Publications by authors named "Tzevat Tefik"

Background: Laparoscopic upper abdominal surgeries are prone to respiratory complications, possibly due to mechanical ventilation and the surgery itself. In this study, we aimed to investigate the changes in lung condition in living donor nephrectomy patients using perioperative ultrasound guidance.

Methods: Living donor nephrectomy patients who underwent fully laparoscopic surgery in the lateral position were included in the study.

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Background: Urinary tract stone disease is quite common in the population, and treatment modalities are constantly evolving. Technological advancements in endourology have led to a shift towards more minimally invasive treatments. Nowadays, robotic flexible ureteroscopy is becoming increasingly popular, showing promising results.

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Introduction: Pre-stenting remains a subject of debate, and its influence on FANS assisted ureteroscopy is unclear. The global FANS collaborative group aims to address the influence of pre-stenting on FANS-assisted ureterorenoscopy (URS).

Material And Methods: This prospective multicentre study assesses the outcomes of 394 patients undergoing FANS-assisted ureteroscopy for renal stones.

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Background: Flexible and navigable suction ureteral access sheaths (FANS) have proven to be effective in reducing operative time and infectious complications and in increasing stone-free rate during retrograde intrarenal surgery (RIRS). FANS may reduce intrarenal pressure, thus reducing parenchymal renal damage. The aim of the present study was to assess acute kidney injury (AKI) rate following RIRS with FANS.

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Background: Flexible and navigable suction ureteral access sheath (FANS) has been proven to improve stone-free rate (SFR) and many studies report high intraoperative 100% stone-free status (IO-SFS) and postoperative 100% stone-free status (PO-SFS). The reliability of IO-SFS vis-à-vis image-proven PO-SFS needs to be evaluated as it has implications on perioperative management.

Methods: Our prospective, multicenter study enrolled 704 adult patients from 21 centers who underwent FURS with FANS between August 2023 and October 2024.

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Technology has driven the evolution of endourology over the past decades. Endoscopic stone surgery could benefit greatly from integration of artificial intelligence to refine diagnostics and enhance training and postoperative care. However, ethical, accessibility, and cost challenges need to be addressed to realise the full potential of artificial intelligence in this setting.

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Objective: To study the long-term outcomes of the flexible and navigable suction ureteral access sheath (FANS) in flexible ureteroscopy (FURS). FANS has well-established efficiency and 30-day perioperative safety; however, its influence on pelvicalyceal and ureteric anatomy remains to be investigated.

Methods: This was a prospective study of patients with normal renal anatomy who underwent FURS with FANS for renal stones from April 2023 to August 2024 in 16 centers worldwide.

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Objective: To assess urologists' perceptions and current practices of using suction-based techniques and technologies in percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS) for kidney stones.

Materials And Methods: A customized web-based 28-item questionnaire was created. All participation was voluntary.

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Purpose: To investigate the current thoughts and perspectives on kidney stone analysis amongst urologists and urology residents worldwide.

Methods: In October 2022 an online survey supported by the EULIS was circulated amongst urologists and urology residents worldwide. The survey was based on the current EAU guidelines regarding stone analysis and its role in urolithiasis management.

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Objectives: Chemokines are inflammatory mediators directly involved in immunological mechanisms that mediate alloimmune responses; recently, gene expression analysis studies have aroused great interest in the field of transplantation. We aimed to evaluate the predictive role of chemokine gene expression in rejection in renal transplant patients.

Materials And Methods: Our study included 91 patients who underwent living-related renal transplant.

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Flexible and navigable suction ureteral access sheath (FANS) is a potential game changer in flexible ureteroscopy (FURS). The influence of sheath size on outcomes needs research. The primary aim was to analyze 30-day single stage stone free status (SFS), zero fragment rate (ZFR) and complications when using 10/12Fr sheaths vis a vis other sheath sizes.

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Introduction: Treatment of de novo vesicoureteral reflux (VUR) into the transplanted kidney constitutes a clinical challenge. Herein, we present our data on patients who underwent endoscopic subureteric injection for the treatment of VUR following renal transplantation (RT) in our center.

Methods: The patients who underwent endoscopic subureteric injection for VUR into the transplanted kidney after RT in our department between 2008 and 2023 were reviewed retrospectively.

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Article Synopsis
  • * Data was collected from 16 centers, involving 142 patients, where 96.5% were stone-free 24 hours post-surgery, with a significant number achieving grade A (no fragments).
  • * The findings suggest that using FANS-UAS results in excellent safety and efficacy within 24 hours of surgery, with the only notable complication being transient fever in 7% of patients.
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Objective: To measure the force necessary to win the resistance during insertion of ureteral access sheaths (UAS) in an experimental homemade model and to compare the peak force of insertion (PFOI) of different commercially available UASs.

Methods: Three investigators (2 novice and 1 expert) inserted the UASs into 2 different adapters with diameters of 10 Fr and 8 Fr. The force of insertion was continuously measured with a digital force gauge connected to the UAS during each insertion.

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Background/aim: Management of asymptomatic kidney stones is an ongoing debate with follow-up and treatment guidelines based on low-level evidence. Our aim was to evaluate current management of asymptomatic urinary stones.

Materials And Methods: A 70-question survey was designed in collaboration with European Association of Urology, Young Academic Urologists, Section of Uro-Technology and Section of Urolithiasis groups and distributed.

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Background And Objective: The aim of this study was to evaluate the stone-free status (SFS) rate and complications after flexible ureteroscopy (fURS) for treatment of renal stones using a flexible and navigable suction (FANS) ureteral access sheath.

Methods: Data for adults undergoing fURS in 25 centers worldwide were prospectively collected (August 2023 to January 2024). Exclusion criteria were abnormal renal anatomy and ureteral stones.

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Purpose: To define a peak force of insertion (PFOI) threshold for ureteral damage during ureteral access sheath (UAS) placement on an experimental ureteral orifice model.

Methods: A specially designed water tank using 2 laparoscopic 5 mm ports and 2 different size (10 Fr and 8 Fr) sealing cap adaptors (SCA) as ureteral orifices was used to perform the test. A 10-12 Fr UAS was fixed to a load cell and the force of insertion (FOI) was continuously recorded with a digital force gauge.

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Background: The management of kidney stones, particularly those in the renal pelvis, is a critical aspect of urology. The European Association of Urology guidelines recommend Extracorporeal Shock Wave Lithotripsy or Endourology methods, encompassing Percutaneous Nephrolithotomy and Ureterorenoscopy (URS), for stones ranging from 10-20 mm. Robotic-assisted urological procedures have gained prominence in recent years, promising enhanced precision and safety.

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Purpose: In this study, we aimed to identify the compliance rates of calcium-oxalate stone patients for metabolic evaluation, diet and medical treatment and also determine the factors that are associated with poor compliance rates.

Methods: This study was conducted by the EULIS eCORE working group prospectively. In the initial visit, demographic and stone-related characteristics were recorded.

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Purpose Of Review: Robotic surgery in urology has already been widely employed in robotic-assisted laparoscopic surgery for minimally invasive procedures (MIS). We wanted to analyse rapidly developing robotic ureteroscopy (RoboURS) for the treatment of renal stone disease.

Recent Findings: A comprehensive literature review was performed for technical aspects and clinical outcomes of RoboURS.

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Article Synopsis
  • This study compares the effectiveness and safety of four kidney stone treatments: extracorporeal shockwave lithotripsy (SWL), retrograde intrarenal surgery (RIRS), mini-percutaneous nephrolithotomy (mPNL), and standard-percutaneous nephrolithotomy (stPNL) for 20-30 mm stones, involving a review of 1197 patient records from 8 centers.
  • Results showed that mPNL and stPNL had significantly higher stone-free rates (SFRs) both initially and ultimately, with lower auxiliary treatment rates compared to SWL and RIRS.
  • Although SWL had a lower complication rate, it was less effective than the surgical methods, as mPN
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Urolithiasis, which prevalence is increasing, poses a risk for chronic kidney disease in patients. Dietary habits play a significant role in stone formation, growth and recurrence. Also, comorbidities and lifestyle changes are among the factors affecting stone formation.

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The aim of this study was to construct the fourth in a series of guidelines on the treatment of urolithiasis by the International Alliance of Urolithiasis (IAU) that by providing a clinical framework for the metabolic evaluation, prevention, and follow-up of patients with urolithiasis based on the best available published literature. All recommendations were summarized following a systematic review and assessment of the literature in the PubMed database from January 1976 to June 2022. Each generated recommendation was graded using a modified GRADE methodology.

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Although stone disease is an important health problem with high incidence and recurrence rates, it is a preventable disease. Attitudes and practices of urologists regarding the prevention of recurrence continue to be a subject of debate. In this context, an online survey study was conducted involving 305 urologists from 57 different countries.

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Quadratus lumborum block (QLB) is a new fascial plane block that may be helpful for laparoscopic surgeries. In this present study, we aim to evaluate the analgesic efficacy of QLB in laparoscopic living related donor nephrectomy (LLRDN) applied continuously via a catheter that was placed under laparoscopic vision by the surgeon. Following the approval of the Clinical Research Ethics Committee of Istanbul University, Istanbul Medical Faculty (2019/1552), 9 study (Group QLB) and 26 control (Group M) patients that underwent LLRDN were enrolled in this retrospective study.

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