Turkish Journal of Medical Sciences最新文献

{"title":"Examination of the transport characteristics of pediatric trauma patients.","authors":"Ramiz Yazici, Muhammed Güner, Efe Demir Bala, Ayşe Fethiye Basa Kalafat, Eyüp Sari, Salih Fettahoğlu, Rabia Birsen Tapkan, Utku Murat Kalafat, Aziz Ahmet Sürel, Serkan Doğan","doi":"10.55730/1300-0144.5856","DOIUrl":"10.55730/1300-0144.5856","url":null,"abstract":"<p><strong>Background/aim: </strong>Injury is an important public health problem in the pediatric age group and one of the leading global causes of morbidity and mortality. The fact that pediatric trauma has a significant impact on patients, families, and countries shows the need for a better understanding of this phenomenon. This study investigates the demographic characteristics, reasons for admission to the hospital, and diagnoses of pediatric trauma patients who received prehospital emergency health services.</p><p><strong>Materials and methods: </strong>This study was designed as a retrospective observational study and included all patients under the age of 18 who received emergency healthcare due to trauma and were registered in the Emergency Health Automation System after a call was placed to the emergency call center between 1 January 2018 and 31 December 2022. Information such as the reason for calling an ambulance, ICD-10 diagnosis codes, mechanism of injury, time of arrival at the scene, transport duration from the scene to the hospital, and reasons for interfacility transfers were collected for all patients.</p><p><strong>Results: </strong>A total of 37,420 patients were included in the analysis. Seventeen patients were found dead at the scene of the trauma and 35 patients experienced cardiac arrest on the way to the hospital from the scene. The difference between age groups in terms of time from arrival at the scene to arrival at the hospital was statistically significant (p < 0.001). Falls were the most common cause of trauma in all age groups, followed by traffic accidents. Patients requiring a specialist and transferred primarily for fall-related injuries were in direct proportion to the total number of cases (65.0%, n = 1838), followed by cases of traffic accidents and sports injuries. Most of the secondary transports were made to a training and research hospital or state hospital.</p><p><strong>Conclusion: </strong>Targeted preventive measures and community education should address the specific causes of trauma that are more prevalent in certain age groups. Early identification of special patient groups that typically require secondary transport can reduce mortality and morbidity related to trauma by facilitating direct transfers to appropriate hospitals.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11407336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationships between stenosis severity, functional limitation, pain, and quality of life in patients with cervical spondylotic radiculopathy.","authors":"Aydın Sinan Apaydin, Musa Güneş","doi":"10.55730/1300-0144.5842","DOIUrl":"https://doi.org/10.55730/1300-0144.5842","url":null,"abstract":"<p><strong>Background/aim: </strong>This study aimed to examine the relationships between severity of stenosis, pain, functional limitation, disability, and quality of life in patients with cervical spondylotic radiculopathy.</p><p><strong>Materials and methods: </strong>Patients (45 female, 19 male) with radiculopathy due to spondylotic changes in the cervical spine were included in this study. Stenosis severity (thecal sac cross-sectional area (CSA)), numbness, neck and arm pain severity, functional limitation (Cervical Radiculopathy Impact Scale), disability, and quality of life (EQ-5D-3L General Quality of Life Scale) were evaluated. The study was registered at ClinicalTrials.gov as NCT06001359.</p><p><strong>Results: </strong>According to CSA values, 28 (43.75%) patients had severe stenosis and 36 (56.25%) had moderate stenosis, and the average CSA was 81.65 ± 10.08 mm². Positive correlations were found between both neck and arm pain and neck disability (r = 0.597, r = 0.359), and negative correlations were found for the General Quality of Life Scale index score and EQ-5D-3L visual analog scale (r = -0.787, r = -0.518). There were significant positive correlations between Cervical Radiculopathy Impact Scale subscales and severity of stenosis, neck and arm pain, numbness, and disability (p < 0.05 for all). A significant negative correlation was observed between Cervical Radiculopathy Impact Scale subscales and quality of life (p < 0.01). Stenosis severity was correlated with pain, neck disability, and quality of life (p < 0.01 for all).</p><p><strong>Conclusion: </strong>There are direct relationships between cervical spondylotic radiculopathy and neck and arm pain, numbness, disability, and quality of life. Additionally, an increase in the severity of cervical stenosis is associated with an increase in pain and disability.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11407326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early relaparotomy in recipients after living donor liver transplantation: causes, risk factors, and consequences.","authors":"Bora Barut, Cengiz Ceylan, Akile Zengin, Mehmet Güzel, Yasin Dalda, Sezai Yilmaz","doi":"10.55730/1300-0144.5863","DOIUrl":"https://doi.org/10.55730/1300-0144.5863","url":null,"abstract":"<p><strong>Background/aim: </strong>Despite advancements in surgical methodologies and the extensive perioperative and postoperative care administered to recipients, the prevalence of complications requiring early relaparotomy following living donor liver transplantation (LDLT) remains persistent. This study sought to analyze the determinants influencing relaparotomy occurrences in the initial 30 days following LDLT. Additionally, it was aimed to evaluate the impact of early laparotomy on both graft and patient survival within this distinct patient cohort.</p><p><strong>Materials and methods: </strong>The study encompassed recipients (n = 535) aged 18 years and older who underwent primary LDLT at our institution from January 2019 to December 2021. Exclusion criteria involved patients necessitating early retransplantation. Early relaparotomy was specified as surgical intervention within the initial 30 days following LDLT.</p><p><strong>Results: </strong>The study enrolled a total of 535 patients, among whom 85 (15.9%) underwent early relaparotomy. The median age of the patients was 54 (range: 41-60) years, with a predominant male representation (66.2%). Univariate analysis comparing the laparotomy and nonrelaparotomy groups revealed statistically significant differences in the creatinine (p = 0.043) and sodium (p = 0.025) levels, graft side (p < 0.001), etiology (p = 0.005), and blood loss (p = 0.012).In the multivariate analysis, creatinine (p = 0.039; OR = 1.668; 95% CI = 1.027-2.709) and left lobe graft (p < 0.0001; OR = 3.611; 95% CI = 1.960-6.652) emerged as independent risk factors for relaparotomy.</p><p><strong>Conclusion: </strong>The primary causes of early relaparotomy following LDLT include postoperative bleeding, biliary leakage, and vascular complications. Preoperative elevation in creatinine and sodium levels, the presence of Budd-Chiari syndrome, utilization of a left lobe graft, and intraoperative blood loss are identified as risk factors associated with early relaparotomy after LDLT. Patients undergoing early relaparotomy exhibit inferior survival rates compared to those who do not.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11518318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The function of p97/valosin-containing protein (VCP) and small VCP-interacting protein (SVIP) in invasion and migration of pancreatic cancer cells.","authors":"Ebru Alimoğullari, Sevil Çayli","doi":"10.55730/1300-0144.5894","DOIUrl":"https://doi.org/10.55730/1300-0144.5894","url":null,"abstract":"<p><strong>Background/aim: </strong>Misfolded proteins are eliminated by a process known as endoplasmic reticulum-associated protein degradation (ERAD). ERAD has an impact on a variety of illnesses, such as diabetes, cystic fibrosis, cancer, and neurological conditions. As one of the many proteins involved in ERAD, this study is focused on p97/valosin-containing protein (VCP) and small VCP-interacting protein (SVIP). The existence and function of SVIP and p97/VCP in various types of pancreatic cancer have not yet been investigated. The study's objectives are to examine the expressions of SVIP and p97/VCP in two pancreatic cancer types and to show whether these proteins aid in the invasion and migration of pancreatic cancer cells.</p><p><strong>Materials and methods: </strong>In this work, MIA PaCa-2 and PANC-1 human cell lines were examined. Immunocytochemistry and immunofluorescence were performed to detect the cellular localization and presence of p97/VCP and SVIP in pancreatic cancer cells. Following p97/VCP siRNA and SVIP siRNA transfection of the cells, protein expressions were assessed using Western blot analysis. The effects of this suppression on cell invasion and migration were determined using the xCELLigence real-time analysis system (RTAC).</p><p><strong>Results: </strong>In the nucleus and cytoplasm of MIA PaCa-2 and PANC-1 cells, p97/VCP and SVIP immunoexpressions were seen. The decrease in protein expressions of p97/VCPsi and SVIPsi was significant in pancreatic cells compared to the controlsi. The p97/VCP siRNA transfection reduced the invasion and migration of MIA PaCa-2 and PANC-1 cells. In addition, the SVIP siRNA suppression resulted in increasing the invasion and migration ability of both cells. This study also demonstrated, for the first time, SVIP expression in MIA PaCa-2 and PANC-1 cells.</p><p><strong>Conclusion: </strong>Overall, the findings show the differential expression and function of p97/VCP and SVIP in pancreas ductal adenocarcinoma cells. The potential of the pancreatic cancer cells to migrate and invade altered when the two cell lines were transfected with p97/VCPsi and SVIPsi.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11518332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phthalate exposure induces cell death and ferroptosis in neonatal microglial cells.","authors":"Elif Keleş, Arzu Aral, Zübeyir Elmazoğlu, Hasan Hüseyin Kazan, Elif Gülçiçek Abbasoğlu Topa, Mehmet Ali Ergün, Hayrunnisa Bolay","doi":"10.55730/1300-0144.5889","DOIUrl":"https://doi.org/10.55730/1300-0144.5889","url":null,"abstract":"<p><strong>Background/aim: </strong>Phthalates are the materials used for plasticizing polyvinyl chloride. Di-(2-Ethylhexyl) phthalate (DEHP) is one of the phthalates most frequently used in a wide range of applications, including medical equipment such as endotracheal and feeding tubes, intravenous catheters, central lines, extracorporeal membrane oxygenation sets, total parenteral nutrition bags, blood product sets, and intravenous pump lines, respiratory sets in neonatal intensive care units (NICUs). Studies have shown that phthalates, including DEHP, can cross the placenta and blood-brain barrier, possibly leading to neurodevelopmental impairment in vitro and in vivo. However, the molecular mechanisms affected by phthalate exposure have not been explored in depth. This study aimed to illuminate the effects of DEHP on neuroinflammation at the molecular level using neonatal microglial cells as the model.</p><p><strong>Materials and methods: </strong>Mouse BV-2 neonatal microglia cells were exposed to DEHP under controlled conditions. Cellular toxicity was assessed via a cell viability assay and specific markers were used to evaluate the apoptosis/necrosis, cellular iron content, reactive oxygen species (ROS), and organelle integrity. Proinflammatory proteins were quantified using enzyme-linked immunosorbent assay, while ferroptosis was assessed using a ferroptosis blocker, and affected gene expressions were determined using quantitative reverse-transcriptase real-time polymerase chain reaction (RT-PCR).</p><p><strong>Results: </strong>The results revealed that high concentrations of DEHP exposure increased toxicity via increased levels of ROS and inflammation. Elevated ROS levels were observed to increase the tendency for mitochondrial-lysosomal disruption, bringing about apoptosis or necrosis. Moreover, iron homeostasis was dysregulated by DEHP, which putatively triggered ferroptosis in a dose-dependent manner.</p><p><strong>Conclusion: </strong>This study indicates that neonatal exposure to DEHP may be linked to neurodevelopmental impairment via inflammation-related cell death and ferroptosis. The prevalence of DEHP in NICU medical devices raises concerns about potential neurodevelopmental deficits, including disorders like autism and mental retardation. These findings highlight the urgency of addressing DEHP exposure in neonatal care.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11518348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are there any concerns about the usage of biological agents in psoriasis?","authors":"Burhan Engin, Eylül Kasapoğlu","doi":"10.55730/1300-0144.5860","DOIUrl":"https://doi.org/10.55730/1300-0144.5860","url":null,"abstract":"","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11407340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the Bulut Index-Beta method and Global Health Security Index: results from the world's countries.","authors":"Tevfik Bulut, Mehmet Top, Murat Atan, Burkay Genç","doi":"10.55730/1300-0144.5854","DOIUrl":"https://doi.org/10.55730/1300-0144.5854","url":null,"abstract":"<p><strong>Background/aim: </strong>The Global Health Security Index (GHSI), which is used to assess the global health security preparedness levels of countries, and the Bulut Index-Beta (BI-β) method, developed as a multicriteria decision-making method, were compared in terms of global health security in the context of the world's countries. It was aimed to demonstrate the feasibility of the BI-β method by testing it on GHSI datasets and contribute to the methodological development of the GHSI.</p><p><strong>Materials and methods: </strong>The datasets used in this study were the publicly available GHSI datasets, which allow for comparative evaluations of countries. The BI-β method and GHSI were used to compare countries in terms of global health security.</p><p><strong>Results: </strong>In 2021, the top three best-performing countries in terms of global health security were the United States (BI-β = 85.46), Australia (BI-β = 82.53), and the United Kingdom (BI-β = 82.29). For 2019, the United States (BI-β = 85.44) and Australia (BI-β = 81.69) had the same ranks as in 2021, but the United Kingdom (BI-β = 76.63) dropped to 9th place. There was a statistically significant positive weak monotonic relationship between BI-β and GHSI rankings.</p><p><strong>Conclusion: </strong>Since the GHSI scoring system is not consistent or questionable, the weighting process needs to be objectively reconsidered and the reasons for the weighting process need to be explained. The GHSI was conceptualized based on a narrow and technical framework. Therefore, it is recommended that the social and political determinants of public health be taken into account in the GHSI. On the other hand, the BI-β method can be easily used in solving other multicriteria decision-making problems, especially in public health areas such as global health security.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11407367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thoracic trauma in the geriatric population and possible preventive measures: a retrospective analysis of 261 cases.","authors":"Mehmet Çetin, Necati Solak, Büşra Özdemir Çiflik, İlteriş Türk, Sebahattin Sefa Ermancik, Koray Aydoğdu","doi":"10.55730/1300-0144.5880","DOIUrl":"https://doi.org/10.55730/1300-0144.5880","url":null,"abstract":"<p><strong>Background/aim: </strong>The increase in the proportion of the elderly population within society is concurrently escalating their vulnerability to traumas, notably falls associated with age-related comorbidities.</p><p><strong>Materials and methods: </strong>This retrospective analysis involved the examination of data pertaining to patients aged 65 and above who were admitted to our clinic for inpatient treatment following thoracic trauma. Various parameters were statistically compared between the groups with indoor and outdoor traumas.</p><p><strong>Results: </strong>Of the 261 patients included in the study, 59.4% were male, and the average age in the entire sample was 75.52 ± 7.79. Moreover, 136 (52%) patients had indoor trauma, while 125 (48%) had outdoor trauma. The mean value for all the patients on the Itaki Fall Risk Scale (FRS) II score was 11.04 ± 4.18. The Itaki FRS II score was significantly higher for indoor accidents (11.90 ± 4.34) compared to outdoor accidents (10.10 ± 3.78) (p < 0.001). Additionally, the absence of a fall history and low risk according to the Itaki FRS II score were higher for outdoor accidents compared to indoor accidents, and the difference was statistically significant (p < 0.001). In geriatric trauma occurring outdoors, bilateral rib fractures and extrathoracic findings were significantly more prevalent (p = 0.011 and p = 0.010, respectively). The majority of patients were followed-up without any surgical intervention (73.9%), the most common surgical interventions were catheter (10.3%) and tube thoracostomy (10.3%), and 1.5% of the patients required surgical exploration. Trauma resulted in mortality in 1.5% of the patients.</p><p><strong>Conclusion: </strong>In the future, specialized measures and prospective studies tailored to the geriatric population, which will constitute the largest demographic segment of society, can facilitate the prevention of trauma-related morbidity and mortality, including associated financial costs.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11518327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antifibrotic treatment response comparison of progressive pulmonary fibrosis and idiopathic pulmonary fibrosis.","authors":"Berna Akıncı Özyürek, Kerem Ensarioğlu, Tuğçe Şahin Özdemirel, Esma Sevil Akkurt, Özlem Özdağ, Esma Zenbilli","doi":"10.55730/1300-0144.5866","DOIUrl":"https://doi.org/10.55730/1300-0144.5866","url":null,"abstract":"<p><strong>Background/aim: </strong>Idiopathic pulmonary fibrosis (IPF) and progressive pulmonary fibrosis (PPF) are two entities categorized as fibrotic lung diseases. With a similar clinical presentation and treatment modalities in many cases, the line differentiating these two diseases may not be evident. Hence, it was aimed herein to evaluate the effectiveness of antifibrotic treatment and the course of fibrotic lung diseases.</p><p><strong>Materials and methods: </strong>The study included patients diagnosed with IPF and PPF who were given antifibrotic treatment and followed-up for 12 months at our clinic. At the final follow-up, treatment response and radiological evaluation were investigated via high-resolution computed tomography.</p><p><strong>Results: </strong>Eighty-seven patients were included in the study (57 with IPF and 30 with PPF). Under antifibrotic treatment, there were no statistically significant decreases in the six-minute walking test, forced vital capacity, and diffusing capacity of the lungs for carbon monoxide values at 6 and 12 months posttreatment. The most common side effects were photosensitivity for patients under the pirfenidone regimen, while diarrhea was predominantly observed in the PPF group. Radiological progression was observed in 22.9% of the patients at 12 months posttreatment. Hospitalization requirements were more evident in the PPF group, with at least one hospitalization history present in 60% (n = 18) of the PPF patients compared to 12.3% (n = 7) of the IPF patients.</p><p><strong>Conclusion: </strong>A personalized approach is preferred with similar clinical profiles for both treatment modalities, with specific side effects considered.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11518374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of intraoperative microvascular Doppler during subinguinal microsurgical varicocelectomy in children reduces complications.","authors":"Cem Kaya, Sibel Eryilmaz, Alparslan Kapisiz, Ali Atan, Ramazan Karabulut, Zafer Türkyilmaz, Kaan Sönmez","doi":"10.55730/1300-0144.5849","DOIUrl":"https://doi.org/10.55730/1300-0144.5849","url":null,"abstract":"<p><strong>Background/aim: </strong>This study assessed the impact of intraoperative microvascular Doppler ultrasonography (MDU) during microsurgical subinguinal varicocele correction in children.</p><p><strong>Materials and methods: </strong>Nineteen patients who underwent intraoperative MDU during subinguinal microsurgical varicocelectomy between 2021 and 2023 were included in this study. Each patient's age, varicocele side, clinical examination findings, preoperative ultrasonography results, intraoperative findings, spermatic artery counts and findings in terms of MDU use, postoperative complications, and results were evaluated.</p><p><strong>Results: </strong>All varicoceles were on the left side and the average age of the patients was 15.2 years. The indications for varicocelectomy were testicular hypotrophy (n = 10) and scrotal pain or fullness (n = 9). When a surgical microscope was used, testicular artery pulsation was detected in only five patients, whereas it was detected in all cases when MDU was used. In 16 cases, a single testicular artery was identified, and two arteries were identified in three cases. Additionally, in a case where a spermatic vein was suspected, it was not ligated due to the detection of pulsation with an arterial pattern using MDU. Two to three lymphatic channels were isolated and preserved, an average of 7.5 vessels were ligated, and five external spermatic veins were identified and ligated. There were no complications, and six of the patients with testicular hypotrophy showed signs of the catch-up growth phenomenon.</p><p><strong>Conclusion: </strong>The use of MDU during subinguinal microsurgical varicocelectomy in children not only increases the success rate but also minimizes complications such as hydrocele and recurrence.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11407351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}