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    Safety and Efficacy of Live Retrograde Intrarenal Surgery in Patients with Kindey Stone: Outcomes from a Boutique Course Series Which Complies with the Live Surgery Event Policies
    (Iniestares, S.A., 2023) Ozman, Oktay; Citgez, Sinharib; Basatac, Cem; Akguel, Haci Murat; Kalender, Goektug; Yazici, Cenk Murat; Tanidir, Yiloeren
    Background: Live surgery events (LSEs) are frequently organized for sharing the surgical experiences with surgeons at the beginning of their learning curves. The aim of this study was to investigate whether the outcomes and complication rates of patients underwent retrograde intrarenal surgery (RIRS) at LSEs are comparable with regular cases. Methods: Ten courses were organized during 2017-2022. Data of 32 patients who operated in the LSEs were 1:3 matched (for stone burden and surgeon) with the data of patients who underwent regular RIRS within the course periods at the same centers (n = 96). All courses took place in concordance with the latest LSE policies. The primary outcomes were stone-free and complication rates. Fluoroscopy and operation times were the secondary outcomes. Results: Stone-free rates of the groups were similar (84% in LSE and 79% in control group; p = 0.520). Similarly, there were no differences in complication rates (p = 0.428) and fluoroscopy time (p = 0.477). Duration of the LSE cases (82.24 +/- 31.12 min) was slightly but insignificantly longer than regular cases (73.77 +/- 20.89 min, p = 0.092). Moreover, guest surgeons tend to have longer operation time with statistically insignificant prolongation (74.92 +/- 30.43 min for host, 89.52 +/- 28.34 min for guest surgeons, p = 0.064). Conclusions: RIRS can be performed without jeopardizing operation efficiency and patient safety in LSEs. If surgeon is not familiar with operating room set-up or staff, live surgery must be performed by host surgeon to avoid extended operating time.
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    The factors affecting the examination of outside of prostate and its incomplete tissues sampling in 12 core guided prostatic biopsies directed to the periphery
    (Endoüroloji Derneği, 2020) Kocan, Huseyin; Yildirim, Ilker; Citgez, Sinharib; Toktas, Mahmut; Çalışkan, Selahattin; Özdemir, Enver
    Objectives: During prostate tissue sampling, it is recommended to direct toward the lateral of the prostate as prostate cancer displays more localization toward the periphery of prostate tissue. Insufficient tissue sampling is frequently encountered in lateral biopsies, due to the outside structure of the prostate and the prostatic anatomy. We aimed to determine the factors affecting this failure in systematic prostate biopsies taken accompanied by transrectal ultrasonography (TRUS).Material and Methods: A total of 2509 patients who underwent systematic 12-core guided TRUS biopsy of the periphery in our clinic were enrolled in the study and scanned retrospectively. Patients were divided into two groups as those with non-prostate tissue identified in pathology specimens (Group 1) and with only prostate tissue in all foci (Group 2). Each of the patients were evaluated for age, prostate volume, prostate-specific antigen (PSA), number of tissue samples taken from the periphery in 12-core guided biopsy, normal or abnormal digital rectal examination (DRE) results, absence or presence of tumor in the pathology.Results: Of the 2509 patients, 467 (18.61%) were identified to have non-prostate tissue. Mean age was 65.6 years, mean PSA was 14 ng/mL, mean PV was 45.5, 19.7% had suspect digital rectal examination and 25.8% were positive for tumor. Among the groups, statistically significant values were obtained for the effects of age (p=0.220), PSA(p=0.030), prostate volume (0.065), digital rectal examination (DRE) (p=0.09) and identification of non-prostate tissue in pathology result (p=0.052).Conclusion: The PSA values of those without non-prostate tissue in prostate biopsy taken with systematic 12-core TRUS were higher. Patients with tumor identified (+) were observed to have higher observational rates of no non-prostate tissue compared to patients negative for tumor. Patients with suspect DRE were identified to have higher observational rates of no non-prostate tissue.