Faculty of Medicine

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Author: search.filters.author.Sergey KlyuevHas files: Yes

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    Generative Artificial Intelligence Accuracy in Interpreting Forest Plots in Pediatric Surgery Meta-analyses: A Perspective From Pediatric Surgery Meta-analysis Study Group (PESMA)
    (Elsevier BV, 2025-04)
    Mustafa Azizoglu
    ;
    Maria Escolino
    ;
    Tahsin Onat Kamci
    ;
    Sergey Klyuev
    ;
    Sonia Perez Bertolez
    Pediatric surgery is a relatively newer specialty compared to fields such as orthopedics, internal medicine, and pediatrics. The number of pediatric surgeons worldwide is significantly lower than in many other medical disciplines. Consequently, this has resulted in a lower cumulative volume of academic research in pediatric surgery, including a smaller number of meta-analyses. However, in recent years, there has been a noticeable increase in the number of meta-analyses within this field and dedicated pediatric surgery meta-analysis study groups such as PESMA have emerged. Despite this progress, there remains a considerable need for further research in this area.
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    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.
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    Alisklamp versus Conventional Dorsal Slit Circumcision: A Multicentric Randomized Controlled Trial
    (MDPI (Multidisciplinary Digital Publishing Institute), 2024-08)
    Mustafa Azizoglu
    ;
    ;
    Sergey Klyuev
    Background: There are numerous methods of circumcision performed worldwide, typically classified into two main groups: conventional surgical techniques and various device-assisted techniques. Each method has its own advantages, limitations, and potential complications. The aim of this study was to compare outcomes of the Alisklamp technique versus the dorsal slit technique in male circumcision procedures. Method: This multicenter RCT compared the dorsal slit and Alisklamp techniques for circumcision, assessing patient demographics and intraoperative and postoperative outcomes. All patients, under local anesthesia via dorsal penile nerve block, were discharged on the same day and followed up at 24-48 h, 1 week, and 1 month. Results: A total of 180 patients enrolled, and 166 patients were included. The study compared postoperative outcomes between the Alisklamp (AK) and dorsal slit (DS) circumcision techniques in 166 patients. Key findings included significantly higher penile edema in the DS group (19%) compared to the AK group (2.4%) (p < 0.001), with severe edema occurring only in the DS group. Wound gaping was more common in the AK group (8.3%) compared to the DS group (1.2%) (p = 0.030). Skin tunnels were observed only in the DS group (9.5%) (p = 0.004). There were no significant differences in nausea, vomiting, bleeding, necrosis, infection, wound dehiscence, chordee, rotational anomalies, or secondary phimosis between the groups. Mean operation time was lower in the AK group than the DS group (7.8 min vs. 15.5 min; p < 0.001). Conclusions: The Alisklamp technique is recommended as the preferred method for circumcision because it minimizes complications, shortens the procedure time, and is easy to apply.
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    THE IMPACT OF CAUDAL BLOCK ANESTHESIA ON POSTOPERATIVE COMPLICATIONS IN DISTAL HYPOSPADIAS SURGERY: A MULTI-CENTER RANDOMIZED CONTROLLED TRIAL
    (2024-06)
    ;
    Mustafa Azizoğlu
    ;
    Sergey Klyuev
    Aim of the study: This study aimed to assess the effect of caudal block anaesthesia on the outcomes of distal hypospadias surgery. Methods: The patients were randomly divided into two groups. Group 1 (n=) received caudal block anesthesia Group 2 (n=) received no caudal block. The postoperative complications were compared. All patients underwent repair with the TIPU technique. Results: Group 1, consisting of 101 patients, and Group 2, with 78 patients, were evaluated for the prevalence of complications. The findings revealed that meatal stenosis occurred in 6.9% of Group 1 and 7.7% of Group 2, urethrocutaneous fistula in 6.9% of Group 1 compared to 5.1% in Group 2, glans dehiscence in 2% of Group 1 and 3.8% of Group 2, and urethral stenosis was observed in 2% of patients in both groups. Notably, there were no instances of urethral diverticula in either group. Statistical analysis showed no significant differences in the rates of meatal stenosis (p=0.846), urethrocutaneous fistula (p=0.619), glans dehiscence (p=0.453), and urethral stenosis (p=0.793) between the two groups. Conclusion: The study demonstrated that caudal block anesthesia does not significantly increase the postoperative complications in distal hypospadias surgery, with similar complication rates observed in both study groups.