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Küçük hücre dışı akciğer kanserlerinde cerrahi başarı, iyi bir anatomik rezeksiyon sonrası makroskobik ve mikroskobik olarak temiz gelen cerrahi sınır olması ve lenf nodlarında yayılım görülmemesidir. Cerrahi, akciğer kanserlerinde özellikle erken evrelerde en büyük tedavi şansını oluştururken tümör ve komşu dokuların birlikte anblok rezeksiyonları, cerrahi sınırda tümör dokusunun kalmayışı en uzun süreli sağkalımı sağlamaktadır. Küçük hücreli dışı akciğer kanserli hastaların yaklaşık %70’inde kullanılan lobektomi standart bir anatomik rezeksiyondur. Uygulanan teknik pulmoner venlerin, arterin ve bronşun ayrı ayrı serbestleştirilmesi ve ardından mutlak bir şekilde hiler lenf nodları ve lenfatiklerin dikkatli diseksiyonudur. Akciğer rezeksiyonu geçirecek bütün hastalar için rezeksiyon öncesi evreleme; hastalığın seyri ve onkolojik girişimlerin algoritması için mutlaka yapılmalıdır.

Most of the previous studies evaluating lung volume of pectus excavatum (PE) patients were based on spirometric measurements. We aimed to calculate lung volume of patients with PE and compare them with lung volume of patients without chest wall deformity using CT volumetry. After institutional review board approval, preoperative chest CT of PE patients who underwent minimal invasive procedure between January 2012 and February 2018, were evaluated retrospectively. As a control group, age and sex matched patients who underwent chest CT scan in the same period were enrolled. Total, right and left lung volumes were calculated using an automated software. Haller indexes were measured for both groups. Lung volumes and Haller indexes compared between the two groups. We also compared left and right lung volumes in both groups. We evaluated whether there is a correlation across the Haller index and total lung volume. Total, right and left lung volumes were not statistically different between the two groups. While left lung volumes were significantly smaller in PE group (p = 0.041), there was no significant difference between the left and right lung volume in the control group (p = 0.12). Haller index and total lung volume showed no significant correlation between patients with the same age and gender (p = 0.14, R = −0.3). PE deformity does not reduce lung volume when compared to age and sex matched control group. Quantitative CT volumetric evaluation of lung gives valuable data about lung volume.

WOS: 000448749100002, PubMed: 30377655, Cyst hydatid in the lung is still a health problem for many countries. It develops in the lung and can grow into the lung parenchyma. When it is diagnosed as a giant cyst, surgery should be performed. In the surgery, capitonnage is necessary to protect the lung parenchyma.

WOS: 000448440500021, PubMed: 30505474, …

Pneumomediastinum is the presence of air in the mediastinum. It may occur as spontaneous, traumatic, or iatrogenic pneumomediastinum. Although spontaneous pneumomediastinum is usually observed in healthy young men, traumatic pneumomediastinum may be caused by blunt or penetrating trauma to the chest and neck. Pneumomediastinum is a clinical condition with potential complications that cause high morbidity and mortality rates. Pneumomediastinum also may develop without tracheal or oesophageal injury after spontaneous or blunt chest, neck and facial injuries, and it may be accompanied by pneumothorax. We treated two patients who had pneumomediastinum. Case 1 was a 20-year-old man who had pain and dyspnoea around the sternum for one hour, as a result of a blow from an elbow during a football match. Case 2 was a 23-year-old man who had a two-day history of dyspnoea and chest pain with no history of trauma. In both patients, diagnosis of pneumomediastinum was confirmed with thoracic computed tomography scans, and the condition resolved within five days of in-patient observation. In conclusion, the diagnosis of pneumomediastinum should be considered for all patients who present to the emergency department with chest pain and dyspnoea.

Antik schwannomlar nadiren görülen tümörlerdir. Genellikle retroperiton yerleşimlidirler. Asemptomatik olarak büyük boyutlara ulaşabilmektedir. Radyolojik tetkikler tümörün yerleşimi ve karakteri hakkında yardımcı olmaktadır. Tedavisi cerrahi olarak rezeksiyondur. Tanısı patolojik olarak konur., Ancient schwannomas are rarely seen tumors. Generally they are located in retroperitoneum. They can arrive larger diameters without clinical symptoms. Radiological imaging is beneficial for location and morphology of tumor. The treatment is surgical resection of tumor. It is diagnosed by pathology specimen.

OZ Amac: Bu retrospektif calismada dev pulmoner kist hidatiklerde parankim koruyucu ve minimal invaziv ameliyat deneyimlerimiz sunuldu. Ca­lis­ma­ pla­ni:­ Dev kist hidatikli 19 hasta (13 erkek, 6 kadin; ort. yas 22 yil) ameliyat edildi. Dev kistin en dis katmani olan adventisya normal parankime kadar eksize edildi ve onceden tespit edilen bronsiyal kacaklar kapatildi. Serbest hale gelen kistin adventisyasi karsilikli olarak parankim icerisine dikildi. Bul gu lar: Kist hidatikler 13 hastada sag hemitoraksta, bes hastada sol hemitoraksta ve bir hastada iki tarafli idi. Guvenli bronsiyal kapatma parankimi germeden pulmoner hacim kaybini engelledi. Ameliyata bagli komplikasyonlar bir hastada plevral efuzyon, iki hastada atelektazi, bir hastada yara enfeksiyonu ve uc hastada pnomoni idi. Bilgisayarli tomografi ile olculen kist caplari ortalama 10 cm idi. Hastanede ortalama kalis suresi 7.5 gun idi. So­nuc:­ Guncel kist hidatik tedavisi kistin cerrahi ile tam olarak cikarilmasini takiben pulmoner parankimin genislemesine izin vermelidir. Parankim koruyucu ve minimal invaziv torakotomi teknigi ile ameliyat edilen hastalarin hicbirinde rezeksiyona gerek kalmadi. Teknigimizin avantajlari; dusuk komplikasyon orani ve kistin minimal invaziv torakotomi ile kapitonaj gerektirmeden tek bir drenle cikilmasidir. Anah­tar­soz­cuk­ler: Yeni bir teknik; dev kist hidatikler; minimal invazif torakotomi. ABSTRACT Background:­This retrospective study aims to present our parenchyma-preserving and minimally invasive operation experiences on giant pulmonary hydatid cysts. Methods: Nineteen patients (13 males, 6 females; mean age 22 years) with giant hydatid cysts were operated. The outermost layer of the giant cyst, the adventitia, was excised up to the normal parenchyma, and the previously detected bronchial leaks were closed. The released adventitia were reciprocally sutured into the parenchyma. Results:­ Hydatid cysts were in the right hemithorax in 13 patients, in the left hemithorax in five patients, and bilateral in one patient. The safe bronchial closure prevented pulmonary volume loss without stretching the parenchyma. Operative complications were pleural effusion in one patient, atelectasis in two patients, wound infection in one patient, and pneumonia in three patients. The diameter of cysts, measured by computed tomography, was approximately 10 cm. The mean duration of hospitalization was 7.5 days. Conclusion:­ Current treatment of hydatid cysts should allow pulmonary expansion after complete surgical removal of the cyst. Thanks to parenchyma-preserving and minimally invasive thoracotomy technique, none of the operated patients required resection. Advantages of our technique include low rate of complications, and removal of the cyst using a single thoracic drain with minimally invasive thoracotomy without requiring capitonnage.

Gastroözefageal reflü için uygulanan cerrahi tedavilerden biri olan Nissen fundoplikasyonu, minimal invaziv olması, hastada daha az ağrıya yol açması ve daha kısa süreli hospitalizasyon gerektirmesi nedeniyle yaygınca uygulanmaktadır. Ancak komplikasyon oranı oldukça düşük olmasına rağmen ölüme neden olabilecek tansiyon pnömotoraks gibi bir klinik durum ortaya çıkabilmektedir. Hastamızda reflü cerrahisi (Nissen fundoplikasyonu) sonrası tansiyon pnömotoraks ve sonrasında hidrotoraks gelişmiştir. Bu gibi komplikasyonlar hastanede kalış süresini uzatmakta, morbiditeyi artırmaktadır. Laparoskopik cerrahi işlemler kolay ve yaygın uygulamalardır; intraoperatif ve postoperatif komplikasyonlar açısından erken tanı önemlidir, Nissen fundoplication, one of the surgical procedures applied to treat gastroesophageal reflux, is performed commonly because it is minimally invasive, causes the patient less pain, and requires shorter hospitalization. However, despite the low complication rate some patients may develop tension pneumothorax, a clinical condition that can be fatal. After reflux surgery (Nissen fundoplication), our patient develop tension pneumothorax and then hydrothorax. Such complications lead to prolonged hospitalization and increased morbidity. Laparoscopic surgical procedures are practical and common interventions; and early diagnosis is important for intraoperative and postoperative complications.

WOS: 000215585400034, Large-cell neuroendocrine carcinomas of the lung are extremely rare. There are difficulties related to the diagnosis and treatment and there are no consensus because of the small number of studies. 65-year-old male patient presented with hemoptysis. Chest X-ray and thoracic computorized tomography scan showed a mass lesion and it could not be diagnosed by bronchoscopic biopsy and lavage. Lobectomy was performed due to the high value of standardized uptake value in positron emission tomography. Large cell neuroendocrine carcinoma was diagnosed with pathological evaluation and immunohistochemical study and after 20-month follow-up there was no recurrence. The diagnosis, treatment, and prognosis of large cell neuroendocrine carcinoma in the light of the literature is presented.

Objective : The goal of this retrospective study was to evaluate the outcomes of bilateral video-assisted thoracoscopic sympathectomy for primary hyperhydrosis. Methods : Between January 2007 and December 2011, a total of 335 patients (192 male, 143 female, mean age 28.3 years) who underwent bilateral thoracoscopic sympathectomy for primary hyperhydrosis were reviewed retrospectively. Results : Hyperhydrosis occurred in the palmar and axillary region in 175 (52.23%) patients, in only the palmar region in 52 (15.52%), in the craniofacial region in 44 (13.13%), in only the axillary region in 42 (12.53%), and in the palmar and pedal regions in 22 (6.56%) patients. Bilateral thoracoscopic sympathectomy was performed in all patients. The mean follow-up period was 24 (6-48) months. The initial cure rate was 95% and the initial satisfaction rate was 93%. There was no mortality in this study. The complication rate was 15.82% in 53 patients. Conclusion : Video-assisted thoracoscopic sympathectomy for the treatment of primary hyperhydrosis was effective, with low rates of morbidity and mortality. Despite the appearance of postoperative complications, such as compensatory sweating, patient satisfaction with the procedure was high and their quality of life improved.

WOS: 000328933900006, PubMed: 24240383, Background: We present the results of surgical correction of pectus excavatum (PE) and pectus carinatum (PC) deformities in adults, and also report a new method of sternal support used in surgery for PE deformities. Methods: We present the results of 77 patients between the ages of 10 and 29 years (mean 17) with PE (n = 46) or PC (n = 31) deformities undergoing corrective surgery from 2004 to 2011, using the Ravitch repair method. Symptoms of the patients included chest pain (15%) and tachycardia (8%). Three patients underwent repair of recurrent surgical conditions. Results: All of the patients with dyspnoea with exercise experienced marked improvement at five months post operation. Complications included pneumothorax in 5.1% (n = 4), haemothorax in 2.6% (n = 2), chest discomfort in 57% (n = 44), pleural effusion in 2.6% (n = 2), and sternal hypertrophic scar in 27% (n = 21) of patients. Mean hospitalisation was eight days. Pain was mild and intravenous analgesics were used for a mean of four days. There were no deaths. Results after surgical correction were very good or excellent in 62 patients (80%) at a mean follow up of three years. Three patients had recurrent PE and were repaired with the Nuss procedure. In three patients who underwent the Ravitch procedure, a stainless steel bar was used for sternal support instead of Kirschner wire. Conclusions: Pectus deformities may be repaired with no mortality, low morbidity, very good cosmetic results and improvement in cardiological and respiratory symptoms.

WOS: 000408345600004, PubMed: 28825029, Introduction Esophageal foreign body (FB) in all age groups can cause serious morbidity or mortality. The study aims to report our experience retrieving FBs from the upper esophagus in children using Magill forceps. Materials and Methods In this study, 88 patients (45 males [51.1%] and 43 females [48.9%]) were presented with suspected FB ingestion. FB ingestion was determined via endoscopic analysis, or lateral and posterior-anterior radiographies, including oropharynx, neck, chest, and abdomen. Cases were classified into seven groups, according to history, diagnostic method, and postintervention findings, as follows: (1) coins, (2) toys, (3) metals, (4) bones, (5) battery, (6) glass, and (7) food. A laryngoscope was used to elevate the larynx and expose the esophageal entrance. Magill forceps were advanced into the esophagus and opened to observe and extract the FB. Results All 88 patients who underwent endoscopic examination due to suspected FB ingestion were confirmed to have ingested a FB. Median age was 12 years; 15 patients were aged < 5 years; 63 (71.5%) were diagnosed based on routine radiographic findings, and others were diagnosed based on physical findings and history. The most common type of FB was coins (n = 51 [57.9%]). Mean surgical duration was 20 minutes. Conclusion FBs located at cervical esophageal level are usually the most difficult to remove. Magill forceps should be used before other methods.

WOS: 000387037900004, PubMed: 28824977, Transient vision loss after major surgical procedures is a rare clinical complication. The most common etiologies are cardiac, spinal, head, and neck surgeries. There has been no report on vision loss after lung resection. A 65-year-old man was admitted to our clinic with lung cancer. Resection was performed using right upper lobectomy with no complications. Cortical blindness developed 12 hours later in the postoperative period. Results from magnetic resonance imaging and diffusion-weighted investigations were normal. The neurologic examination was normal. The blood glucose level was 92 mg/dL and blood gas analysis showed a PO2 of 82 mmHg. After 24 hours, the patient began to see and could count fingers, and his vision was fully restored within 72 hours after this point. Autonomic dysfunction due to impaired microvascular structures in diabetes mellitus may induce posterior circulation dysfunction, even when the hemodynamic state is normal in the perioperative period. The physician must keep in mind that vision loss may occur after lung resection due to autonomic dysfunction, especially in older patients with diabetes mellitus.

Background: A significant proportion of cases of tracheobronchial foreign body aspiration due to life-threatening condition is observed during childhood. The aim of the present study was to describe our experience with the diagnosis and treatment of foreign body aspirations during childhood and review published literature. Methods: One hundred and eighty-four patients under 16 years of age with a tentative diagnosis of foreign body aspiration were retrospectively evaluated according to age, sex, patient delay symptoms at presentation, foreign body type, localization and the diagnostic and therapeutic methods used. Results: The most frequently aspirated objects were shelled nuts and seeds such as sunflower seeds, pistachio and hazelnuts. The chief symptom was cough. On physical examination, the most frequent findings were unilateral decrease of respiratory sound on the affected side with coarsening and bronchi. While 51% of cases presented a radiological finding, chest X-ray was normal in the other. All patients underwent rigid bronchoscopy under general anesthesia and a foreign body was identified in 137 (74.3%). The rigid bronchoscopy intervention was used in some cases, especially in the presence of tracheal foreign bodies of organic origin. Conclusions: Tracheobronchial foreign body aspiration is a significant cause of childhood morbidity and mortality. Early diagnosis and treatment is of utmost importance. Rigid bronchoscopy under general anesthesia should be performed in all patients suspected of foreign body aspiration, which could minimize mortality and morbidity if performed by experienced personnel with safe methods.

WOS: 000310721500012, PubMed: 23188607, BACKGROUND Penetrating cardiac injuries carry high mortality rates due to serious clinical outcomes. This study was planned to investigate patients treated surgically in our hospital for penetrating cardiac injury. METHODS In this article, we reviewed retrospectively 21 patients (18 male, 3 female) suffering from penetrating heart injuries who admitted to our hospital between February 2006 and January 2011. Patients were evaluated with respect to clinical findings, treatment methods and clinical outcomes. RESULTS Among the patients, 19 cases were due to stab injury and 2 cases to gunshot injury. Emergent surgical interventions were performed in all patients. Cardiac injuries involved the right ventricle in 13 patients, left ventricle in 5 patients and right atrium in 3 patients. There was no left atrial injury. Cardiac injuries were repaired by primary suturing method. Mortality was determined in 6 patients (28.6%). CONCLUSION Penetrating cardiac injuries are seen generally in young people. Early transport, proper resuscitation and emergent surgery treatment improved survival in patients who sustained penetrating cardiac injuries.

WOS: 000448027400013, PubMed: 29752918, …

PubMed: 26625768, Background: In this study, we aimed to determine platelet indices such as platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), Plateletcrit (PCT) platelet count (PLT) in lung cancer cases, and evaluate any relationships between these parameters and stage or histologic types. Materials and Methods: This retrospective study covered 44 lung cancer patients and 47 healthy subjects. Platelet indices including PLT, PCT, MPV, PDW were estimated and compared with normal subjects. The results were evaluated statistically. Results: The PDW value was significantly higher in the cancer group compared to the control group; however, the values for PCT and MPV were lower. Conclusions: We suggest potential use of platelet indices in diagnosis of lung cancer.

Simultaneous bilateral pneumothorax is a very rarely condition that is mainly seen in patients with underlying metastatic disease or lung cancer. It is estimated that < 1% of all cases of spontaneous pneumothorax are tumor-associated and most commonly due to the metastatic osteogenic or soft tissue sarcomas .

WOS: 000354772200013, PubMed: 26033659, Cardiac injuries may rarely be observed due to blunt thoracic traumas. Cardiac injury often creates a life-threatening condition requiring urgent surgical intervention, and follow-up of these patients should be carefully carried out in the perioperative period. These injuries depend on various factors including clinical presentation, type of injury, the time that passes until the patient reaches the hospital, bleeding, cardiac tamponade, or additional injuries. This article aimed to report a case who suffered penetrating cardiac injury in blunt thoracic trauma. Evaluated in the emergency department due to a motor vehicle accident, the 61-year-old male patient's chest x-ray revealed pulmonary contusion, rib fractures and cardiac tamponade. The patient was operated emergently. Right atrial injury was observed in the operation. The cardiac injury was repaired with primary suture technique. Cardiac injury in patients with blunt thoracic trauma is likely to be observed. In these patients, careful physical examination, early diagnosis, and treatment are very important.

Selçuk Üniversitesi Tıp Fakültesi Çocuk Cerrahisi ve Göğüs Cerrahisi Kliniklerince Ocak 2013 ile Ocak 2014 tarihleri arasında çocuk hastalarda özofagus'a yabancı cisim tanısıyla yatmış ve tedavi olmuş olguların retrospektif değerlendirilmesi amaçlandı. Gereç ve yöntem: Selçuk Üniversitesi Tıp Fakültesi Çocuk Cerrahisi ve Göğüs Cerrahisi Kliniklerince Ocak 2013 ile Ocak 2014 tarihleri arasında çocuk hastalarda özofagusda yabancı cisim tanısıyla yatmış ve tedavi olmuş olgular retrospektif değerlendirildi. Bulgular: Hastanemizde son 1 yıl içinde toplam 13 hasta, endoskopik olarak özofagusda yabancı cisim nedeniyle tedavi edildi. Ortalama yaş 4.8 yaş (6ay-12yaş) idi. Birinci darlıkda yabancı cisim 10 hastada olup 6'sında (%60) bulunan cisim paraydı. 2. darlık'da 2 olguda bu gıda artığı olup, bu iki olgunun birinde opere özofagus atrezi darlığı nedeniyle gıda artığı vardı, diğerinde ise koraziv madde içimi sonrası oluşan darlığa sekonder gıda artığı vardı. Sonuç: Özofagus yabancı cisimlerinin erken tanısı, tedavisi ciddi ve hayatı tehdit edebilecek komplikasyonlardan dolayı çok önemlidir. Yabancı cisimlerden para en sık görülümekte olup, özofagustaki yabancı cisim disk pil ise, erken dönemde çıkarılmalıdır. Çünkü ciddi yanık ve perforasyon yapabilir, The medical records of all hospitalized and treated patients diagnosed with foreign body in the esophagous between January 2013 and January 2014 in Department of Pediatric Surgery and Thorasic Surgery in Selcuk University Medical Faculty were evaluated retrospectively. Material and methods: The files of these patients were evaluated in terms of age, sex, type of foreign body, foreign body localization, treatment, symptoms, and complications. Results: Thirteen patients were treated endoscopically in our hospital during the last year for foreign bodies in the esophageal web. The average age of the patients was 4.8 years (6 months-12 years). Foreign body was located in the 1st narrow section in 10 patients and in 6 (60%) it was coin. In two cases, in the 2nd narrow section residual food was the foreign body in the esophageal web. Out of these two cases, residual food was in the 2nd narrow section due to operated esophageal atresia. In the other one, due to swallowing of corrosive material secondary residual food was in the 2nd narrow section. There were only 2 patients, aged 5 years and more, with foreign body in was in the 2nd narrow section. Conclusion: Early diagnosis of foreign bodies in the esophageal web is of almost importance due to the possibility of serious and life-threatening complications. Among the foreign bodies, coin was the most evident one. If the foreign body in the esophageal web is a disc battery, it should be removed at an early stage as it may lead to severe burns and perforation

Aim:As a risk factor for childhood swallowing corrosive substance and results of burns are very frequently,The aim of this study was to evaluate the managment of our 89 patient admitted among to 2004-2009 years of corrosive substance ingestion and the success of the early period of conservative treatment.Materials and Methods:We retrospectively analyzed the managment of 89 pediatric cases corrosive substance ingestion first 24-48 hours whom consisted of prompt endoscopy. There were 63 male (70 %), 26 female (30 %) patients age ranges 2 month to 16 years. Treatment protocols were chosen according to the initial endoscopic evaluations.Results:77 patients (86,5%) were found to have esophageal burns and 2 patients(2,2 %)of them underwent treatment for stricture formation.patient with grade 2a -2b injuries in endoscopic evaluation needed at least 3 months dilatations programe.There were no esophageal rupture our cases. We observed at least 2 years dilatation after there were no reccurense.Conclusion:Corrosive agents should keep away from a children result of esophageal damage. It s a very good clinical progress about to ingestion diluated corrosive agent. Our clinical experience there were a best result which we started conservative therapy and steroids in early stage.

Amaç: Çocukluk çağında bir risk faktörü olarak korozif madde içimi ve buna bağlı olarak gelişen yanıklar sık görülmektedir. Kliniğimize korozif madde içimi nedeni ile 2004-2009 yılları arasında başvuran 89 hastanın erken dönemde yapılan konservatif tedavinin başarısının ortaya konulması amaçlandı. Gereç ve Yöntem: Korozif madde içimi sonrası ilk 24-48 saat içerisinde özefagoskopi yapılan 89 olgu değerlendirildi. Olguların 63’i erkek (%70), 26’i kız (%30) olup, yaşları 2 ay ile 16 yaş arasında değişmekteydi. Olgularımıza ilk endoskopi sonrasında tedavi protokolu uygulandı. Bulgular: Toplam 77 olguda (%86,5) özefagus yanığı belirlenirken, bu hastalardan 2 tanesine (%2,2) dilatasyon uygulandı. Endoskopik olarak yanık derecesi grade 2a ve 2b olan olgularımıza yaklaşık 3 aydan daha uzun süren dilatasyon programına gerek duyuldu. Olgularımızın hiçbirinde özefagus perforasyonu gelişmedi dilate edilen olgularda 2 yıllık peryotlarda izlendiler hiç birinde nüks görülmedi. Sonuç: Korozif maddelerin çocuklardan uzak tutulması, daha sonra gelişecek olan özefagus yanıklarının ve striktürün önlenmesinde önemli bir etkendir. Şuanki çamaşır sularının seyreltik olması özefagus yanıklarının kliniğinin ılımlı geçmesinde önemli bir etkendir. Ayrıca klinik tecrübelerimiz erken dönemde konservatif tedavi ve steroidin yararını ortaya koymuştur.