Aims and Scope Eurasian Journal of Medicine (Eurasian J Med) is an international, scientific, open access periodical published by independent, unbiased, and tripleblinded peer-review principles. The journal is the official publication of
Background/aim: Mediastinoscopy is an invasive procedure that is used in the diagnosis of mediastinal diseases and in staging lung cancer. Tumor cell seeding during mediastinoscopy along the mediastinum and the incision line is a very rare complication. This study aimed to test the safety of mediastinoscopy in terms of tumor seeding by cytological evaluation of mediastinal lavage samples taken before and after biopsy.
Materials and methods:The patients who underwent mediastinoscopy in our hospital between 2011 and 2014 were studied prospectively. Seventy-three patients with a diagnosis of lung or mediastinal malignancy were included in the study. All patients underwent classical cervical mediastinoscopy and mediastinal lavages were taken before and after the biopsy. Both lavage samples were sent to the pathology department in syringes for malignant cell cytology screening.
Results:The results of the histopathological examinations of lymph node biopsies were reactive in 25 patients and positive for malignancy in 48 patients. In 2 of 48 patients whose lymph nodes were reported to be positive for malignancy, the mediastinal lavage sample was reported to be positive for malignancy after biopsy, although it was negative preoperatively. In two patients, both the pre-and postbiopsy lavage samples were reported to be positive for malignancy.
Conclusion:While performing dissection and biopsy during mediastinoscopy, tumor seeding into the mediastinum may occur. Long follow-up periods and large patient series are needed to determine how cytopathological examination of both fluids would affect the prognosis.
Bu çalışmada küçük hücreli dışı akciğer kanseri hastalarında akciğer kanserinin türü, evresi ve yaygınlığı ile serum ve akciğer dokularındaki signal peptide-Complement C1r/C1s, Uegf, and Bmp1-epidermal growth factor domaincontaining protein 1 düzeyleri arasında ilişki olup olmadığı ve malign veya benign hastalıklı hastaların signal peptide-Complement C1r/C1s, Uegf, and Bmp1epidermal growth factor domain-containing protein 1 düzeyleri arasında farklılık olup olmadığı araştırıldı.Ça lış mapla nı:Çalışmaya tanı veya tedavi amacıyla ameliyat edilen 25 rezektabl küçük hücreli dışı akciğer kanseri hastası (21 erkek, 4 kadın; ort. yaş 64.6±9.4 yıl; dağılım, 41-79 yıl) (grup 1), 15 unrezektabl küçük hücreli dışı akciğer kanseri hastası (10 erkek 5 kadın; ort. yaş 61.8±9.6 yıl; dağılım, 48-82 yıl) (grup 2) ve kanser dışı nedenlerle ameliyat edilen 15 hasta (14 erkek, 1 kadın; ort. yaş 42.5±19.5 yıl; dağılım, 18-76 yıl) (grup 3; kontrol grubu) olmak üzere üç gruba ayrılan 55 denek (45 erkek, 10 kadın; ort. yaş 57.8±15.9 yıl; dağılım 18-82 yıl) dahil edildi.Bul gu lar: Grup 1 ve 2'de ameliyat öncesi serum signal peptide-Complement C1r/C1s, Uegf, and Bmp1-epidermal growth factor domain-containing protein 1 düzeyleri kontrol grubuna göre daha yüksek idi (p= 0.045). Grup 2'de serum signal peptide-Complement C1r/C1s, Uegf, and Bmp1-epidermal growth factor domain-containing protein 1 düzeyleri diğer iki gruba göre anlamlı şekilde daha yüksek idi (p= 0.008). Küçük hücreli dışı akciğer kanseri hastalarında doku örneklerindeki signal peptide-Complement C1r/C1s, Uegf, and Bmp1-epidermal growth factor domain-containing protein 1 düzeyleri anlamlı şekilde daha yüksekti ve prognostik öneme sahipti; öyle ki, doku signal peptide-Complement C1r/C1s, Uegf, and Bmp1-epidermal growth factor domain-containing protein 1 konsantrasyonundaki 1 ng/mL'lik bir artış ölüm riskinde 1.4 kat artışa neden oldu (p= 0.009).
So nuç:Serum ve tümör dokusundaki signal peptide-Complement C1r/C1s, Uegf, and Bmp1-epidermal growth factor domain-containing protein 1 konsantrasyonu küçük hücreli dışı akciğer kanseri hastalarında tanı ve prognozu belirlemede önemli bir biyobelirteç olabilir.Anah tar söz cük ler: Tanı; akciğer kanseri; signal peptide-Cub-epidermal growth factor domain-containing protein 1.
Background: Pneumomediastinum is defined as the presence of air in the mediastinal region. It is associated with events or diseases leading to a sudden increase in alveolar pressure. The air in the mediastinum may originate in the pharynx, the tracheobronchial tree or the esophagus. This study aimed to assess the clinical and radiological characteristics of patients who were diagnosed with spontaneous pneumomediastinum and received treatment at our clinic. Materials and Methods: A total of 23 patients who had spontaneous pneumomediastinum and were treated at our clinic between 2007 and 2019 were retrospectively assessed for their age, etiological factors, clinical and radiological characteristics; treatment and outcomes. Chest radiography and computed tomography of the thorax were used for diagnosis in all patients. Results: Of the patients, 15 were males and eight females and their mean age was 33.91 (15-82) years. The most common symptom on admission was shortness of breath (n = 12) and chest pain (n = 11). The etiological factors were excessive vomiting in six patients and excessive cough in five. Radiologically, the most common findings besides pneumomediastinum were subcutaneous emphysema (n = 6) and pneumothorax (n = 4). Of the patients, seven required esophagoscopy, four required bronchoscopy and no pathology was observed. All patients were fully recovered when they were discharged. Conclusions: The underlying etiological factor is crucial in pneumomediastinum. Conservative treatment methods are often sufficient in spontaneous pneumomediastinum patients with no pathology in endoscopic evaluation.
Extrapleural hematoma is a rare clinical condition whose most common causes are blunt chest trauma, central venous catheterization and ruptured thoracic aortic aneurysm. This study aimed to present three cases that underwent video-assisted thoracoscopic surgery due to extrapleural hematoma. Etiologic factors in these cases were falls from height in two cases and a dialysis catheter placed into the right internal jugular vein in one case.
Early surgical rib stabilization in flail chest is a safe treatment method which has a low complication rate and can reduce the morbidity and mortality which develop from mechanical ventilation.
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