Introduction: Pneumomediastinum (PM) is a self-limiting disease with a good prognosis. Mediastinitis is a rare but potentially fatal complication of PM. Identification of risk factors for mediastinitis is essential for better management. Methods: This is a single-center, retrospective study conducted in a university hospital. Adult patients with PM between January 2016 and June 2020 were involved in the study. The data about age, gender, symptoms, signs, treatment, development of mediastinitis, hospital stay, and mortality were investigated. Results: In total, 79 patients with PM were analyzed. The most common symptom was dyspnea(58;73.4%) and the most common sign was subcutaneous emphysema (48;60.7%). Thirty(37.9%) of them were iatrogenic PM (IPM), while 22 (27.9%) were spontaneous PM (SPM) and27 (34.2%) were traumatic PM (TPM). Mediastinitis developed in 17 (12 from IPM, 4 from TPM,1 from SPM) patients, and 11 (58.8%) of these patients died. The incidence of mediastinitis in the IPM group was significantly higher than in the TPM and SPM group (respectively, P=0,03,P=0,01). There was no significant difference between the age, gender, symptoms, and signs of those with or without mediastinitis. Mortality was lower in TPM and SPM than IPM (respectively,P=0,05, P=0,03), and hematological malignancy was remarkably common in patients who died from mediastinitis in the TPM and SPM group. Conclusion: Mediastinitis and mortality were significantly higher in IPM, while hematological malignancy was remarkably prevalent in patients deceased from mediastinitis in TPM and SPM.

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Introduction: Pulmonary aspergilloma (PA) is a chronic lung infection. Lobectomy is the recommended surgical modality. However, recent studies have suggested that wedge resection may be better than lobectomy. Aim: We compared short-term complications and mortality according to surgical methods in pulmonary aspergilloma. Material and methods: In this study, we analyzed the patients diagnosed with PA in the period 2015-2019 at a tertiary hospital. We obtained the data about the age, gender, smoking history, symptoms, radiological findings, operation technique, complications, length of hospital stay, and mortality from the electronic patient files. Then we compared short-term complications and mortality according to surgical methods in PA. Results: Of a total of 27 PA patients, 22 (81.5%) were male, with a mean age of 48.1 ±15.6 years. The most common symptom was dyspnea (48.1%). Nineteen (70.0%) of the patients had wedge resection and 6 (22.3%) of the patients had a lobectomy. Prolonged air leak and empyema were the most common postoperative complications. Prolonged air leak was significantly more common in lobectomy than in wedge resection (p = 0.046). There was no significant difference in other complications, hospital stay length, intensive care unit stay length or mortality between lobectomy and wedge resection. Conclusions: Wedge resection can be safely performed in aspergilloma. Prolonged air leak was less common in wedge resection than in lobectomy.

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Increased complication risk of surgical interventions performed in patients with hemoptysis is a common concern among surgeons. Therefore, here, we investigated the surgical outcomes of tuberculosis patients with hemoptysis. Materials and methods: Patients, between 1985 and 2018, diagnosed with tuberculosis surgically, were analyzed retrospectively. The patients were divided into two groups; those without hemoptysis (Group 1) and those with hemoptysis (Group 2). The analysis included age, gender, symptoms, comorbidities, Positron Emission Tomography-Computed Tomography (PET-CT) findings, surgical interventions, perioperative complications, lengths of hospital stay, recurrence of hemoptysis, and comparison of Group 1 and 2. Results: 541 patients with pulmonary tuberculosis diagnosed surgically were analyzed. 448 patients were in Group 1 and 93 patients were in Group 2. The patients in Group 2 were significantly younger than the patients in Group 1 (Group 1 mean age 57.8±6.2, Group 2 mean age 31.2±5.3, p<0.01). The most frequent comorbidity was malignancy in both groups. Cavitation was more common in Group 2 (Group 1 92 (20.5%), Group 2 79 (84.9%), p<0.01). Postoperative complications and hospital stay length were similar in both groups and there was no hemoptysis recurrence in Group 2. There was no perioperative death in Group 1 while 3 (3%) patients died in Group 2. Conclusion:The surgical morbidity and mortality of patients diagnosed with tuberculosis after the surgical intervention performed for the diagnosis or treatment of the hemoptysis were not significantly different from those of the patients without hemoptysis

Background: The aim of this study was to investigate the effect of bronchiectasis operation on anxiety and depression. Methods: Between August 2014 and March 2019, a total of 167 patients with bronchiectasis (107 males, 60 females; mean age: 43.5±13.9 years; range, 18 to 84 years) who received medical (n=70) and surgical (n=97) treatment were retrospectively analyzed. Data including patients" characteristics, operation indication, operation type, and bronchiectasis localization were obtained from the electronic patient files. The patients were reached via phone calls and evaluated whether the operation provided a significant symptomatic improvement and whether the symptoms disappeared. The number of exacerbations/hospitalizations associated with bronchiectasis within the last year was also questioned. The anxiety and depression status of the patients in both groups was assessed by the Hospital Anxiety and Depression Scale. Results: Eleven (15%) patients in the medical group and 10 (10%) patients in the surgical group had an anxiety score above 7. Twenty-one (30%) patients in the medical group and 10 (10%) patients in the surgical group had a depression score above 7. Both the anxiety and depression scores were significantly lower in the surgical group than the medical group (p<0.001). Annual exacerbation and annual hospitalization rates were also significantly lower in the surgical group (p<0.001). Conclusion: Our study results suggest that patients with bronchiectasis treated medically rather than surgically are more prone to be anxious and depressive. The benefits of surgical treatment in patients with bronchiectasis is not limited to improving symptoms and decreasing the frequency of exacerbations/hospitalizations. We believe that surgical treatment also reduces anxiety and depression and improve the quality of life. While making a surgical decision, the anxiety/depression status of bronchiectasis patients should be considered.

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