Purpose. Pectus deformities and cardiac problems sometimes require simultaneous surgery. We report our experience of performing this surgery and review the relevant literature. Methods. We performed simultaneous pectus deformity correction and open-heart surgery in six patients between 1999 and 2006. The pectus deformities were pectus carinatum in one patient and pectus excavatum in fi ve patients. The cardiac problems were coronary artery disease in one patient, an atrioseptal defect (ASD) with a ventricular septal defect (VSD) in one, a VSD in one, mitral valve insuffi ciency with left atrial dilatation in one, and an ascending aortic aneurysm with aortic valve insuffi ciency caused by Marfan's syndrome in two. We corrected the pectus deformities using the modifi ed Ravitch's sternoplasty in all patients. First, while the patient was supine, we resected the costal cartilage; then, after completing the cardiac surgery, the sternum was closed and the additional time required for the pectus operation was calculated for each patient. Patients were examined 1, 4, and 6 months postoperatively. Results. The average operation time was 102 min, and there were no major complications. The pectus bars were removed 4-6 months postoperatively. Good cardiac and cosmetic results were achieved in all patients, who were followed up for 5 years. Conclusions. Concomitant pectus deformity correctionand open-heart surgery can be performed safely, eliminating the risks of a second operation in a staged procedure.

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Castleman's disease is a rare lymphoproliferative disease and its etiology is still unknown. It may occur at every site where lymph tissue is present. A definitive treatment is possible with complete resection. The most important problem is bleeding which may occur during surgery due to the high vascularization. In this study, we present the surgical treatment of a case with mediastinal Castleman's disease, treated preoperatively with embolization because of hypervascularization detected on thoracic CT.

OBJECTIVES:Trauma is currently among the most important health problems resulting in mortality. Approximately 25% of traumarelated deaths are associated with thoracic trauma. In the present study, morbidity and mortality rates and interventions performed in patients who had been treated as inpatients in Dr. Siyami Ersek Thoracic and Cardiovascular Surgery hospital after trauma were aimed to be evaluated. MATERIAL AND METHODS:In our study, 404 patients who were treated as inpatients because of thoracic trauma between January 2005 and December 2008 were retrospectively evaluated. RESULTS:The rates of blunt and penetrating trauma were 39.6% and 60.4%, respectively. In the study, 115 (28.4%) patients were noted to have pneumothorax, 99 (24.5%) had hemothorax, and 57 (14.1%) had hemopneumothorax. While tube thoracostomy was sufficient for treatment in approximately 80% of the patients, major surgical interventions were performed in 12.6% of the patients. Mortality rate was found to be 2.2%. CONCLUSION:In patients with chest trauma, necessary interventions should be started at the time of the event, and the time from trauma to arriving at the emergency department should be made the best of. Mortality and morbidity rates in thoracic trauma cases may be reduced by timely interventions and effective intensive care monitoring. KEYWORDS: Trauma, thorax, morbidity, mortality INTRODUCTIONThoracic traumas have a wide spectrum from simple rib fractures to major vascular injuries. Traumas are the major cause of death in individuals younger than 40 years [1]. Approximately 50% of deaths following trauma are directly or indirectly associated with thoracic trauma [2]. However, recently published studies have reported a decrease in mortality rates related to thoracic trauma. Glinz [3] reported that 10% and 18% of 460 trauma-related deaths are directly and indirectly related to thoracic trauma, respectively.Penetrating injuries are less common than blunt trauma in thoracic trauma patients, and mortality after penetrating injuries is lower than that after blunt traumas. However, mortality rate varies according to the trauma mechanism and organ damage after trauma. While mortality rate is between 1% and 8% after stab wounds, the rate is between 14% and 20% after gunshot wounds. Mortality is higher in patients with cardiac injury. Mortality rate rises to 25-28% in case there is diaphragmatic, pulmonary, or large vessel injury after trauma [2]. The pathological process after thoracic trauma is associated with respiratory and hemodynamic changes. The most common pathology observed is hypoxia. Hypoxia occurs because of reasons such as bleeding, collapse, or compression of the lung, respiratory or cardiac failure, pulmonary contusion, intrathoracic pressure change, and mediastinal shift.Chest X-ray is the first and most valuable diagnostic tool to reveal the pathology after thoracic trauma and to determine the treatment approach. Computed tomography helps reveal the pathologies that cannot be determined by the chest X-ray.Supportive or sur...

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There was no significant difference between thoracoscopic sympathectomy and sympathicotomy at the third ganglia (T3) level for the treatment of primary palmar hyperhidrosis in terms of initial surgery results, complications, and patient satisfaction. Neither surgical technique is better than the other one for palmar hyperhidrosis treatment. Development of severe compensatory sweating and postoperative pain are major determinant factors of patient dissatisfaction. Sympathicotomy should be preferred for palmar hyperhidrosis treatment, as it is much technically shorter, simpler to implement, and also easier to learn.