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Author: search.filters.author.Ozkan, BurakHas files: Yes

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    Robotic-assisted partial nephrectomy without using ureteral stent: a single center experience
    (AVES, 2016-01-01) Ozkan, Burak; Coskuner, Enis Rauf; Yalcin, Veli
    Objective: To share our results of robotic assisted partial nephrectomy (RAPN) we performed without using ureteral stent in a single center from Turkey. Material and methods: Medical records of consecutive 45 patients (34 men and 11 women) who underwent RAPN for kidney lesions between March 2011 and December 2014 were retrieved, and evaluated. All the procedures were performed by a transperitoneal approach without using ureteral stent prior to surgery. Renal artery clamping was used in all cases and intraoperative ultrasonography was used in 2 cases. Results: Patients undergoing RAPN had a mean tumor size of 4.42 cm (2-8) and a mean renal nephrometry score of 5.82 (4-11). The mean estimated blood loss was 250 mL (150-450 ml) and the mean operative time was 195 minutes (150-300). There was no statistical difference between the preoperative and postoperative serum creatinine levels at the first follow-up visit (0.9 vs. 0.95, p= 0.087). Surgical margin positivity was not detected in any patient, and the mean surgical margin distance was calculated as 0.4 mm (0.2-10). In only 1 patient disease recurrence was detected at the 21st month of the the follow-up period, and no distant metastases was reported in our patients at a mean follow-up of 10 months (3-36 mos). Our complication rate was 11.1\% and according to the Clavien system complications were as
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    Acute appendicitis coexisting with acute pyelonephritis causing diagnostic dilemma: a case report
    (SPRINGER, 2021-01-01) Ozkan, Burak; Ustun, Cemal; Coskuner, Enis Rauf
    Background Acute appendicitis and acute pyelonephritis are the most common diseases admitted to emergency departments. Both conditions have common symptoms such as flank pain, abdominal pain, and fever. Patients' history, physical examination, laboratory evaluation, and imaging methods are used to differentiate these two conditions. Diverticulitis, colitis, gynecological pathologies, and ureteral stones that mimic acute appendicitis should be kept in mind as differential diagnoses. Cases of pyelonephritis mimicking acute appendicitis have been reported in the literature, but there has not been a reported case in which acute appendicitis occurs during management of acute pyelonephritis. In this article, a case report which can cause such a diagnostic dilemma has been presented. Case presentation A 42-year-old female patient presented with clinical features suggestive of acute appendicitis that developed after a diagnosis of acute pyelonephritis. She underwent laparoscopic appendectomy on account of acute appendicitis during medical treatment for acute pyelonephritis. Physical examination showed only right costovertebral tenderness without any rebound tenderness at McBurney's point at the first admission, but during treatment rebound tenderness at McBurney's point was also detected. The Alvarado score of the patient was 5 at the first admission and 7 when acute appendicitis was diagnosed. The patient fully recovered and was discharged after both diseases were completely treated. Conclusions As seen in this case, it should be remembered that both diseases can be seen together which causes a diagnostic dilemma. If clinical or biochemical progression is detected in a patient under treatment, imaging methods should be repeated and additional ones with higher resolutions should be used.
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    The Role of Partial Nephrectomy without Arterial Embolization in Giant Renal Angiomyolipoma
    (HINDAWI LTD, 2012-01-01) Coskuner, Enis Rauf; Ozkan, Burak; Yalcin, Veli
    Angiomyolipoma is a benign neoplasm composed of varying admixtures of blood vessels, smooth muscle cells, and adipose tissue. Because of an increased risk of spontaneous haemorrhage, surgical approach is needed greater than 4-8 cm size. We here report our partial nephrectomy experience in the 24 cm size giant angiomyolipoma. 26-year-old woman referred to our clinic with a 24 cm size angiomyolipoma in her lower pole of right kidney. The inferior vena cava was deviated to the left by the mass. All the blood tests were normal and we offered her the choices of partial nephrectomy or nephrectomy. Right subcostal approach was used. The patient underwent resection of the mass with a safety region of 1 cm. Frozen section evaluation was consistent with angiomyolipoma and free for surgical margin. Warm ischemia time was 35min. and intraoperative bleeding volume was 200 cc. Postoperative 2nd day the drain was taken and hospital stay was 4 days. In literature we observed very rare angiomyolipoma cases with such a large dimension treated by partial nephrectomy without arterial embolization. If technically suitable partial nephrectomy is the main chioce in this kind of benign lesions in young patients.
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    Radical Prostatectomy in the Robotic Era. Comparison of Three Different Methods: Retropubic, Robotic and Perineal
    (2022-01-01) Ozkan, Burak; Coskuner, Enis Rauf
    Prostate cancer is the second most prevalent cancer among men and is the 6th cancer type leading to death. Starting with the use of PSA screening, there has been a steep increase in the number of cases diagnosed with and treated for localized prostate cancer. Radical prostatectomy use has increased following the increase in the number of cases and has become the golden standard for surgical procedures for their treatment. For over 50 years, while open retropubic and perineal methods have been used separately, advantages and disadvantages of each method have been expressed in official and unofficial grounds. The use of nerve-sparing radical prostatectomy that began particularly after the clearer definition of the neurovascular bundles and the anatomy of the prostate by Walsh and the improvements in continence and potency has proved open radical retropubic prostatectomy (RRP) more advantageous. The da Vinci Surgical System (Intuitive Surgical, Sunnyvale, CA, USA), developed to qualify disadvantages of laparoscopy in radical prostatectomy, came into use in 2000. With Abbou's identification of first robotic assisted radical prostatectomy (RARP), it finds increasing areas of application. Still there is need for further comparison of especially the three methods (RPP, RRP, and RARP) in prostate cancer treatment with more patients and longer follow-up periods. The objective of the first part of this paper is to provide a brief comparison of RRP and RARP results and in the second part we will discuss the perineal radical prostatectomy.