Faculty of Medicine

Permanent URI for this communityhttps://repository.ukim.mk/handle/20.500.12188/14

Browse

Settings

Author: search.filters.author.Esra KarakasLanguage: search.filters.language.English

Search Results

Now showing 1 - 2 of 2
  • Loading...
    Thumbnail Image
    Some of the metrics are blocked by your 
    consent settings
    Item type:Publication,
    Comparing Loop and Divided Colostomy for Anorectal Malformation: A Systematic Review and Meta-Analysis
    (Elsevier, 2025-01)
    Gonca Gerçela
    ;
    Mustafa Azizoglu
    ;
    Esra Karakas
    ;
    ;
    Maria Escolino
    Introduction: 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.
  • Loading...
    Thumbnail Image
    Some of the metrics are blocked by your 
    consent settings
    Item type:Publication,
    Letter to the Editor in Response to: Short- and Long-Term Outcomes of Thoracoscopic and Open Repair for Esophageal Atresia and Tracheoesophageal Fistula
    (Elsevier, 2024-08)
    Mustafa Azizoglu
    ;
    Sergey Klyuev
    ;
    Secil Yuksel
    ;
    Tuba Erdem Sit
    ;
    Esra Karakas
    We have read with interest the study of Yalcin, et al., titled “Short- and Long-Term Outcomes of Thoracoscopic and Open Repair For Esophageal Atresia and Tracheoesophageal Fistula”, in which they published their esophageal atresia experiences [1]. The article by Yalcin et al. provides a comprehensive analysis of the short- and long-term outcomes of thoracoscopic versus open repair in patients with esophageal atresia and tracheoesophageal fistula (EA/TEF). This retrospective cohort study, encompassing two decades of data, offers valuable insights into the efficacy and safety of these surgical techniques. The authors' data cover the years 2000-2020. Although recent meta-analyses have not shown significant results regarding anastomotic stricture and anastomotic leak, they recommend preserving the azygos vein to reduce the risk of pneumonitis. I would like to ask the authors whether they have preserved the azygos vein in cases since 2020? It appears from the study that, up until 2020, the azygos vein was transected in all patients. Although the authors have discussed long-term outcomes, the study does not report on “musculoskeletal anomalies after EA repair,” a topic that has recently gained significant attention. Studies by Aubert et al. [2], Borselle et al. [3], and Hattori et al. [4] have reported lower rates of scoliosis in the thoracoscopic (TR) group. Similarly, these studies found significantly lower rates of rib deformity in the TR group. Our unpublished meta-analysis revealed that the TR group had a significantly lower scoliosis rate compared to the conventional open repair (COR) group (I2 ¼ 36%) (RR: 0.35, 95% CI: 0.14 to 0.84; p ¼ 0.02). The overall scoliosis rates in the TR and COR groups were 3.1% and 16%, respectively (Fig. 1). Additionally, our unpublished meta-analysis found that the TR group had significantly lower rib deformity rates compared to the COR group (I2 ¼ 0%) (RR: 0.05, 95% CI: 0.01 to 0.25; p ¼ 0.0002). The overall rib deformity rates were 0% in the TR group and 41.5% in the COR group (Fig. 2). I would like to ask Yalcin et al. whether they have evaluated long-term musculoskeletal complications, such as scoliosis and rib deformity, which are quite common after thoracotomy. If they have, publishing their data would provide valuable evidence and contribute to a more rigorous meta-analysis on this subject.