Objective: Urolithiasis is an important disease that can lead to permanent kidney dysfunction and severe clinical symptoms in pediatric patients. We aimed to present our findings of rigid ureteroscopy combined with Holmium YAG laser lithotripsy.Material and Methods: We retrospectively reviewed the ultrasonography, and medical records of pediatric patients with urolithiasis who were operated in Sutcu Imam University Department of Pediatric Surgery, Kahramanmaraş between April 2018 and December 2019.Results: Sixty-one pediatric patients (M/F=38/23) with urolithiasis were enrolled in this study. The mean age was 6.7±4.9 years (range 3 month-17 years). Thirteen (34.2%) male patients need an urgent operation (rigid ureteroscopy combined with Holmium YAG laser lithotripsy) while the corresponding number was 4 (17.4%) in female patients. The difference between two sexes was statistically non-significant (p=0.156). Thirty-two male patients (84.2%) and 12 (52.2%) females patients had a successful operation (rigid ureteroscopy combined with Holmium YAG laser lithotripsy). The difference between the two sexes was statistically significant (p=0.019). The ratio of female patients with right-sided stone was significantly greater than the corresponding rates of male patients (p=<0.001). There was no difference between infants (3 years of age) with respect to gender, side of stone, procedural success, and need for urgent surgery (p>0.05). Regression analysis showed that female gender was a risk factor for a failed attempt (OR=-0.313, 95% CI: 0.052 – 0.528; p=0.0018).Conclusion: Safe and effective stone treatment can be performed considering that more than one operation can be performed in infants and children with mini ureteroscopy and holmium laser. However, while evaluating this treatment option in female patients, alternative treatment methods such as flexible or percutaneous nephrolithotomy may be preferred.

Background and Aims: Foreign body aspiration (FBA) is frequently seen in children, and progresses with symptoms related to airway obstruction, leading to serious complications. The aim of this study was to discuss the diagnosis and treatment principles of patients who underwent bronchoscopy for suspected foreign body aspiration (FBA), and to emphasize its preventability. Method: A retrospective review was made of the records of patients who underwent bronchoscopy for evaluation of FBA in the Pediatric Surgery Clinics of two hospitals where the authors work from January 2017 to February 2020. Age, gender, history of FBA, clinical symptoms, chest radiography findings, bronchoscopy findings, complications, and outcome were recorded for each patient. A history of FBA, physical examination findings, and radiological study results were analyzed statistically to determine the most accurate diagnostic tool to differentiate cases with and without FBA. Results: Bronchoscopy was performed in 102 patients with suspected FBA. A foreign body was detected in 51% (52/102) of the patients. No statistically significant difference was determined in respect of age and gender (p>0.005). There was a statistically significant difference in respect of history and time of presentation, but no difference in terms of physical examination and radiological findings. Of the foreign bodies aspirated, 87% were nuts. No life-threatening complications occurred in any patient due to bronchoscopy. Conclusion: Nuts are the most frequently aspirated foreign bodies in childhood. History, physical examination, and radiological findings may not be available for all patients. Preventive measures are important as FBA can lead to fatal consequences. Careful evaluation of the patient is necessary to reduce the negative bronchoscopy rate.

Background: We retrospectively analyzed the initial results of laparoscopic pyeloplasty, among pediatric patients undergoing the procedure by transperitoneal access. Methods: We retrospectively reviewed the medical records of patients who were operated with transperitoneal laparoscopy-assisted pyeloplasty at our institution between 2015 and 2020. Results: The mean age of the 51 patients (M/F = 36/15) was 59 ± 49.8 months. The mean preoperative renal pelvis anterior–posterior diameter was 32.9 ± 13.4 mm, and the relative renal function was 42 ± 12.1% on the operation side. Forty-three (84.3%) patients had no excretion on MAG3 examination preop. The number of patients with no excretion decreased to 10 (19.7%) after surgery. One of them underwent a successful endopyelotomy; eight of them underwent a successful laparoscopic re-pyeloplasty. There was nothing to do in only one patient whose DRF decreased to 11%. The mean anterior posterior diameter decreased significantly to 16.7 ± 11.2 mm after surgery (p < 0.001). Conclusion: Preoperative increased renal pelvis anterior–posterior diameter detected in our study was found to be a risk factor in the failure of transperitoneal laparoscopy-assisted pyeloplasty procedure.

Objectives: The main targets of the treatment modalities for pilonidal sinus are to prevent recurrences, and to increase the quality of life. It is unknown whether there is a different treatment trend in pediatric patients as compared with adults. In this study, we aimed to evaluate the surgical methods in pediatric and adult patients with pilonidal sinus. Material and Methods: This retrospective study was conducted at the Pediatric and General Surgical Department of Necip Fazil City Hospital, Kahramanmaras from 2013 to 2017. A total of 66 pediatric patients and 68 adult patients were enrolled in this study. Results: The number of pediatric patients was significantly higher than adults in mean of Flap closure (21 (31.8%) vs 2 (2.9%), p=

Objective: Acute appendicitis (AA) is one of the most common surgical emergency in pediatric population. Herein, we aimed to compare the incidence and severity of AA before and during the Coronavirus Disease-19 (COVID-19) outbreak. Materials and Methods: This multicenter study was conducted in three medicine faculty hospitals between the periods of 15 March-30 June 2019 (Group A), and the pandemic period of 15 March-30 June 2020 (Group B). We evaluated the clinicopathological characteristics of the patients in each group in terms of age, gender, serum leukocyte, C-reactive protein, radiological imaging use of postoperative peritoneal drain and presence of serious complications. Results: A total of 141 patients were identified and divided into two groups as Group A (n=64) and Group B (n=77). We found higher complication rates in Group B. Fewer patients applied in Group B, but a higher rate of AA was diagnosed. During the COVID-19 period, more patients were admitted with the later stages of the AA and with significant complications. Radiological imaging of patients with appendicitis in Group B showed more severe findings compared to Group A. Conclusion: Higher rate of perforated and complicated appendicitis in the pandemic period was due to misdiagnosis/delayed diagnosis in primary care centers as a result of fear from contagious coronavirus. Although the period of the COVID -19 pandemic brings out difficulties in treatment of patients, comprehensive assessment and physical examination in children with suspected surgical conditions should always be emphasized.