 2021 EDIZIONI MINERVA MEDICA.BACKGROUND: Intrahospital transport, general anesthesia, and the prolonged duration of the central venous catheterization (CVC) in unfavorable conditions pose a significant risk to a critically-ill premature infant. We aimed to demonstrate a minimalized and safe manner of CVC in this patient population. METHODS: We worked on a prospective study in 51 critically-ill premature infants in which a 22 Gauge catheter was put in one of the central thoracic veins with the guidance of sonography as a bedside procedure. Of the patients, 27 (53%) were extremely premature, and 21 (41%) were extremely low birth weight infants (ELBW). The mean gestational age was 29±5 weeks, and the mean weight at the time of the procedure was 1655±1028 grams. While no anesthetic and sedative drugs were administered to ELBW infants during procedures, in the remainder of the cohort, procedures were carried out only under sedoanalgesia. RESULTS: Vascular access was achieved in 48 (94%) of the patients after a mean number of 1.47±0.75 attempts. Body heat loss of the patients at the end of the procedures was not statistically significant (P=0.164). However, ELBW infants lost their body heat significantly more than the rest of the cohort (P=0.032). We experienced clinically insignificant common carotid artery puncture in three patients and hemothorax in one patient. CONCLUSIONS: CVC of critically ill premature infants can be safely and successfully achieved in incubators using sonography guidance, protecting them from hypothermia and anesthetic drugs.

Introduction: Acute appendicitis (AA) is one of the most common emergency surgical diseases in pediatric population. Herein, we aimed to compare the incidence and severity of AA before and during the COVID-19 outbreak. Methods: This multicenter study was conducted in three medical faculty hospitals between the periods of 15 March-30 June 2019 (Group A), and the pandemic period of 15 March-30 June 2020(Group B). We evaluated the clinicopathological characteristics of the patients in each group due to age, gender, serum leukocyte, C-reactive protein, radiological imaging use of postop peritoneal drain and presence of serious complications. Results: A total of 141 patients were identified, 64 in Group A and 77 in Group B. We found higher complication rates in Group B. Fewer patients applied in Group B, but a higher rate of AA was diagnosed. During the COVID-19 period, more patients were admitted with the later stages of the AA and with significant complications. Radiological imaging of patients with appendicitis in Group B showed more severe disease than cases in Group A. Conclusion: Higher rate of perforated and complicated appendicitis in the pandemic period was due to misdiagnosis/delayed diagnosis in primary care centers as a result of fear from contagious coronavirus. While the period of the COVID - 19 pandemic presents difficulties in treating infected patients, we would like to emphasize the importance of a comprehensive assessment and physical examination in children with suspected surgical conditions.

Purpose: We present our experience of stented and unstented distal hypospadias repaired by tubularized incised plate urethroplasty (TIPU). Patients and Methods: Data of 84 patients who were operated by TIPU method in 2 hospitals were retrospectively analyzed, and they were invited to be included in the study. Sixty-six patients agreed to participate in the study and were divided into 2 groups. Group 1 consisted of 38 boys operated in Sütçü İmam University Hospital on using a stent between 2015 and 2017. Group 2 consisted of 28 boys operated in Private Hospital of Megapark on without a stent between 2016 and 2017. The hypospadias objective scoring evaluation (HOSE) scale was used to compare the groups. Results: The median age was 2.81 years in group 1 and 1.95 years in group 2 (p = 0.243). The mean follow-up duration was 25.74 ± 4.62 and 24.5 ± 4.19 months in groups 1 and 2 respectively (p = 0.268). The HOSE scores were similar in both groups with comparable results (p = 0.622). Conclusions: No difference was observed between the groups in this study, regarding functional and cosmetic outcomes according to the HOSE score. However, the results should be supported by prospective studies with a sufficient number of patients.

Amaç: Ürolitiyazis, pediatrik hastalarda kalıcı böbrek fonksiyon bozukluğuna ve ciddi klinik semptomlara yol açabilen önemli bir hastalıktır. Bu çalışmada, rijit üreteroskopi ve Holmiyum YAG lazer litotripsi sonuçlarımızı sunmayı amaçladık.Gereç ve Yöntemler: Nisan 2018 ile Aralık 2019 tarihleri arasında Sütçü İmam Üniversitesi, Çocuk Cerrahisi kliniğinde ürolitiyazis tanısı ile opere olan çocuk hastaların ultrasonografi bulguları ve tıbbi kayıtları geriye dönük olarak değerlendirmeye alındı.Bulgular: Bu çalışmaya ürolitiyazis tanısı almış 61 çocuk hasta (E/K=38/23) alındı. Ortalama yaş 6.7±4.9 yıl (3 ay-17 yıl) idi. On üç (%34.2) erkek hastanın acil girişim (rijit üreteroskopi ve Holmiyum YAG lazer litotripsi) ihtiyacı olurken, kız hastalarda bu sayı 4 (%17.4) idi. Bu konuda iki cinsiyet arasındaki fark istatistiksel olarak anlamlı değildi (p=0.156). Otuz iki erkek hasta (%84.2) ve 12 (%52.2) kız hastada işlem (rijit üreteroskopi ve Holmiyum YAG lazer litotripsi) başarılı bir şekilde sonuçlandı. Erkek hastalardaki bu başarı oranı kız hastalardan istatistiksel olarak anlamlı yüksek idi (p=0.019). Sağ tarafta taşı olan kız hasta oranı, erkek hastaların oranlarından daha anlamlı olarak yüksekti (p3 yaş) arasında cinsiyet, taşın tarafı, işlem başarısı ve acil cerrahi gereksinimi açısından fark yoktu (p>0.05). Regresyon analizinde, kız cinsiyetinin girişimin başarısızlığı açısından risk faktörü olduğu saptandı (OR=-0.313, %95 CI: 0.052-0.528; p=0.0018).Sonuç: Mini üreteroskopi ve holmiyum lazer, çocukluk yaş grubundaki ürolitiyazis vakalarında güvenli ve etkili tedavi seçeneğidir. Ancak özellikle kız hastalarda bu tedavi seçeneği değerlendirilirken alternatif tedavi yöntemleri olan fleksibl veya perkutan nefrolitotomi tercih edilebilir., Objective: Urolithiasis is an important disease that can lead to permanent kidney dysfunction and severe clinical symptoms in pediatric patients. We aimed to present our findings of rigid ureteroscopy combined with Holmium YAG laser lithotripsy.Material and Methods: We retrospectively reviewed the ultrasonography, and medical records of pediatric patients with urolithiasis who were operated in Sutcu Imam University Department of Pediatric Surgery, Kahramanmaraş between April 2018 and December 2019.Results: Sixty-one pediatric patients (M/F=38/23) with urolithiasis were enrolled in this study. The mean age was 6.7±4.9 years (range 3 month-17 years). Thirteen (34.2%) male patients need an urgent operation (rigid ureteroscopy combined with Holmium YAG laser lithotripsy) while the corresponding number was 4 (17.4%) in female patients. The difference between two sexes was statistically non-significant (p=0.156). Thirty-two male patients (84.2%) and 12 (52.2%) females patients had a successful operation (rigid ureteroscopy combined with Holmium YAG laser lithotripsy). The difference between the two sexes was statistically significant (p=0.019). The ratio of female patients with right-sided stone was significantly greater than the corresponding rates of male patients (p=3 years of age) with respect to gender, side of stone, procedural success, and need for urgent surgery (p>0.05). Regression analysis showed that female gender was a risk factor for a failed attempt (OR=-0.313, 95% CI: 0.052 – 0.528; p=0.0018).Conclusion: Safe and effective stone treatment can be performed considering that more than one operation can be performed in infants and children with mini ureteroscopy and holmium laser. However, while evaluating this treatment option in female patients, alternative treatment methods such as flexible or percutaneous nephrolithotomy may be preferred.

Klinigimizde ozefagus atrezisi ve trakeaozefageal fistul (OA ve TOF) tanisi ile ameliyat edilen hastalarin tedavi sonuclarini degerlendirmek. Nisan 2017 - Kasim 2019 tarihleri arasinda ozefagus atrezisi ve trakeaozefageal fistul tanisiyla ameliyat edilen hastalarin sonuclari retrospektif olarak degerlendirildi. Hastalarin gestasyonel yas, dogum agirligi, cinsiyet, atrezi tipi, cerrahi yaklasim, tedavi suresi acisindan degerlendirildi. Postoperatif mekanik ventilator takibi, nazogastrik tup ve oral beslenmeye gecis suresi ve komplikasyonlar acisindan incelendi. Calismaya 20 (% 83) erkek ve 4 (% 17) kiz toplam 24 hasta dahil edildi. Ortalama ameliyat yasi 3,9 gun idi. Hastalarin gestasyonel yasi 35 hafta ve ortalama dogum agirligi 2391 gramdi. Distal trakeaozefageal fistul + proksimal atrezi 22 (% 92) hastada tespit edildi. Ondort (% 58) hastada konjenital kalp hastaligi tespit edildi. Ventilatorde takip suresi 27 saat, ortalama oral beslenme suresi 11 gundu. Uc (%12.5) hasta oldu. Hastanede kalis suresi 16 gundu. Takiplerinde 5 (% 21) hastada anastomoz darligi, bir (% 4) hastada anastomoz kacagi goruldu. OA ve TOF cerrahi tedavi ile yuksek oranda iyilestirilebilen anomalilerdir. OA hastalarinin yenidogan ekibi tarafindan izlenmesi, ek anomalilerin takibi ve tedavisi icin onemlidir. Bu nedenle bu hastalar multidisipliner bir yaklasimla takip edilmelidir. Ameliyat sonrasi sik karsilasilan anastamoz darligi acisindan aileler bilgilendirilmelidir.

Objectives: The main targets of the treatment modalities for pilonidal sinus are to prevent recurrences, and to increase the quality of life. It is unknown whether there is a different treatment trend in pediatric patients as compared with adults. In this study, we aimed to evaluate the surgical methods in pediatric and adult patients with pilonidal sinus. Material and Methods: This retrospective study was conducted at the Pediatric and General Surgical Department of Necip Fazil City Hospital, Kahramanmaras from 2013 to 2017. A total of 66 pediatric patients and 68 adult patients were enrolled in this study. Results: The number of pediatric patients was significantly higher than adults in mean of Flap closure (21 (31.8%) vs 2 (2.9%), p=

Introduction and objectives To compare the results in terms of efficacy and safety of the endoscopic management for vesicoureteral reflux (VUR) in two different standardized primary VUR cohorts treated with Dexell and Vantris. Patients 128 refluxing renal units (RRU) in 87 patients with primary VUR (64 females, 23 males). Patients with secondary VUR and severe bladder and bowel dysfunction were excluded. A total of 22 continent children with mild bladder-bowel dysfunction underwent bladder-bowel training before the implantation. All procedures were performed in the presence of sterile urine using a conventional subureteral transurethral injection technique. Results There were no statistically significant differences between groups in terms of mean age, sex, RRU side, 99mTc-DMSA uptake, and reflux grade. The overall resolution rates based on the number of RRUs for up to three endoscopic treatments were 80% (56/70) in Dexell group and 94.8% (55/58) in Vantris group (P = .012). No postoperative recurrences or vesicoureteral junction obstructions were seen in any group. Conclusions Dexell and Vantris provided an effective and safe endoscopic VUR treatment in the early and mid-term follow up of children with primary VUR. The effectiveness of these substances, which can produce different mass effects with different particle sizes, in safe VUR resolution, needs further investigations.

Disgerminom, dev boyutlara ulaşabilen overin en sık görülen malign tümörüdür. Genelde hormon salgılamamakla beraber beta-HCG salgılayabilirler. Bizde karında kitle ve karın ağrısı şikâyetleri olan radyolojik görüntüleme ile tespit edilen beta-HCG salgılayan dev boyutlara ulaşmış disgerminom tanılı 3 olguyu inceledik. Üç olguya da salpingo-ooferektomi ameliyatı yapıldı. Bir olguda komsu lenf nodlarından, peritondan ve karşı overden örnekleme yapıldı. Bir olgu da üç haftada bir dört kür BEP (Bleomisin, Etoposid, Sisplatin) kemoterapi protokolü ile fertilite de korunarak tedavi sağlanmış oldu. Bir olguda da 3 kür BEP kemoterpi protokülü verilmesi planlandı ve 2 kür BEP kemoterapi protokolü verildi.

Amaç: Bu çalışmanın amacı Çocuk Cerrahisi yenidoğan yoğun bakım ünitesinde tedavi edilmiş hastalarda sağlık bakımı ilişkili enfeksiyon (SBİE) sıklığını, enfeksiyon etkenlerini ve risk faktörlerini araştırmaktır.Gereç ve Yöntem: Hastalar cinsiyet, doğum şekli, doğum kilosu, gestasyonel yaş, başvuru anındaki yaş, hastanede kalış süresi, ameliyat yapılıp yapılmaması, sepsis gelişimi, TPN (Total parenteral nutrisyon) alımı, toraks tüpü uygulaması, endotrakeal entübasyon, idrar sondası kullanımı, nazal veya oral sonda kullanımı, karın dreni uygulaması, santral kateter uygulaması, oral beslenmeme süresi, laboratuar parametreleri, cerrahi stres dereceleri, yara niteliği yönünden incelendi. Bulgular: Düşük doğum ağırlığı, yüksek cerrahi stres derecesi, TPN kullanımı ve süresi, toraks tüpü takılması ve süresi, endotrakeal entübasyon ve süresi, idrar sondası ve süresi, santral kateter, ameliyatlarda karın dreni konulması, nazal-oral sonda süresi ve enteral beslenmesiz geçen sürenin uzaması SBİE için risk faktörü olarak bulundu. SBİE olan hastaların 57’sinde sepsis saptandı, bunların 35’i öldü. Sonuç: İnvaziv işlemler ve süresinin azaltılması, hastanede kalış süresinin kısaltılması, salgın şeklindeki mikroorganizmalara özel önlemler alınması SBİE ve buna bağlı ölüm oranlarını düşürebilir., Purpose: The purpose of this study is to investigate the infectious agents, risk factors and prevalance of the healthcare-associated infections (HAIs) in patients treated at surgical neonatal intensive care unit. Materials and Methods: Patients were examined for application date, sex, mode of delivery, birth weight, gestation age, age at admission, hospital stay, hospitalization at another center, the provinces they come, surgery, developement of sepsis, use of TPN (Total parenteral nutrition), application of chest tube, endotracheal intubation, urinary catheter use, nasal or oral catheter use, application of abdominal drains, central catheter application, oral feeding time, laboratory parameters, degree of surgical stress and the nature of wounds. Results: Low birth weight, prior hospitalisation at another center, high degree of surgical stres, TPN use and duration, chest tube application and duration, endotracheal intubation and duration, urinary catheterisation and duration, central cathetery, application of abdominal drains at surgery, duration of nasal-oral catheterisation and the duration of nonenteral feding were found as risk factors of HAIs. Sepsis was detected at 57 of HAIs patients and 35 of them died.Conclusion: Decreasing the number and duration of invasive procedures, shorten the duration of hospital stay, special measures for the epidemic microorganisms can reduce the HAIs and the related deaths.

The Gastrointestinal system is one of the most common places for extranodal Non-Hodgkin lymphomas. On the other hand, Non-Hodgkin lymphomas have been seen less in the small intestine. We present here a rare condition in the literature which is a case of bilateral adrenal mass and Burkitt lymphoma with small intestine origin. Eleven years old male patient applied to pediatric emergency service with acute abdomen. In the abdominal USG examination intussusception and bilateral adrenal mass had seen. In a surgical operation, five lesions were seen in the small intestine. Partial small intestine resection was performed. In the pathological examination of the resection material Burkitt Lymphoma with the origin of the small intestine diagnosed to the patient. Prognosis of NHL with the origin of the small intestine, adrenal mass and come with an acute abdomen depends on the histological type and grade. He was started on NHL - BFM95 chemotherapy and had a good clinical response and he was remained in complete remission for two months after completion of chemotherapy. Bilateral adrenal mass remains a rare form of Burkitt lymphoma and care must be taken in ruling out other causes of bilateral adrenal masses.

Amaç: Lenfadenopatilerde maligniteçıkma olasılığı %1-3 oranındadır ve ensık lenfomalar gözlenir. Ultrasonografi ayırıcı tanıda hekime bazı bulgularıile malignite yönünde yardımcı olabilir. Tanısı kesinleştirilememiş, malignitedüşünülen vakalarda biyopsi yapılması esastır. Bu çalışmada patolojik lenfadopatili hastaların sosyo demografik verileriklinik laboratuvar, ultrason bulgularıve histopatoloji sonuçlarının karşılaştırılması hedeflenmiştir.Yöntemler: Buçalışmada Kahramanmaraş Sütçü İmam Tıp Fakültesi Hastanesi’ne Ocak 2014 veEylül 2016 tarihleri arasında başvuran 857 lenfadenopatili hastadan (328kız-529 erkek) 50 adet (39’u erkek, 11’ikız) patolojik lenfadenopatili hasta geriye dönük olarak değerlendirildi.Bulgular: Patolojiklenfadenopati tanılı 50 hastanın yaşları 12-192 ay arasında değişmektedir.Hastaların 24’ünde lenfadenopati boyutu 3 cm’nin üzerindeydi.Lenfadenopatilerden 35’i servikal, 15’i ise servikal dışı lokalizasyonasahipti. Bu hastalardan 35’ine reaktif, 15’ine ise non-reaktif USG sonucusaptandı. Hastalardan 38’inde benign hastalık, 12’sinde ise malignite saptandı.Yapılan istatistiksel analizler neticesinde patoloji sonuçları ile USG özelliğiarasında ve aynı zamanda lenfadenopati boyutu ile USG’de tespit edilen boyutarasında anlamlı bir ilişki saptandı (p, OBJECTIVE: The likelihood of malignancy in lymphadenopathies is 1-3% and the mostly lymphomas are seen. Ultrasonography may be helpful in malignancy with some findings in the differential diagnosis of the disease. In cases where malignancy is suspected, which the diagnosis is incomplete, the biopsy is required. In this study, we aimed to compare sociodemographic data of clinical, laboratory, ultrasound findings and histopathology of patients with pathologic lymphadenopathy.MATERIAL AND METHODS: For this purpose, among 857 lymphadenopathic patients (328 females-529 males) who were admitted to Kahramanmaras Sütçü İmam University Medical Faculty Hospital between January 2014 and September 2016, 50 patients (39 male, 11 female) were retrospectively evaluated.RESULTS: The ages of the 50 patients included in the study ranged from 12 months to 192 months. Lymphadenopathy size was over 3 cm in 24 of the patients. Of the lymphadenopathies, 35 had cervical and 15 had non-cervical localization. Among these patients, it was diagnosed with reactive in 35 patients and non-reactive in 15 patients. Of the patients, 38 had benign disease and malignancy was observed in 12 patients. As a result of the statistical analyzes, a significantly correlated relationship was found between pathology results and ultrasonography as well as lymphadenopathy size and the size observed in ultrasonography (p

Henoch-Schonlein purpura (HSP) is the most common childhood systemic vasculitis. Gastro-intestinal involvement occurs in two-thirds of patients. The characteristic skin lesions generally precede abdominal symptoms or present concurrently. A 7-year-old boy presented with intussusception and acalculous cholecystitis and had a cholecystectomy. Two weeks later he was re-admitted with features typical of HSP which responded to corticosteroids. Eleven months later he presented with abdominal pain and recurrence of HSP and, at laparotomy, there was acute appendicitis. This is the first case of a child presenting with HSP complicated by acalculous cholecystitis.