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IntroductionOptimal surgical approach for the treatment of resectable lung cancer accompanied by coronary artery disease (CAD) remains a contentious issue. In this study, we present our cases that were operated simultaneously for concurrent lung cancer and CAD.MethodsSimultaneous off-pump coronary artery bypass surgery (OPCABG) and lung resection were performed on 10 patients in our clinic due to lung cancer accompanied by CAD. Demographic features of patients, operation data and postoperative results were evaluated retrospectively.ResultsMean patient age was 63.3 years (range 55-74). All patients were male. Six cases of squamous cell carcinoma, three of adenocarcinoma and one case of large cell carcinoma were diagnosed. Six patients had single-vessel CAD and 4 had two-vessel CAD. Three patients underwent OPCABG at first and then lung resection. The types of resections were one right pneumonectomy, three right upper lobectomies, one right lower lobectomy, three left upper lobectomies, and two left lower lobectomies. Reoperation was performed in one patient due to hemorrhage. One patient developed intraoperative contralateral tension pneumothorax. One patient died due to acute respiratory distress syndrome at the early postoperative period.ConclusionSimultaneous surgery is a safe and reliable option in the treatment of selected patients with concurrent CAD and operable lung cancer.

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Regardless of the daily drainage, chest tubes can safely be removed earlier than anticipated in most patients after lobectomy if the protein content of the draining fluid is low.

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ÖZAmaç: Bu çalışmada, meteorolojik değişiklikler ile primer spontan pnömotoraks gelişimi arasındaki ilişki araştırıldı. Ça lış ma pla nı:Ocak 2010 -Ocak 2014 tarihleri arasında primer spontan pnömotoraks tanısı ile hastanemize başvuran 1097 hastanın (975 erkek, 122 kadın; ort. yaş 23.5±4.2 yıl; dağılım, 17-32 yıl) tıbbi kayıtları geriye dönük olarak incelendi. Yerel meteoroloji gözlemevinden elde edilen hava sıcaklığı, rüzgar hızı, nem oranı ve atmosfer basıncı değerleri için günlük ortalama değerler kaydedildi. Dört yıllık çalışma periyodu en az bir primer spontan pnömotoraks gelişen (grup 1) ve primer spontan pnömotoraks gelişmeyen günler (grup 2) olmak üzere iki gruba ayrıldı. Bul gu lar:Toplam 1461 günlük çalışma döneminde, primer spontan pnömotoraks gözlenen 759 gün içinde 1097 olgu kaydedildi. Hastaların %89'u erkekti. Gruplar arasında ortalama hava sıcaklığı, nem oranı ve rüzgar hızı açısından anlamlı farklılık yoktu. Atmosfer basıncı grup 1'de anlamlı olarak daha düşüktü (p<0.001). Bir önceki güne göre atmosfer basıncında azalma primer spontan pnömotoraks gelişimi riskini anlamlı ölçüde artırdı (p<0.001).So nuç:Çalışmamızda, düşük atmosfer basıncı ve önemli basınç azalmaları primer spontan pnömotoraks ile güçlü bir ilişki gösterdi. Sıcaklık, rüzgar hızı ve nem değerleri primer spontan pnömotoraks gelişimini etkilemedi.Anah tarsöz cük ler: Atmosfer basıncı; meteoroloji; pnömotoraks. ABSTRACTBackground: This study aims to investigate the relationship between meteorological changes and the development of primary spontaneous pneumothorax. Methods:Medical records of 1,097 patients (975 males, 122 females; mean age 23.5±4.2 years; range, 17 to 32 years) admitted to our hospital with a diagnosis of primary spontaneous pneumothorax between January 2010 and January 2014 were evaluated retrospectively. Daily mean values for air temperature, wind speed, humidity rate and atmospheric pressure values obtained from the local meteorological observatory were recorded. The four-year study period was separated into two groups as days with at least one primary spontaneous pneumothorax development (group 1) and days without any primary spontaneous pneumothorax development (group 2). Results:Within the study period of a total of 1,461 days, 1,097 cases were recorded in 759 days during which primary spontaneous pneumothorax was observed. Eighty-nine percent of the patients were male. There was no significant difference between the groups in terms of mean air temperature, humidity rate, and wind speed. Atmospheric pressure was significantly lower in group 1 (p<0.001). Decrease in atmospheric pressure with respect to the previous day increased the risk of primary spontaneous pneumothorax development significantly (p<0.001). Conclusion:In our study, low atmospheric pressure and significant pressure decreases showed a strong correlation with primary spontaneous pneumothorax. Temperature, wind speed, and humidity values did not influence primary spontaneous pneumothorax development.

Introduction The aim of this study was to evaluate the delayed chest closure (DCC) results in patients who underwent lung transplantation. Methods Sixty patients were evaluated retrospectively. Only bilateral lung transplantations and DCC for oversized lung allograft (OLA) were included in the study. Six patients who underwent single lung transplantation, four patients who underwent lobar transplantation, two patients who underwent retransplantation, and four patients who underwent DCC due to bleeding risk were excluded from the study. Forty-four patients were divided into groups as primary chest closure (PCC) (n=28) and DCC (n=16). Demographics, donor characteristics, and operative features and outcomes of the patients were compared. Results The mean age was 44.5 years. There was no significant difference between the demographics of the groups ( P >0.05). The donor/recipient predicted total lung capacity ratio was significantly higher in the DCC group than in the PCC group (1.06 vs . 0.96, P =0.008). Extubation time (4.3 vs . 3.1 days, P =0.002) and intensive care unit length of stay (7.6 vs. 5.2 days, P =0.016) were significantly higher in the DCC group than in the PCC group. In the DCC group, postoperative wound infection was significantly higher than in the PCC group (18.6% vs. 0%, P =0.19). Median survival was 14 months in all patients and there was no significant difference in survival between the groups (16 vs. 13 months, P =0.300). Conclusion DCC is a safe and effective method for the management of OLA in lung transplantation.