BACKGROUND: A total of 412 patients who applied to our clinic after a thoracic trauma between March 2010 and December 2019 were examined retrospectively In this study, late complications that developed as a result of blunt and penetrating thoracic traumas were evaluated and it was aimed to present a prediction for the management of these complications to physicians who are dealing with trauma. METHODS: Among the 412 thoracic trauma cases, 62 cases (15.04%) who developed late-term complications which constituted the main theme of this study were evaluated in terms of age, gender, the type of trauma, the cause of trauma, thorax, and concomitant organ pathologies that developed when the trauma first occurred, the late-term complications, and the treatment methods for them while considering mortality. RESULTS: Of 62 patients with late complications due to thoracic trauma, 47 (75.80%) were male, 15 (24.20%) were female, and the average age was 56.98±21.22. When the trauma type of the patients who developed posttraumatic late-term complications was evaluated, blunt traumas were seen in 90.33% (n=56) of the cases, whereas penetrating traumas were seen in 9.47% (n=6). Traffic accidents were the most common cause in blunt trauma cases (66.07%), whereas pointed and sharp-edged weapon injuries were the most common in penetrating traumas (83.33%). The most common thorax pathology is pulmonary contusion (75%) in blunt traumas and hemopneumothorax in penetrating traumas (66.66%). When the groups were analyzed separately, the most common late-term complication for penetrating traumas was retained hemothorax (66.66%), while pneumonia was the most common (41.07%) in blunt trauma cases. Video-assisted thoracoscopic surgery was performed in seventeen patients with retained post-traumatic hemothorax and thoracotomy was performed in eight cases. Seven patients with post-traumatic empyema underwent thoracoscopy, and four patients underwent decortication with thoracotomy. Six of the patients who developed late-term complications died. The mortality rate is 9.67%. Pneumonia was detected as a late complication type in 83.33% of cases with mortality. CONCLUSION: It will be appropriate for the physicians who are interested in trauma to determine the treatment modalities of the patients by considering many factors such as the age of the patient and the trauma type in terms of the late complications that they will not be able to detect at first glance.
Özet: Spontan pnömotoraks göğüs cerrahisi kliniklerinde sık karşılaşılan hastalıklardan birisidir. Küçük boyutta ve asemptomatik pnömotoraks hastalarında O2 desteği ile gözlem genellikle yeterli olurken; semptomatik olan hastalarda tedavi, aspirasyondan açık cerrahi girişime kadar değişkenlik gösterebilir. Bu çalışmada 2015 ile 2017 yılları arasında kliniğimizde tedavi edilen spontan pnömotoraks hastalarının cinsiyet, yaş, tedavi şekilleri ve nüks oranları açısından değerlendirilmeleri amaçlandı. 2015 ile 2017 tarihleri arasında spontan pnömotoraks geçiren 41 hasta çalışmaya dahil edildi. Bu hastalar cinsiyet, yaş, tedavi şekilleri ve nüks oranları açısından değerlendirildi 41 hastadan 3'ü (%7,3) kadın, 38'i (%92,7) erkekti. Hastaların genel yaş ortalaması 29,2 olarak hesaplandı. Primer spontan pnömotorakslı 35 hastada yaş ortalaması 25,8 (15-41), sekonder spontan pnömotorakslı 6 hastada ise 49,3 (26-70) olarak bulundu. Hastalardan 3 (%7,3) tanesinde oksijen desteği ile gözlem yeterli oldu. 26 (%63,4) hasta tüp torakostomi ile iyileşirken, 12 (%29,3) hasta için ise takılan göğüs tüpü ile tedavi yeterli olmayıp, ileri cerrahi prosedür gerekli oldu. Cerrahi işlemler video yardımlı torakoskopik cerrahi (VYTC) veya torakotomi yöntemleri ile yapıldı. Çift lümen entübasyonu tolere edemeyen, yaygın büllöz-amfizamatöz değişiklikleri olan veya toraks içerisinde ileri düzey yapışıklıkları olan hastalarda torakotomi yöntemi kulanıldı. VYTC ile bül eksizyonu ve plevral abrazyon yapılan hastalardan bir tanesinde nüks gözlendi. Tüp torakostomi veya cerrahi işlem sırası ve sonrasında herhangi bir komplikasyona rastlanmadı. Müdahale gerektirecek boyutta olan veya O2 desteği ile resorbe olmayan semptomatik pnömotoraks olgularında tüp torakostomi işlemi ilk tedavi seçeneği olarak güvenle uygulanabilir. Tekrar eden pnömotoraks, uzamış hava kaçağı ve ekspansiyon problemi olan olgularda ek cerrahi işlem yapılmalıdır. Anahtar Kelimeler: pnömotoraks; tüp torakostomi; video yardımlı torasik cerrahi.
Background/Aim: Lung cancer, where early diagnosis is particularly important, is one of the leading causes of death worldwide. Unfortunately, patients with lung cancer present at advanced stages. Biomarkers are needed to detect cancer at an earlier stage. In the present study, we aimed to emphasize that Plexin C1 level can be used in the early diagnosis of patients with lung cancer. Methods: This prospective case-control study included 50 patients with lung cancer who presented between May 2020-September 2020 (25 males and 25 females) in the patient group and 40 healthy individuals (23 males and 17 females) in the control group. All patients with lung cancer underwent routine preoperative tests. Additionally, the preoperative Plexin C1 levels of all patients were measured with the ELISA method and compared between the patient and control groups, and with respect to cancer staging. Results: The median Plexin C1 levels in the patient and control groups were 9.5 ng/mL and 4.0 ng/mL, respectively (P<0.001). The patients with Stage 4 tumors had significantly higher serum Plexin C1 levels than those with Stage 1, Stage 2, and Stage 3 tumors (P<0.001). Also, Plexin C1 levels were higher in patients with greater depth of invasion (P<0.001), more lymph node involvement (P<0.001), and distant metastasis (P<0.001). Conclusion:Plexin C1 can be used as a predictive biomarker at the time of diagnosis for lung cancer, and for cancer stage discrimination to show early, advanced, or metastatic disease.
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