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OBJECTIVE: In this study, the effect of tocilizumab (TCZ) on lung tissue in lung ischemia-reperfusion (I/R) injury in rats was investigated. MATERIAL AND METHODS: A total of 24 Wistar rats were divided into 4 equal groups, with 6 rats in each group: Left lung I/R was applied to I/R groups. In the I/R groups, the left lung hilum was clamped for 45 minutes, and then the clamp was removed and reperfused for 120 minutes. In the TCZ groups, 4 mg/kg and 8 mg/kg of TCZ were administered intraperitoneally to the rats 30 minutes before surgery. RESULTS: The tumor necrosis factor-alpha mean value was not statistically significant between the groups (P = .091). Statistically significant results were observed between group I/R-TCZ (8 mg/kg) and group I/R for catalase. (P = .005). Statistically significant results were observed between group I/R-TCZ (8 mg/kg) and group I/R for malondialdehyde. (P = .009). The difference in total ischemia score between group I/R-TCZ (4 mg/kg) and group I/R-TCZ (8 mg/kg) and group I/R was statistically significant (P < .001). In terms of alveolar hemorrhage, there was a statistically significant difference between group I/R-TCZ (4 mg/kg) and group I/R-TCZ (8 mg/kg) and group I/R (P = .01 and P = .002, respectively). There was a statistically significant difference between group I/R-TCZ (8 mg/kg) and group I/R in terms of neutrophil accumulation (P = .01). In terms of interstitial edema, there was a statistically significant difference between group I/R-TCZ (4 mg/kg) and group I/R-TCZ (8 mg/kg) and group I/R (P = .006 and P = .001, respectively). In terms of pulmonary edema, there was a statistically significant difference between group I/R-TCZ (4 mg/kg) and group I/R-TCZ (8 mg/kg) and group I/R (P = .01 and P = .009, respectively). CONCLUSION: Lung tissue may be affected by I/R injury and this damage can be reversed with the use of TCZ. [ABSTRACT FROM AUTHOR]

In our study, preoperative factors affecting the development of re-operation after lung resection were examined.413 patients who underwent lung resection between 2018-2020 were included in our study. The preoperative data of 25 (6.1%) patients who underwent re-operation and 388 (93.9%) patients who did not undergo re-operation were compared. Preoperative hemoglobin level (p=0.009), neoadjuvant therapy (p<0.001), pneumonectomy (p<0.001), thoracotomy (p=0.005), amount of intraoperative blood loss (p<0.001), need for intraoperative blood product use (p). =0.005), intraoperative mean arterial pressure (p=0.01), pulse rate (p=0.001), postoperative hemoglobulin amount (p<0.001) were found to affect and increase the probability of re-operation. It was statistically significant that the need for postoperative blood product usage was higher (p<0.001), postoperative complications (100% vs. 22.8%, p<0.001) and mortality (0.6% vs. 4%, p=0.01) in reoperated patients. It was found that the hospitalization day in the ICU was longer in those who underwent reoperation than in those who did not (3.2 days vs. 1.5, p<0.001). Independent risk factors affecting re-operation according to multiple logistic regression analysis; neoadjuvant treatment (p<0.001), operation time (p=0.04), intraoperative pulse rate (p=0.01) and postoperative hemoglobin (p<0.001) were found. Low preoperative hemoglobin level, on the other hand, independently affected the development of re-operation at a level close to significance (p=0.06). Re-operation due to bleeding after lung resection increases the rate of cardiopulmonary complications in the postoperative period. Careful follow-up and approach of surgery and anesthesia in the intraoperative period will contribute to the decrease in the incidence of re-operation. [ABSTRACT FROM AUTHOR]