Araştırma Çıktıları

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Author: search.filters.author.Dogruoz, AlperHas files: No

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    Utility of Cervical Cannulation During Difficult Resternotomy in Congenital Heart Surgery
    (SAGE PUBLICATIONS INC, 2020-01-01) Temur, Bahar; Davutoglu, Arda; Dogruoz, Alper; Aydin, Selim; Suzan, Dilek; Kirat, Baris; Odemis, Ender; Erek, Ersin
    Background: Adhesions due to previous surgeries and some anatomical difficulties may make resternotomy dangerous in children. Femoral vessels are usually small and may not be suitable for cannulation. The aim of this report is to describe our experience with cervical cannulation during risky resternotomy in children. Methods: Between January 2014 and January 2018, cervical cannulation was performed in eight pediatric patients during sternal reentry. Their ages were between 3 months and 17 years (mean: 5.4 years). Three patients underwent stage III extracardiac Fontan operation with the diagnosis of hypoplastic left heart syndrome. Three patients had supravalvular aortic and/or pulmonary stenosis after previous arterial switch operation. One patient had proximal aortic arch stenosis and subvalvular aortic stenosis after interrupted aortic arch repair. The last patient had aortic root pseudoaneurysm and aortic insufficiency due to endocarditis. Through a separate cervical incision, a polytetrafluoroethylene graft was anastomosed to the common carotid artery and the arterial cannula was inserted into the graft. Antegrade selective cerebral perfusion (ASCP) was used in two patients. Results: During resternotomies, no major injury or bleeding occurred. Three-month-old patient who had previous interrupted aortic arch repair died despite extracorporeal membrane oxygenation support due to sepsis and multi-organ failure. Median intensive care unit stay and hospital stay were 3 days (1-40 days) and 17 days (7-60 days), respectively. Mean follow-up was 17.9 +/- 15.8 months. All patients were in good clinical condition. Conclusions: Cervical cannulation may be a useful and safe technique during high-risk resternotomy in children. This technique may also simplify the performance of ASCP if necessary.
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    Robotic Rectal Cancer Surgery with the da Vinci Xi System: First 100 Cases
    (ISTANBUL TRAINING \& RESEARCH HOSPITAL, 2019-01-01) Ozben, Volkan; Dogruoz, Alper; Boga, Salih Anil; Aytac, Erman; Baca, Bilgi; Hamzaoglu, Ismail; Karahasanoglu, Tayfun
    Introduction: The da Vinci Xi system, the latest model of the robotic technology, is proposed to enable multiquadrant abdominal surgery to be performed in a fully robotic approach without the need for a laparoscopic assistance, robot re-docking or re-positioning of the trocars. However, the literature has limited data on this topic. In this study, we aimed to evaluate the feasibility of the Xi robot use in rectal cancer surgery, a multiquadrant surgical procedure. Methods: Patients undergoing robotic mezorectal excision for rectal adenocarcinoma using the da Vinci Xi system between December 2014 and June 2017 were included in this study. Data were collected prospectively and analyzed retrospectively. Demographic data, perioperative clinical findings, histopathologic data and postoperative 30-day outcomes were analyzed. Results: One hundred patients were included in this study. There were 57 male and 43 female patients with a mean age of 61.4 +/- 12.3 years. Low anterior resection and abdominoperineal recetion were performed in 90 and 10 patients, respectively. In all the operations, the abdominal and pelvic stages of the procedure were completed robotically without a need for dual docking or trocar re-positioning. The mean operative time was 328.4 +/- 105.8 min and blood loss was 131.7 +/- 170.3 mL. Intraoperative complication occurred in 2 patients (2\%). Two procedures were converted to open surgery (2\%). The mean number of harvested lymph nodes was 25.3 +/- 12.0. All the surgical margins were clear except for four patients (4\%). The rate of incomplete mesorectal fascia was 3.2\%. The mean length of hospital stay was 6.6 +/- 3.6 days and the overall postoperative morbidity rate was 25\%. Conclusion: The da Vinci Xi model enables rectal cancer operations to be performed in a fully robotic fashion. This feature of the robot helps surgeon to benefit optimally from the advantages robotic surgery in all stages of the procedure.