Faculty of Medicine

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Author: search.filters.author.E Karakaş

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    Comparing loop and divided colostomy for anorectal malformation: a systematic review and meta-analysis
    (2024-11)
    G Gerçel
    ;
    M Azizoğlu
    ;
    E Karakaş
    ;
    ;
    M Escolino
    Aim: The optimal type of colostomy for patients with anorectal malformations (ARM) remains unclear. We conducted a systematic review and meta-analysis to compare the clinical outcomes of loop colostomies (LC) versus divided colostomies (DC) in patients with ARM. Methods: After review registration (PROSPERO: CRD42024513335), we searched multiple databases for comparative studies on LCs and DCs in patients with ARMs. Gray literature was sought. The complications examined included stoma prolapse, urinary tract infection (UTI), skin excoriation, stoma retraction, parastomal hernia, wound infection rate, and stoma stricture. Three reviewers independently assessed the eligibility and quality of the included studies. Meta-analysis of selected complications was performed using Revman 5.4, with p < 0.05 considered significant. Results: Eleven studies were included in the analysis, incorporating a total of 2550 neonates with ARMs, of which 1147 underwent LCs and 1403 underwent DCs. The meta-analysis revealed no significant differences between the two groups in the incidence of stoma prolapse (OR: 1.55, 95% CI: 0.63 to 3.79; p=0.34), UTIs (OR: 1.78, 95% CI: 0.50 to 6.36; p=0.38), skin excoriation (OR: 1.26, 95% CI: 0.68 to 2.34; p=0.46), stoma retraction (OR: 0.79, 95% CI: 0.09 to 6.64; p=0.83), parastomal hernia (OR: 0.99, 95% CI: 0.22 to 4.48; p=0.99), wound infection (OR: 0.35, 95% CI: 0.10 to 1.20; p=0.10), and stoma stricture (OR: 0.70, 95% CI: 0.22 to 2.18; p=0.53). Conclusions: The findings suggest that LCs and DCs are viable options for fecal diversion, presenting similar risks and benefits. The choice between these techniques should consider individual patient characteristics and surgical expertise.
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    Effects of azygos vein preservation in esophageal atresia repair: a systematic review and meta analysis
    (2024-11)
    C Gigena
    ;
    M Azizoğlu
    ;
    M Gazzaneo
    ;
    TO Kamçı
    ;
    M Escolino
    The purpose of this study is to evaluate the impact of azygos vein preservation on postoperative complications in esophageal atresia-tracheoesophageal fistula (EA-TEF). Method We performed English literature review using EMBASE, PubMed, Medline, SCOPUS, Web of Science, and Cochrane databases, encompassing all relevant publications up to July 2024. The impact of azygos vein preservation on postoperative complications, including anastomotic leaks, esophageal strictures, chest infections, and mortality were analysed. Patients were analyzed in two groups as azygos vein preservation (PAV) and azygos vein ligation (LAV). Results A total of 7 studies were included. RCT subgroup analysis showed that PAV group has lower anastomotic leak rate (I²=0%) (OR: 0.50, 95% CI: 0.28 to 0.88; p=0.02). Overall analysis showed that the PAV group has a lower anastomotic stricture rate (I²=9%) (OR: 0.58, 95% CI: 0.34 to 0.97; p=0.04). The PAV group had a significantly lower chest infection rate (I²=0%) (OR: 0.29, 95% CI: 0.18 to 0.49; p<0.00001). The PAV group had a significantly lower mortality rate (I²=0%) (OR: 0.48, 95% CI: 0.28 to 0.82; p=0.007). The overall mortality rates in the PAV and LAV groups were 9.2% and 18%, respectively. Conclusion The preservation of the azygos vein provides significant benefits in reducing anastomotic leaks, pulmonary infections, and mortality rates in esophageal atresia repair, potentially enhancing surgical success. However, these results need to be supported by randomized controlled trials.