Yazar "Elhan A." seçeneğine göre listele

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    Extended pelvic lymph node dissection: Before or after radical cystectomy? A multicenter study of the Turkish society of urooncology
    (2012) Ozen H.; Ugurlu O.; Baltaci S.; Adsan O.; Aslan G.; Can C.; Gunaydin G.; Elhan A.; Beduk Y.
    Purpose: We aimed to ascertain the effects of performing extended pelvic lymph node dissection (PLND) on the duration of surgery, morbidity, and the number of lymph nodes removed when the dissection was performed before or after radical cystectomy (RC). Materials and Methods: We used the database of our previous prospective multicenter study. A total of 118 patients underwent RC and extended PLND. Of the 118 patients, 48 (40.7%) underwent extended PLND before RC (group 1) and 70 (59.3%) underwent extended PLND after RC (group 2). The two groups were compared for extended PLND time, RC time, and total operation times, per operative morbidity, and the total numbers of lymph nodes removed. Results: Clinical and pathologic characteristics were comparable in the two groups (pgt; 0.05). The mean RC time and mean total operation times were significantly shorter in group 1 than in group 2 (p<0.001). The mean number of lymph nodes removed was 27.31±10.36 in group 1 and 30.87±8.3 in group 2 (p=0.041). Only at the presacral region was the mean number of lymph nodes removed significantly fewer in group 1 than in group 2 (p=0.001). Intraoperative and postoperative complications and drain withdrawal time were similar in both groups (p=0.058, p=0.391, p=0.613, respectively). Conclusions: When extended PLND was performed before RC, the duration of RC and consequently the total duration of the operation were significantly shorter than when extended PLND was performed after RC. Practitioners may consider performing extended PLND before RC and rechecking the presacral area for additional lymph nodes after RC, particularly in elderly patients with high co-morbidity for whom the duration of surgery matters. © The Korean Urological Association, 2012.
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    Reliability of Frozen Section Examination of External Iliac, Hypogastric, and Obturator Lymph Nodes During Radical Cystectomy: A Multicenter Study
    (2007) Adsan Ö.; Baltaci S.; Çal Ç.; Büyükalpelli R.; Ugurlu Ö.; Bozlu M.; Türkölmez K.; Şahin H.; Elhan A.
    Objectives: To evaluate the accuracy of frozen section examination (FSE) for detecting lymph node (LN) metastasis in patients with bladder cancer undergoing radical cystectomy and pelvic LN dissection. To our knowledge, the accuracy of FSE to identify LN metastases in patients with bladder cancer is still undetermined. Methods: The clinical data of 360 patients who had undergone radical cystectomy with pelvic lymphadenectomy for bladder cancer in six urologic institutions were retrospectively analyzed. The nodal regions included were the external iliac, hypogastric, and obturator LNs. The FSE results of the right and left LN regions were compared with the final histopathologic results of the respective LN regions. Results: The final pathologic examination revealed nodal metastases in 65 patients (18.1%). Of the 720 right and left LN regions in 360 patients, 88 (12.2%) were metastatic at the final pathologic examination. Although the FSE findings were negative, the final pathologic examination revealed LN metastases in 26 patients and in 29 pelvic LN regions. All LN regions with positive FSE findings were positive at the final pathologic examination. When we considered the 720 LN regions, the sensitivity, specificity, and positive and negative predictive values for FSE were 67%, 100%, 100%, and 95.6%, respectively. Conclusions: Until innovations in imaging methods improve nodal staging in patients with bladder cancer, performing FSE of the external iliac, hypogastric, and obturator LNs seems to be a reliable procedure for the evaluation of the LNs. The information obtained with FSE of the LNs can be used to determine intraoperatively the extent of LN dissection. © 2007 Elsevier Inc. All rights reserved.
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    Salmonella enterica serotypes and Salmonella infections: A multicenter study covering ten provinces in Turkey [Salmonella enterica serotipleri ve Salmonella enfeksiyonlari: Türkiye'de on ili kapsayan çok merkezli bir çalişma]
    (2004) Erdem B.; Hasçlik G.; Gedikoglu S.; Gür D.; Ercis S.; Sümerkan B.; Aysev A.D.; Tuncer I.; Tugrul M.; Tatman Otkun M.; Tünger A.; Akgün Y.; Acar N.; Köksal I.; Gültekin M.; Söyletir G.; Elhan A.
    In order to find the distinctive features of Salmonellae and Salmonella infections in Turkey, 620 Salmonellae strains, isolated from various clinical samples (481 stool, 108 blood, 12 urine, 3 bone marrow, 3 cerebrospinal fluid, 9 pus, and one from each of the bile, pleural fluid, wound, catheter samples) in 13 clinical microbiology laboratories of 10 provinces in Turkey (Ankara, Antalya, Bursa, Edirne, Eskişehir, İstanbul, İzmir, Kayseri, Konya and Trabzon) between July 1, 2000 and June 30, 2002, were serotyped. Among the patients 43% were female, 57% were male, 63.2% were from outpatient clinics and 36.8% were hospitalized patients. Seventy eight percent of the patients had gastroenteritis, 10.7% had septicemia/local infection, 9.8% had typhoid/ paratyphoid fever and 1.5% were carriers. Incidence of gastroenteritis was higher in 0-5 years age group (p<0.001). Of the 620 Salmonella enterica isolates, 47.7% were S.Enteritidis, 34.7% S.Typhimurium, 6% S.Paratyphi B, 2.9% S.Typhi, 0.2% S.Paratyphi A, 6.1% serogroup C1, and 2.4% serogroup C2. S.Enteritidis was the most common serotype in all provinces except for Kayseri, where S.Typhimurium was found to be the most common serotype (68.2%). Overall, the most frequently isolated serotype was S.Enteritidis, also being the most common serotype in stool and blood cultures. During the surveillance period two outbreaks have occurred, the first one by S.Enteritidis strains in Edirne, and the second one by S.Typhimurium strains in Kayseri. As a result, Salmonella infections are still a common health problem in Turkey, and active surveillance of Salmonella infections has vital importance.