A 51-year-old man with adenoid cystic carcinoma in the main stem bronchus was treated by a left lower lobectomy. A 44-year-old man with adenoid cystic carcinoma in the peripheral small bronchi underwent a right sleeve upper lobectomy with tracheobronchoplasty and neo-carina reconstruction; because of positive tumor margins, radiotherapy was administered postoperatively. Both patients were alive without any signs of tumor after 30 and 24 months of follow-up, respectively.

Article History

Bu makale ATUDER'in düzenlediği 1.Ulusal Acil Tıp E Kongresinde11-13 Haziran tarihinde 63 vaka ile bildiri olarak sunulmuştur. ARAŞTIRMA MAKALESİ / Research Article Öz Amaç Toraks travmaları tüm travma türleri arasında sık görülmektedir. Bu çalışmada, acil servise travmatik pnömotoraks ile başvuran hastaların demografik özellikleri, travma nedenleri, gelişen patolojiler, tedavi yaklaşımları ve mortalite nedenlerinin analizlerini yapmak amaçlandı. Gereç ve Yöntem 2018 Ocak ile 2019 Aralık arasında travmatik pnömotoraks nedeniyle acil serviste değerlendirilen 127 hastanın hastane kayıtları geriye dönük olarak değerlendirildi ve analiz edildi. Bulgular Çalışmaya dahil edilen 127 hastanın ortalama yaş 53,49 ±16.96 ve ortalama yatış süresi 7.63 ±3.65 idi. Travmatik pnömotoraks oluşturan künt travmalarda en sık sebebi trafik kazaları iken penetran travmalarda delici kesici alet yaralanması olarak tespit edildi. Kontüzyon şiddeti, kot kırığı sayısı ve yaş ile yatış süreleri arasında anlamlı ilişki tespit edildi (p=0,045, p=0,045 ve P<0,001). Multitravmalı pnömotoraks hastalarında nöroşirurjik patolojinin eşlik ettiği grupta mortalitede anlamlı bir fark görüldü(P<0,001). Sonuç Travmatik pnömotoraks kaburga kırıkları ve kontüzyon sebebiyle varlığında oldukça önemli ve erken müdahale gerektiren bir patolojidir. Özellikle yaşlı hastalarda, kot kırığı sayısı fazla olan hastalarda ve akciğer kontüzyonunun eşlik ettiği durumlarda etkin medikal tedavi ve solunum fizyoterapisi çok büyük önem arz etmektedir.

Background: In this study, we aimed to analyze the effects of admission time to the hospital and different variables on the treatment efficiency and to evaluate the recurrence during the clinical management process in patients with the diagnosis of primary spontaneous pneumothorax. Methods: A total of 149 patients with primary spontaneous pneumothorax (131 males, 18 females; mean age: 24.8±6.8 years; range, 17 to 35 years) treated in our clinic between January 2015 and December 2019 were retrospectively analyzed. Time from symptom onset to hospital admission (admission time) was classified as three periods: <24 h, between 24 and 72 h, and >72 h. Data including admission time, demographic and clinical characteristics, smoking history, body mass index, the use of pleurectomy or pleural abrasion during surgery were collected from the charts of the patients. Results: Admission time had no statistically significant effect on the length of hospital stay, recurrence, and the need for surgery. Male sex, smoking history, and lower body mass index had no significant effect on the recurrence. Recurrence and length of hospital stay did not significantly differ between the patients in whom pleurectomy or pleural abrasion added to the procedure during the operation. Conclusion: A longer interval between symptom onset and hospital admission and lower body mass index have no adverse effect on treatment outcomes and the recurrence in patients with primary spontaneous pneumothorax. Despite the fact that surgical treatment significantly decreases the recurrence rate, pleurectomy and pleural abrasion techniques have no significant difference on the clinical influence and recurrence of these patients.

The hospital records of 168 PSP patients treated in the thoracic surgery department of Recep Tayyip Erdogan University Education and Research Hospital over the 5-year period between January 2016 and December 2020 were reviewed retrospectively. All patients with PSP, who aged between 17 and 35 years, presented to our clinic, and had complete records, were included in the study. Patients, who aged <17 years or >35 years, whose records were incomplete, or who presented to our hospital from outside the region, were excluded.Demographic data collected from the patients' records included age, gender, PSP side, a first episode or recurrence, length of hospital stay, smoking status, treatment received,

No abstract

ÖzetAmaç: Bu çalışmanın amacı, eş zamanlı akciğer ve karaciğer kist hidatikli hastalarımızdaki tek aşamalı operasyon deneyimlerimizi ve sonuçlarımızı incelemektir. Gereç ve Yöntem: 2002 ile 2011 yılları arasında akciğerin yanı sıra, eş zamanlı karaciğer kist hidatiği de mevcut olan 29 olgu incelendi. Bu olguların 21'inde, karaciğer kistleri kubbe yerleşimliydi. Bu olgular sağ torakotomi ve frenotomi ile opere edildiler. Yirmibir olguda, yaş, cinsiyet, semptomlar, kist boyutları, cerrahi yöntem, operasyon süresi ve komplikasyonlar retrospektif olarak incelendi. Bulgular: Ortalama yaş 60,0±16,72 yıl olarak hesaplandı. Operasyon uygulanan 21 hastanın 8'i erkek,13'ü kadın idi. Öksü-rük ve yan ağrısı en sık karşılaşılan semptom iken, 2 hastada izole karın ağrısı görüldü. 4 hasta ise asemptomatikti. Akciğer kistleri için, kist çapı ortalama 7,50±1,29 cm , karaciğer için 7,0±1,76 cm olarak bulundu. Akciğerdeki kistler kistotomi ve/veya kapitonaj yada wedge yöntemi ile tedavi edildiler. Karaciğerdeki kistler için seçilen tedavi yöntemi ise kistotomi ve kavitenin inversiyonu ile subdiyafragmatik bölgenin drene edilmesiydi. Operasyon süresi ortalama 145,0±15,26 dakika idi. İki hastada uzamış safra drenajı gözlendi. Mortalite izlenmedi. Tartışma: Eş zamanlı sağ akciğer ve subdiyafragmatik karaciğer hidatik kistli hastalarda, sağ torakotomi ve frenetomi ile transdiyafragmatik olarak karaciğer kistine müdahale, güvenilir ve efektif bir yöntemdir. Anahtar KelimelerHidatik Kist; Akciğer, Karaciğer; Tek Aşamalı Cerrahi Abstract Aim: The purpose of this study is to examine our single stage operation experiences of patients with lung and liver hydatid cyst and to examine the results. Material and Method: Between 2002 and 2011, 29 patients with both lung and liver hydatid cyst were examined. Among those, 21 patients had cysts located on the dome of the liver. Those patients were operated on with phrenotomy through a right thoracotomy. 21 patients are retrospectively examined by reviewing age, gender, symptoms, cyst sizes, operation methods, operation duration, and complications. Results: The age mean was 60,0±16,72 cm. Of the 21 operated patients, 8 were males and 13 were females. While cough and abdominal pain were the most common symptoms, isolated abdominal pain was observed at 2 patients. 4 patients were asymptomatic. It is found that the average diameter was 7,50±1,29 cm for lung cysts, 7,0±1,76 cm for liver cysts. Lung cysts were managed through cystotomy with / without capitonnage or wedge methods. On the other hand, the chosen method for liver cyst was cystotomy and cavity invertion with drainage of subdiaphragmatic area. The average operation duration was 145,0±15,26 minutes. Prolonged biliary drainage was observed at two patients. There was no mortality. Discussion: The transdiafragmatic liver cyst management by frenetomy via right thorocotomy is a reliable and effective method at patients with simultaneous right lung and subdiafragmatic liver hydatid disease patients.

Objective: VATS (video-assisted thoracic surgery) is commonly used for variable indications in thoracic surgery procedures such as pleural biopsy and lung resections. The use of VATS in our clinic for various diseases was reviewed. Methods: The files of 45 patients that underwent VATS were assessed retrospectively between May 2009 and March 2011. Cases consisted of 21 males and 24 females; the age range was 15 to 72 years and the mean age was 53.5 years. Results: Fifty-one operations were performed on the 45 cases. A total of six cases, including five cases of hyperhidrosis and one case of pleural effusion, underwent simultaneous bilateral operations. VATS was performed for pleural effusion and/or pleural thickening in 23 cases, for a lung nodule or lung mass in 13, for pneumothorax and prolonged air leak in four, and for hyperhidrosis-sympathetic hyperactivity in five cases. The pathological analyses of 16 patients with pleural effusion indicated malignant disease while seven patients had benign findings. Nine of the patients with pulmonary nodules were reported as benign while four were reported as malignant by pathology. In one patient who underwent wedge resection for pneumothorax, prolonged air leakage occurred and the patient underwent reoperation. Death occurred in one patient. Conclusion: VATS is used for diagnostic and therapeutic purposes in the practice of thoracic surgery. It is the preferred method for selected patients.