Cefuroxime as a prophylactic agent in major thoracic surgical operations was marginally more effective than cefepime, and presented an additional cost advantage.

In this paper we report a case with tracheobroncopathia osteochondroplastica presented with a long segmental tracheal stenosis. Modified slide tracheoplasty was undertaken for the management of the stenosis. In our modification, the oblique tracheal cut was performed from left to right to widen the latero-lateral dimension of tracheal lumen. We assume that preservation of the lateral longitudinal vessels of the trachea results in better healing at the suture line. Postoperative course was uneventful and the patient remains on clinical follow-up for 15 months without any problem.

Although the likelihood of surgical-pathological N2 is slightly higher in patients with adenocarcinoma, radiological examination of patients with cNO NSCLC disease can be as accurate as mediastinoscopy in appropriately staging mediastinal lymph node involvement.

Blunt traumatic diaphragmatic injuries (BTDIs) can be misdiagnosed. Careful evaluation of associated injuries in BTDI is important. In this study, we evaluated treatment options and difficulties in the diagnosis of patients with BTDI. We evaluated ten patients retrospectively with BTDI admitted to our departments, between January 2004 and 2015. Age, gender, trauma type, symptoms, radiological findings, diagnosis time, location and grade of the diaphragmatic injury, surgical type of repair, associated injuries and pericardial rupture, and morbidity and mortality rates were recorded. The mean age of the patients was 46.7 years, and all were males. Ninety percent of BTDI was left sided, and 10 % was on the right side. The diagnosis was confirmed with chest radiograph in 50 % and computed tomography in 70 %. Radiological examination revealed hemothorax in 80 %, the loss of diaphragmatic shadow in 60 %, and visceral organ herniation to the thorax in 60 %. Multiple organ injuries were present in 90 % of cases. Pericardial rupture seen in 30 % was remarkable. Early surgery was performed for eight patients and late surgery for two patients. There were six patients with grade 4 or 5 central diaphragmatic injuries (CDIs). Multiorgan injury was present in all patients developing acute CDI. Multiple organ injury is much higher in patients with severe acute blunt trauma with CDI. Pericardial rupture rate is high in cases with acute BTDI and CDI. Proper diagnosis and early surgical management reduce morbidity and mortality.

Surgery is a treatment choice in the presence of a giant emphysematous bulla (GBE) that covers at least one third of a hemithorax. In this article, a 53-year-old male patient who presented with complaints of progressive shortness of breath, sputum, and inability to perform his daily activities, diagnosed as bilateral GBE after radiological examinations, and post-operative problems were discussed. The right side GBE was operated on. In the postoperative period, there was an air leakage (AL), and the expansion of the lung was insufficient. As soon as respiratory distress and purulent secretion occurred, this important problem was resolved with autologous blood administration. In the presence of GBE, it is difficult to predict the surgical outcome about the lung tissue in the preoperative period. Very serious problems can be encountered in the postoperative period. In the postoperative period, the prolongation of HK and the inability of the lung to expand are very serious problems. Autologous blood application is safe, easy and effective in solving these problems.

No abstract

Perikard ve kalp yaralanmaları travmatik diafragma rüptürüne nadir olarak eşlik eder. Trafik kazası geçiren 42 yaşındaki erkek hastaya diafragma rüptürü teşhisi kondu. Öncelikle laparatomi yapılan hastada, diafragma abdominal yaklaşımla tamir edilmeye çalışıldı. Ancak daha güvenli tamir için yapılan torakotomide perikardın rüptüre olduğu görüldü. Kalp herniye olmuştu. Kalp yerine itildikten sonra perikard ve diafragma primer olarak tamir edildi. Akut diafragma rüptürlerinde ilk yaklaşım genellikle laparotomidir. Ancak abdominal müdahale edilen diafragma rüptürlerinde toraks mutlaka aydınlatılmalı ve intratorasik yapılar her aşamada yakın takip edilmelidir.