Browsing by Author "Narter, Fehmi"

Now showing 1 - 5 of 5

Are the Recommended Criteria for Clinically Insignificant Prostate Cancer Applicable to 12-core Prostate Biopsy Scheme? A Multicentre Study of Urooncology Association, Turkey
(GALENOS PUBL HOUSE, 2021-01-01) Celik, Serdar; Kizilay, Fuat; Yorukoglu, Kutsal; Ozen, Haluk; Akdogan, Bulent; Izol, Volkan; Bayazit, Yildirim; Aslan, Guven; Sozen, Sinan; Baltaci, Sumer; Muezzinoglu, Talha; Narter, Fehmi; Turkeri, Levent; Assoc, Urooncology
Objective: The aim of this study is to investigate the relevance of the Epstein criteria for the 12-core transrectal prostate biopsy (TRUS-Bx) scheme with the evaluation of clinicopathologic data recorded in the Urologic Cancer Database - Prostate (UroCaD-P), Urooncology Association, Turkey (UOAT). Materials and Methods: Patients with detailed pathological 12-core TRUS-Bx data for each biopsy core and who underwent RP due to PCa were included in this study. A total of 1167 patients from seven different centres were analysed. TRUS-Bx pathological findings were separately evaluated in the areas matching the sextant biopsy (6-core paramedian-lateral) scheme and in all 12-core biopsy areas (12-core biopsy scheme). Overall detection rates of PCa and ratios of clinically significant (sPCa) and insignificant PCa (insPCa) after RP were defined and compared between the biopsy schemes. Biopsy findings, according to the Epstein criteria, were also compared between the two schemes. A model for each biopsy scheme was created, including the Epstein criteria and additional biopsy findings using logistic regression analysis to predict clinically sPCa after RP. Results: There was a high correlation for the prediction of clinically insPCa between the two biopsy schemes in the same population. However, 7.3\% of PCa could not be diagnosed in the 6-core TRUS-Bx scheme. Also, 69.4\% of these had clinically sPCa according to the Epstein criteria in 12-core TRUS-Bx scheme and 51.8\% of these were clinically sPCa after RP. The presence of perineural invasion (PNI) in 12-core biopsy was also significant regarding predicting sPCa (p<0.001). Conclusion: The Epstein criteria in 12-core prostate biopsy provide a better prediction of clinically sPCa than the 6-core biopsy scheme. Biopsy PNI findings appeared to improve the effectiveness of 12-core prostate biopsy, in addition to the Epstein criteria.
Autologous omentum transposition for regeneration of a renal injury model in rats
(BMC, 2022-01-01) Bilgic, Tayfun; Ince, Umit; Narter, Fehmi
Background After renal trauma, surgical treatment is vital, but sometimes there may be loss of function due to fibrosis. This study aimed to evaluate the effect of autologous omentum flaps on injured renal tissues in a rat model. Methods A total of 30 Wistar albino rats were included and randomly divided equally into a control group and four intervention groups. Iatrogenic renal injuries were repaired using a surgical technique (primary repair 1 group and primary repair 2 group) or transposition of the autologous omentum (omentum repair 1 group and omentum repair 2 group). Blood samples were taken preoperatively and on the 1st and 7th postoperative days in all groups and on the 18th postoperative day in the control and two intervention groups. All rats were sacrificed on the 7th or 18th day postoperatively, and their right kidneys were taken for histopathological evaluation. Results The mean urea level significantly decreased from day 1 to day 7 and from day 1 to day 18 in the omentum repair 2 group (P = 0.005 and P = 0.004, respectively). There were no other significant changes in urea or creatinine levels within the intervention groups (P > 0.05). There was no significant correlation between the urea and creatinine levels and the histological scores (P > 0.05). The primary repair 1 and 2 groups had significantly higher median granulation and inflammation scores in the kidney specimen than the control and omentum repair groups (P < 0.05). The omentum repair 2 group had significantly lower median granulation and inflammation scores in the surrounding tissues than the primary repair 2 group (P < 0.05). The completion score for the healing process in the kidney specimen was significantly higher in the omentum repair groups than in the primary repair groups (P < 0.05). The omentum repair 2 group had significantly lower median granulation and inflammation scores in the surrounding tissues than the primary repair 2 group (P < 0.05). Granulation degree in the kidney specimen was strongly and positively correlated with the inflammation degree (r = 0.824, P < 0.001) and foreign body reaction in the kidney specimen (r = 0.872, P < 0.001) and a strong and negative correlation with the healing process completion score in the kidney (r = - 0.627, P = 0.001). Inflammation degree in the kidney specimen was strongly and positively correlated with the foreign body reaction in the kidney specimen (r = 0.731, P = 0.001) and strongly and negatively correlated with the healing process completion score in the kidney specimen (r = - 0.608, P = 0.002). Conclusion Autologous omentum tissue for kidney injury repair attenuated inflammation and granulation. Additionally, the use of omental tissue to facilitate healing of kidney injury may theoretically lead to a more effective healing process and reduced fibrosis and tissue and function loss.
Current Status of Urological Surgery Clinical Trials in the Middle East and Its Analysis in Comparison to Global
(GALENOS YAYINCILIK, 2019-01-01) Ozdener, Fatih; Sursal, Alihan; Narter, Fehmi
Objective: To analyze the rates and types of ongoing urological surgery clinical trials (CTs) in the Middle East (ME) and worldwide. Materials and Methods: The number of urological surgery CTs was identified via the ClinicalTrials.gov database. Studies were further analyzed using different filters present in ClinicalTrials.gov. Results: Vast majority of urological surgery CTs are progressing in North America and Europe with 71.53\%. The ME accounts for only 6.19\%. In the ME, only Turkiye hosts studies of pediatric urological surgery. Additionally, the vast majority of adult studies were also belongs to Turkiye with 64\%. Further, the large portion of conducted CTs in the ME is phase 3 studies and studies with no phase indicated. Similarly, all urological surgery CTs conducted in Turkiye are in later phases or with no phase indicated. Moreover, industry resources are not directed upon these studies in the ME. Few countries use the advantages of industry resources for conducting urological surgery CTs. Conclusion: The ME should be considered as a fertile land for adopting urological surgery CTs due to high population despite low ongoing studies. The lack of industry support in the ME is another problem, which may improve via rendering the ME more attractive for sponsors by adopting new regulatory guidelines for some of the countries.
Effects of pneumoperitoneum with carbon dioxide on renal and hepatic functions in rats
(TERMEDIA PUBLISHING HOUSE LTD, 2020-01-01) Bilgic, Tayfun; Narter, Fehmi
Introduction: Laparoscopic surgery is a preferred method based on its many benefits. However, increasing abdominal pressure by CO2 insufflation during the implementation of this technique poses challenges. Aim: To determine the degree of renal and liver injury that occurs in a pneumoperitoneum (PP) model of prolonged CO2 insufflation. Material and methods: Twenty-one female Sprague Dawley rats were separated randomly into three groups. Group 1 was the control group and given anesthesia for 3 h. In group 2, PP was administered under anesthesia for 1 h. In the last group, PP was administered under anesthesia to animals for 3 h. We measured renal and liver injury biomarkers and made a histopathological evaluation to estimate the degree of injury and assessed the correlation of biomarkers including kidney injury molecule-1 (KIM-1) with histopathological findings. Results: Histopathological analysis according to the kidney ischemia tubular damage score showed a statistically significant difference between the 3 groups (p < 0.001). There was an increase in KIM-1 levels in the groups, although it was not statistically significant (p = 0.062, p = 0.156, p = 0.350 respectively). According to the correlation test in this research, KIM-1 results had a statistically significant association with creatinine, urea, aspartate aminotransferase and alanine aminotransferase levels in all control and study groups. Conclusions: According to our results, the increase in KIM-1 was correlated with Cr levels and compatible with histopathological analysis. Moreover, intra-abdominal pressure statistically significantly increased the degree of kidney injury and there was not a significant increase in the levels of KIM-1. There was no difference in liver damage between groups.
Management of Patients with Urological Cancers in Turkey during the COVID-19 Pandemic: Recommendations of Uro-oncology Association
(GALENOS YAYINCILIK, 2020-01-01) Celik, Serdar; Tinay, Ilker; Narter, Fehmi; Eskicorapci, Saadettin; Ataus, Suleyman; Turkeri, Levent; Baltaci, Sumer
Coronavirus disease-19 (COVID-19) has been declared as a pandemic by the World Health Organization. The number of cases has increased over time in correlation with the increasing number of testing worldwide. In order to use the available resources for COVID-19 treatment, urological practice has been limited only to emergency procedures and certain uro-oncological surgeries. In this report, we aim to share our recommendations for the daily uro-oncology practice in light of local circumstances in Turkey.