The most common reasons of pneumomediastinum are thoracic trauma, endoscoping procedures, endotra... more The most common reasons of pneumomediastinum are thoracic trauma, endoscoping procedures, endotracheal entubation and spontaneous pneumomediastinum. The choice of treatment depends on the ethiology, clinical symptoms and the complication risk; and hence varies from spontaneous pneumomediastinum(SPM). Conservative treatment is usually sufficient, but occasionally cervical mediastinotomy or thoracotomy may be necessary. In the last ten years we treated 15 patients with massive subcutaneous emphysema in our clinic. The mean age for the 10 men and 5 women was 40(12-71). The ethiological factors were blunt thoracic trauma (7 cases), endotracheal entubation (4 cases), after asthma attack( 2 case) and spontaneous pneumomediastinum in 2 cases.. The reasons of traumatic cases (blunt thoracic trauma cases) were traffic accidents (4 cases), direct impact by a blunt heavy object (1 case), compression of the chest in anterior posterior direction (2 case) and falling from height (1 case). Pneumothorax was determined in 3 patients with blunt thoracic trauma. Tube thoracostomy was performed to the patients with pneumothorax. Cervical mediastinotomy was performed to our cases with massive mediastinal emphysema for decompression. The patients were discharged within 4-15 days. If symptoms of compression are present, conservative treatment shall be avoided and procedures for decompression should be performed(cutaneous and subcutaneous incisions, needle aspiration, mediastinal catheter application and cervical mediastinotomy). The cervical mediastinotomy is the most effective and reliable method of treatment.
The Korean Journal of Thoracic and Cardiovascular Surgery, Jun 5, 2014
Synovial sarcoma (SS) is a highly malignant tumor that accounts for 10% of all soft-tissue sarcom... more Synovial sarcoma (SS) is a highly malignant tumor that accounts for 10% of all soft-tissue sarcomas. Primary SS arising from the lung is extremely rare, and the prognosis is poor. We report a case of pulmonary SS presenting with a mass lesion invading the right upper and middle lobes, extending to the mediastinum and the chest wall. After tru-cut biopsy, surgical resection was performed. The final diagnosis was SS (biphasic type) based on histological and immunohistochemical findings. There are no guidelines for optimal treatment due to the rarity of these tumors. Current treatment includes surgery and adjuvant chemotherapy and/or radiotherapy.
ABSTRACT Retrosternal goiters (RSGs) can be removed transcervically, but additional incisions are... more ABSTRACT Retrosternal goiters (RSGs) can be removed transcervically, but additional incisions are sometimes necessary. We examined the factors determining the need for additional incisions to remove an RSG goiter, based on our experience and on an algorithm. Among 499 patients who underwent surgery for a goiter, 52 (10.4%) had an RSG removed via a collar incision. Additional incisions were necessary in 11 patients (21% of those with an RSG and 2.2% overall): a partial sternotomy in 4, total sternotomy in 5, and right thoracotomy in 2. Recurrent nerve paralysis developed in two patients and one patient had a tracheal laceration. There was no mortality. A diagnosis of adenomatous goiter was confirmed in all patients. Additional incisions can be made if thyroidectomy cannot be done transcervically and if the goiter extends to the level of the aortic arch. If the thyroid gland extends below the aortic arch and the lateral diameter of the goiter is greater than 10 cm, a partial sternotomy may be required. Total sternotomy is needed when an RSG extends caudally to the azygos vein, if it is located in the retrotracheal or retroesophageal space, or if it is recurrent or ectopic. Coexisting lung disorders and goiters extending to the left atrium also require thoracotomy.
Ekstranodal lenfomalar tüm lenfoma hastalar›n›n %3 ile %5'ini oluflturmaktad›r. Lenfoman›n organ ... more Ekstranodal lenfomalar tüm lenfoma hastalar›n›n %3 ile %5'ini oluflturmaktad›r. Lenfoman›n organ tutulumu böbrekler, mediyasten, perikard, özofagus, rektosigmoid ve psoas gibi çeflitli anatomik lokalizasyonlarda tariflenmifltir. Yaz›m›zda, toraks bilgisayarl› tomografisinde plevral efüzyon ve kal›nlaflma ile kendini gösteren plevral lenfoma olgusunu sunmaktay›z.
Çocukluk çağındaki mediastinal kistler; lokalizasyon ve tedavide cerrahi eksizyon dışında erişkin... more Çocukluk çağındaki mediastinal kistler; lokalizasyon ve tedavide cerrahi eksizyon dışında erişkinlerden farklıdır. İnsidans ve semptom olarak belirgin fark görülür. Semptomlar daha dramatiktir, bazen hayati tehlike dahi oluşturabilir. Embriyonik foregut'dan gelişen kistler bronkogenik kist, dublikasyon kisti (enterogenik kist) ve noroenterik kist olarak isimlendirilirler. Mediastinal kitlelerin ortalama %15'ini oluştururlar. Semptom ve radyoloji genellikle tanı koydurucudur. Cerrahi eksizyon sonuçları yüz güldürücüdür.
Body: Introduction: Pneumatoceles are thin-walled cystic lesions of lung parenchyma. They may be ... more Body: Introduction: Pneumatoceles are thin-walled cystic lesions of lung parenchyma. They may be developed after inflammation or injury. They regress after treatment of underlying disease. Necrotising pneumonia is one of the reasons. In childhood, pneumonia may cause pneumatoceles. Tension pneumatocele may be developed with respiratory and cardiovasculary collapse. Case: Four-year-old boy under treatment of stafilococcus aureus pneumonia was consulted us. Large air-filled multiple cystic lesions were detected compressing the lung. After a small catheter insertion in one of the cystic lesions, the patient got worse. Other cystic lesions were getting larger radiologically, tension was developed and lesions compressed heart also. A second catheter was inserted in the upper lesion. Respiratory symptoms were improved, mediastinal shift regressed. Discussion: Percutaneous decompression may be recommended for single symptomatic pneumatoceles while resection is recommended for symptomatic ones. Because of higher mortality and morbidity rates with surgical management, we think that multiple attempts to percutaneous decompression can be successful and should be tried first.
Pulmonary sequestration is an uncommon disease with non-functioning pulmonary tissue and anomalou... more Pulmonary sequestration is an uncommon disease with non-functioning pulmonary tissue and anomalous systemic blood supply. Diagnosis depends on identification of abnormal systemic vessels. We report a case who went on thoracotomy due to cyst hydatic and the sequestration was diagnosed during the operation. Case: A 68-year-old man complaining of a non-productive cough, stomach ache, nausea and vomiting, admitted to our clinic. He was diagnosed with hepatic cyst hydatic and was treated with surgery one year ago. Chest x-ray showed a prominency at aortic arch. Chest CT imaging was revealed a paraaortic lesion with suspicion about its dansity of cystic or solid which was located posteriorly. This was tought again a hydatic cyst suitable with his medical history and an operation was planned. Left thoracotomy was performed. During the operation the lesion was detected as a sequestration. By histopathological study the lesion was confirmed to be a sequestration. In his 4th. month follow-up the patient remains asymptomatic with normal radiography results. Aberrant feeding vessels cannot always be demonstrated by conventional CT. Moreover, volumetric helical imaging allows three dimensional reconstruction of data, may be useful in the demonstration and characterization of the lesions and also showing vascular structures. Pulmonary sequestration must be in mind for differantial diagnosis of pulmonary lesions especially adjacent to vasculary structures.
E lastofibroma dorsi (ED) is a rare, slow-growing, non-capsulated, benign soft tissue tumour of t... more E lastofibroma dorsi (ED) is a rare, slow-growing, non-capsulated, benign soft tissue tumour of the chest wall that arises from connective tissue forming collagen bundles. ED is most commonly located in the periscapular region, beneath the rhomboid major and latissimus dorsi muscles, especially in older women. ED can be bilaterally, but not always in synchronous localizations. ED may be densely adherent to surrounding muscle and bone. Thus, the suspicion for malignancy is often raised. In addition to careful clinical investigation, radiology is the method of choice leading to a presumptive diagnosis. [1] In addition to a few sporadic cases, the only literature reporting a large series in the literature is with 170 cases. [2] Ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) have all been used to characterize elastofibroma. Surgical extirpation is usually curative. [2,3] We report 10 cases of ED treated with surgery and want to point out a new promising diagnostic technique to differentiate benign lesions without surgery. Methods Eight female and two male patients, ages between 44-72 years-old (median: 54), were admitted to the clinic with the complaint of asymptomatic or painful subcutaneous masses localized subscapular. Lesions were palpated at the Elastofibroma dorsi is a benign lesion commonly presents as a palpable enlarging mass at the inferior pole of the scapula. Clinical presentation and radiological characteristics are often enough to suggest an accurate diagnosis. Increased awareness of the characteristic appearance and location of these benign lesions will increase radiologic diagnosis and decrease the need for biopsy. Ten patients were admitted with a complaint of asymptomatic or painful subcutaneous masses localized at subscapulary region. Thorax computed tomography, magnetic resonance imaging (MRI) and a new feasible technique in differential diagnosis with malignancy and probable diagnosis of elastofibroma dorsi and diffusion-weighted MRI were used for diagnosis. Surgery was applied to all patients, frozen-section biopsies of the lesions at the preoperative period, and final pathologies were all benign. Totally resection of whole lesions as en-bloc excision without any rest was performed at all patients. Postoperative and follow-up periods were uneventful. Diffusion MRI can play an important role in the future and save the patients, especially medically poor ones, from the potential risks of surgery. Necessary further examinations for probable bilaterally lesions will save the patient from the risk of a second operation.
Background: Iatrogenic tracheal rupture is a rare complication after intubation. Overinflation of... more Background: Iatrogenic tracheal rupture is a rare complication after intubation. Overinflation of the tracheal cuff was speculated to be a frequent cause of tracheal rupture. The surgical approach is a widespread treatment for tracheal ruptures. The aim of this study is to evaluate the results of conservative and surgical therapy approaches in tracheal rupture cases inflicted by tracheal intubation. Methods: Data on 12 patients who experienced tracheal ruptures secondary to intubation were reviewed. The average age of the patients was 58 years (range of 38 to 81 years). Six patients were men and 6 patients were women. Four of the patients were performed thoracotomy for primary surgery and underwent surgical therapy. 8 patients were treated conservatively. The results of both approaches were evaluated. Results: Patients, who underwent both conservative and surgical therapy, were completely recovered. There was no rupture originated complication or death. Conclusions: Both conservative and surgical therapies are appropriate for treatment of membranous tracheal rupture.
Interventional Medicine and Applied Science, Mar 1, 2013
We present the case of a 20-year-old man with hemoptysis for 3 years. Chest radiography revealed ... more We present the case of a 20-year-old man with hemoptysis for 3 years. Chest radiography revealed increased pulmonary vascular opacities in the left lower lung field. Computed tomography showed an anomalous systemic artery arising from descending aorta supplying the basal segments of the left lower lobe. Bronchial tree was normal. Pulmonary artery angiogram revealed a hypoplastic inferior lobar branch of the left pulmonary artery. There was no direct communication between anomalous artery and pulmonary veins. We diagnosed our case as aortopulmonary collateral with normal lung parenchyma. Coil embolization of the anomalous systemic artery was performed. The patient survived well without evidence of hemoptysis for 18 months after coil embolization.
BACKGROUND: Tracheal stenosis constitutes one of the most frequently seen problems in thoracic su... more BACKGROUND: Tracheal stenosis constitutes one of the most frequently seen problems in thoracic surgery. Although many treatment modalities to prevent fibroblast proliferation, angiogenesis, or inflammation that causes tracheal stenosis have been attempted, an effective method has not yet been found. In this study, a transforming growth factor beta3 (TGF-3)/chitosan combination was used for this purpose. METHODS: A slow-release preparation containing a thin layer of TGF-3 with a chitosan base was made. Thirty albino Wistar rats were divided into 3 groups. A full-layer vertical incision was made in the anterior side of the trachea of each rat between the second and fifth tracheal rings. The tracheal incision was sutured. Group A was evaluated as the control group. In Group B, a chitosan-based film was placed on the incision line. In Group C, a slow-release TGF-3/chitosan-coated substance was placed on the incision line. The rats were killed on day 30, and their tracheas were excised by cutting between the lower edge of the thyroid cartilage and the upper edge of the sixth tracheal ring together with the esophagus. Epithelialization, fibroblast proliferation, angiogenesis, inflammation, and collagen levels were evaluated histopathologically by the same histopathologist. RESULTS: Statistically significant differences were not found among the 3 groups. Cold abscesses were observed at the incision sites in both the TGF-/chitosan and chitosan groups. These were thought to have formed due to the chitosan. CONCLUSIONS: As this was the first experiment in the literature to use this type of TGF-3 formulation, we intend to change the formulation and perform this study again with a different TGF-3/chitosan preparation.
Üst hava yolu stenozu s›kl›kla üst trakeal ve subglottik seviyelerdeki patolojiler ile iliflkilid... more Üst hava yolu stenozu s›kl›kla üst trakeal ve subglottik seviyelerdeki patolojiler ile iliflkilidir. Enflamatuvar stenoz, trakeal rezeksiyon ve rekonstrüksiyonlar›n en s›k endikasyonudur. Primer trakea tümörlerinin de primer rekonstrüksiyona uygun ise en ideal tedavisi rezeksiyon olmak-tad›r. Benign ve malign sebeplerle trakea cerrahisi uygu-lad›¤›m›z yafllar› 24-50 aras›nda de¤iflen 9 olgudan, postentübasyon trakeal stenoz tan›s› olan 5'ine servikal insizyon ile, trakeal tümör tan›l› 4 hastaya ise torakotomi yolu ile trakeal rezeksiyon ve uç-uca anastomoz baflar›l› flekilde uyguland›. Dikkatli preoperatif de¤erlendirmeyi takiben uygulanacak baflar›l› cerrahi teknik trakeal patolojilerin cerrahisinde tatmin edici sonuçlar› da beraberinde getirmektedir.
Radiological analyses in a 61-year-old patient being followed since 2005 for low-grade, non-invas... more Radiological analyses in a 61-year-old patient being followed since 2005 for low-grade, non-invasive urothelial carcinoma (UC) (Ta) revealed a 5-cm pleural-based mass in the lower lobe of the right lung for which a subsequent transthoracic fine-needle aspiration cytology was performed. Upon observing the carcinoma cells consistent with UC metastasis, systemic chemotherapy was commenced. The patient underwent a metastatectomy based on the thoracic computerized tomography scan performed on the 4(th) month of treatment, which revealed notable regression. The resected tumor was morphologically similar to cells seen in the transthoracic fine-needle aspiration and was immunohistochemically positive for p63, uroplakin, thrombomodulin, CK7 and CK20 at varying degrees but was negative for TTF-1. We report a case of metastatic UC of the lung in a patient who had had a low-grade superficial UC of the urinary bladder and we discuss the cytopathological features of this rare entity in light of the literature.
Turkish Journal of Thoracic and Cardiovascular Surgery, Apr 26, 2021
Jeune sendromu nadir görülen bir iskelet displazisi olup, dar, çan şeklinde toraks (göğüs kafesi)... more Jeune sendromu nadir görülen bir iskelet displazisi olup, dar, çan şeklinde toraks (göğüs kafesi) ve falanks ve pelvis kemiklerinde tipik deformiteler ile karakterizedir. Yenidoğan döneminde dar ve yatay yerleşimli kaburgalar nedeni ile akciğer ekspansiyonu sağlanamaz; bu da, birçok olguda alveolar hipoventilasyon ve nihayetinde yenidoğan ve bebek ölümlerine neden olur. Sternoplasti ile eksternal distraksiyon, ulnar uzatma için tasarlanan kaydırılan parmak fiksatör ile ilk kez ekibimiz tarafından bir yenidoğanda kullanılan, Jeune sendromu tedavisinde yeni bir tekniktir. Bu yaklaşımın geliştirilip yaygınlaştırılarak uygulanması ile yenidoğanlarda hayat kurtarıcı olabileceği kanısındayız.
The most common reasons of pneumomediastinum are thoracic trauma, endoscoping procedures, endotra... more The most common reasons of pneumomediastinum are thoracic trauma, endoscoping procedures, endotracheal entubation and spontaneous pneumomediastinum. The choice of treatment depends on the ethiology, clinical symptoms and the complication risk; and hence varies from spontaneous pneumomediastinum(SPM). Conservative treatment is usually sufficient, but occasionally cervical mediastinotomy or thoracotomy may be necessary. In the last ten years we treated 15 patients with massive subcutaneous emphysema in our clinic. The mean age for the 10 men and 5 women was 40(12-71). The ethiological factors were blunt thoracic trauma (7 cases), endotracheal entubation (4 cases), after asthma attack( 2 case) and spontaneous pneumomediastinum in 2 cases.. The reasons of traumatic cases (blunt thoracic trauma cases) were traffic accidents (4 cases), direct impact by a blunt heavy object (1 case), compression of the chest in anterior posterior direction (2 case) and falling from height (1 case). Pneumothorax was determined in 3 patients with blunt thoracic trauma. Tube thoracostomy was performed to the patients with pneumothorax. Cervical mediastinotomy was performed to our cases with massive mediastinal emphysema for decompression. The patients were discharged within 4-15 days. If symptoms of compression are present, conservative treatment shall be avoided and procedures for decompression should be performed(cutaneous and subcutaneous incisions, needle aspiration, mediastinal catheter application and cervical mediastinotomy). The cervical mediastinotomy is the most effective and reliable method of treatment.
The Korean Journal of Thoracic and Cardiovascular Surgery, Jun 5, 2014
Synovial sarcoma (SS) is a highly malignant tumor that accounts for 10% of all soft-tissue sarcom... more Synovial sarcoma (SS) is a highly malignant tumor that accounts for 10% of all soft-tissue sarcomas. Primary SS arising from the lung is extremely rare, and the prognosis is poor. We report a case of pulmonary SS presenting with a mass lesion invading the right upper and middle lobes, extending to the mediastinum and the chest wall. After tru-cut biopsy, surgical resection was performed. The final diagnosis was SS (biphasic type) based on histological and immunohistochemical findings. There are no guidelines for optimal treatment due to the rarity of these tumors. Current treatment includes surgery and adjuvant chemotherapy and/or radiotherapy.
ABSTRACT Retrosternal goiters (RSGs) can be removed transcervically, but additional incisions are... more ABSTRACT Retrosternal goiters (RSGs) can be removed transcervically, but additional incisions are sometimes necessary. We examined the factors determining the need for additional incisions to remove an RSG goiter, based on our experience and on an algorithm. Among 499 patients who underwent surgery for a goiter, 52 (10.4%) had an RSG removed via a collar incision. Additional incisions were necessary in 11 patients (21% of those with an RSG and 2.2% overall): a partial sternotomy in 4, total sternotomy in 5, and right thoracotomy in 2. Recurrent nerve paralysis developed in two patients and one patient had a tracheal laceration. There was no mortality. A diagnosis of adenomatous goiter was confirmed in all patients. Additional incisions can be made if thyroidectomy cannot be done transcervically and if the goiter extends to the level of the aortic arch. If the thyroid gland extends below the aortic arch and the lateral diameter of the goiter is greater than 10 cm, a partial sternotomy may be required. Total sternotomy is needed when an RSG extends caudally to the azygos vein, if it is located in the retrotracheal or retroesophageal space, or if it is recurrent or ectopic. Coexisting lung disorders and goiters extending to the left atrium also require thoracotomy.
Ekstranodal lenfomalar tüm lenfoma hastalar›n›n %3 ile %5'ini oluflturmaktad›r. Lenfoman›n organ ... more Ekstranodal lenfomalar tüm lenfoma hastalar›n›n %3 ile %5'ini oluflturmaktad›r. Lenfoman›n organ tutulumu böbrekler, mediyasten, perikard, özofagus, rektosigmoid ve psoas gibi çeflitli anatomik lokalizasyonlarda tariflenmifltir. Yaz›m›zda, toraks bilgisayarl› tomografisinde plevral efüzyon ve kal›nlaflma ile kendini gösteren plevral lenfoma olgusunu sunmaktay›z.
Çocukluk çağındaki mediastinal kistler; lokalizasyon ve tedavide cerrahi eksizyon dışında erişkin... more Çocukluk çağındaki mediastinal kistler; lokalizasyon ve tedavide cerrahi eksizyon dışında erişkinlerden farklıdır. İnsidans ve semptom olarak belirgin fark görülür. Semptomlar daha dramatiktir, bazen hayati tehlike dahi oluşturabilir. Embriyonik foregut'dan gelişen kistler bronkogenik kist, dublikasyon kisti (enterogenik kist) ve noroenterik kist olarak isimlendirilirler. Mediastinal kitlelerin ortalama %15'ini oluştururlar. Semptom ve radyoloji genellikle tanı koydurucudur. Cerrahi eksizyon sonuçları yüz güldürücüdür.
Body: Introduction: Pneumatoceles are thin-walled cystic lesions of lung parenchyma. They may be ... more Body: Introduction: Pneumatoceles are thin-walled cystic lesions of lung parenchyma. They may be developed after inflammation or injury. They regress after treatment of underlying disease. Necrotising pneumonia is one of the reasons. In childhood, pneumonia may cause pneumatoceles. Tension pneumatocele may be developed with respiratory and cardiovasculary collapse. Case: Four-year-old boy under treatment of stafilococcus aureus pneumonia was consulted us. Large air-filled multiple cystic lesions were detected compressing the lung. After a small catheter insertion in one of the cystic lesions, the patient got worse. Other cystic lesions were getting larger radiologically, tension was developed and lesions compressed heart also. A second catheter was inserted in the upper lesion. Respiratory symptoms were improved, mediastinal shift regressed. Discussion: Percutaneous decompression may be recommended for single symptomatic pneumatoceles while resection is recommended for symptomatic ones. Because of higher mortality and morbidity rates with surgical management, we think that multiple attempts to percutaneous decompression can be successful and should be tried first.
Pulmonary sequestration is an uncommon disease with non-functioning pulmonary tissue and anomalou... more Pulmonary sequestration is an uncommon disease with non-functioning pulmonary tissue and anomalous systemic blood supply. Diagnosis depends on identification of abnormal systemic vessels. We report a case who went on thoracotomy due to cyst hydatic and the sequestration was diagnosed during the operation. Case: A 68-year-old man complaining of a non-productive cough, stomach ache, nausea and vomiting, admitted to our clinic. He was diagnosed with hepatic cyst hydatic and was treated with surgery one year ago. Chest x-ray showed a prominency at aortic arch. Chest CT imaging was revealed a paraaortic lesion with suspicion about its dansity of cystic or solid which was located posteriorly. This was tought again a hydatic cyst suitable with his medical history and an operation was planned. Left thoracotomy was performed. During the operation the lesion was detected as a sequestration. By histopathological study the lesion was confirmed to be a sequestration. In his 4th. month follow-up the patient remains asymptomatic with normal radiography results. Aberrant feeding vessels cannot always be demonstrated by conventional CT. Moreover, volumetric helical imaging allows three dimensional reconstruction of data, may be useful in the demonstration and characterization of the lesions and also showing vascular structures. Pulmonary sequestration must be in mind for differantial diagnosis of pulmonary lesions especially adjacent to vasculary structures.
E lastofibroma dorsi (ED) is a rare, slow-growing, non-capsulated, benign soft tissue tumour of t... more E lastofibroma dorsi (ED) is a rare, slow-growing, non-capsulated, benign soft tissue tumour of the chest wall that arises from connective tissue forming collagen bundles. ED is most commonly located in the periscapular region, beneath the rhomboid major and latissimus dorsi muscles, especially in older women. ED can be bilaterally, but not always in synchronous localizations. ED may be densely adherent to surrounding muscle and bone. Thus, the suspicion for malignancy is often raised. In addition to careful clinical investigation, radiology is the method of choice leading to a presumptive diagnosis. [1] In addition to a few sporadic cases, the only literature reporting a large series in the literature is with 170 cases. [2] Ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) have all been used to characterize elastofibroma. Surgical extirpation is usually curative. [2,3] We report 10 cases of ED treated with surgery and want to point out a new promising diagnostic technique to differentiate benign lesions without surgery. Methods Eight female and two male patients, ages between 44-72 years-old (median: 54), were admitted to the clinic with the complaint of asymptomatic or painful subcutaneous masses localized subscapular. Lesions were palpated at the Elastofibroma dorsi is a benign lesion commonly presents as a palpable enlarging mass at the inferior pole of the scapula. Clinical presentation and radiological characteristics are often enough to suggest an accurate diagnosis. Increased awareness of the characteristic appearance and location of these benign lesions will increase radiologic diagnosis and decrease the need for biopsy. Ten patients were admitted with a complaint of asymptomatic or painful subcutaneous masses localized at subscapulary region. Thorax computed tomography, magnetic resonance imaging (MRI) and a new feasible technique in differential diagnosis with malignancy and probable diagnosis of elastofibroma dorsi and diffusion-weighted MRI were used for diagnosis. Surgery was applied to all patients, frozen-section biopsies of the lesions at the preoperative period, and final pathologies were all benign. Totally resection of whole lesions as en-bloc excision without any rest was performed at all patients. Postoperative and follow-up periods were uneventful. Diffusion MRI can play an important role in the future and save the patients, especially medically poor ones, from the potential risks of surgery. Necessary further examinations for probable bilaterally lesions will save the patient from the risk of a second operation.
Background: Iatrogenic tracheal rupture is a rare complication after intubation. Overinflation of... more Background: Iatrogenic tracheal rupture is a rare complication after intubation. Overinflation of the tracheal cuff was speculated to be a frequent cause of tracheal rupture. The surgical approach is a widespread treatment for tracheal ruptures. The aim of this study is to evaluate the results of conservative and surgical therapy approaches in tracheal rupture cases inflicted by tracheal intubation. Methods: Data on 12 patients who experienced tracheal ruptures secondary to intubation were reviewed. The average age of the patients was 58 years (range of 38 to 81 years). Six patients were men and 6 patients were women. Four of the patients were performed thoracotomy for primary surgery and underwent surgical therapy. 8 patients were treated conservatively. The results of both approaches were evaluated. Results: Patients, who underwent both conservative and surgical therapy, were completely recovered. There was no rupture originated complication or death. Conclusions: Both conservative and surgical therapies are appropriate for treatment of membranous tracheal rupture.
Interventional Medicine and Applied Science, Mar 1, 2013
We present the case of a 20-year-old man with hemoptysis for 3 years. Chest radiography revealed ... more We present the case of a 20-year-old man with hemoptysis for 3 years. Chest radiography revealed increased pulmonary vascular opacities in the left lower lung field. Computed tomography showed an anomalous systemic artery arising from descending aorta supplying the basal segments of the left lower lobe. Bronchial tree was normal. Pulmonary artery angiogram revealed a hypoplastic inferior lobar branch of the left pulmonary artery. There was no direct communication between anomalous artery and pulmonary veins. We diagnosed our case as aortopulmonary collateral with normal lung parenchyma. Coil embolization of the anomalous systemic artery was performed. The patient survived well without evidence of hemoptysis for 18 months after coil embolization.
BACKGROUND: Tracheal stenosis constitutes one of the most frequently seen problems in thoracic su... more BACKGROUND: Tracheal stenosis constitutes one of the most frequently seen problems in thoracic surgery. Although many treatment modalities to prevent fibroblast proliferation, angiogenesis, or inflammation that causes tracheal stenosis have been attempted, an effective method has not yet been found. In this study, a transforming growth factor beta3 (TGF-3)/chitosan combination was used for this purpose. METHODS: A slow-release preparation containing a thin layer of TGF-3 with a chitosan base was made. Thirty albino Wistar rats were divided into 3 groups. A full-layer vertical incision was made in the anterior side of the trachea of each rat between the second and fifth tracheal rings. The tracheal incision was sutured. Group A was evaluated as the control group. In Group B, a chitosan-based film was placed on the incision line. In Group C, a slow-release TGF-3/chitosan-coated substance was placed on the incision line. The rats were killed on day 30, and their tracheas were excised by cutting between the lower edge of the thyroid cartilage and the upper edge of the sixth tracheal ring together with the esophagus. Epithelialization, fibroblast proliferation, angiogenesis, inflammation, and collagen levels were evaluated histopathologically by the same histopathologist. RESULTS: Statistically significant differences were not found among the 3 groups. Cold abscesses were observed at the incision sites in both the TGF-/chitosan and chitosan groups. These were thought to have formed due to the chitosan. CONCLUSIONS: As this was the first experiment in the literature to use this type of TGF-3 formulation, we intend to change the formulation and perform this study again with a different TGF-3/chitosan preparation.
Üst hava yolu stenozu s›kl›kla üst trakeal ve subglottik seviyelerdeki patolojiler ile iliflkilid... more Üst hava yolu stenozu s›kl›kla üst trakeal ve subglottik seviyelerdeki patolojiler ile iliflkilidir. Enflamatuvar stenoz, trakeal rezeksiyon ve rekonstrüksiyonlar›n en s›k endikasyonudur. Primer trakea tümörlerinin de primer rekonstrüksiyona uygun ise en ideal tedavisi rezeksiyon olmak-tad›r. Benign ve malign sebeplerle trakea cerrahisi uygu-lad›¤›m›z yafllar› 24-50 aras›nda de¤iflen 9 olgudan, postentübasyon trakeal stenoz tan›s› olan 5'ine servikal insizyon ile, trakeal tümör tan›l› 4 hastaya ise torakotomi yolu ile trakeal rezeksiyon ve uç-uca anastomoz baflar›l› flekilde uyguland›. Dikkatli preoperatif de¤erlendirmeyi takiben uygulanacak baflar›l› cerrahi teknik trakeal patolojilerin cerrahisinde tatmin edici sonuçlar› da beraberinde getirmektedir.
Radiological analyses in a 61-year-old patient being followed since 2005 for low-grade, non-invas... more Radiological analyses in a 61-year-old patient being followed since 2005 for low-grade, non-invasive urothelial carcinoma (UC) (Ta) revealed a 5-cm pleural-based mass in the lower lobe of the right lung for which a subsequent transthoracic fine-needle aspiration cytology was performed. Upon observing the carcinoma cells consistent with UC metastasis, systemic chemotherapy was commenced. The patient underwent a metastatectomy based on the thoracic computerized tomography scan performed on the 4(th) month of treatment, which revealed notable regression. The resected tumor was morphologically similar to cells seen in the transthoracic fine-needle aspiration and was immunohistochemically positive for p63, uroplakin, thrombomodulin, CK7 and CK20 at varying degrees but was negative for TTF-1. We report a case of metastatic UC of the lung in a patient who had had a low-grade superficial UC of the urinary bladder and we discuss the cytopathological features of this rare entity in light of the literature.
Turkish Journal of Thoracic and Cardiovascular Surgery, Apr 26, 2021
Jeune sendromu nadir görülen bir iskelet displazisi olup, dar, çan şeklinde toraks (göğüs kafesi)... more Jeune sendromu nadir görülen bir iskelet displazisi olup, dar, çan şeklinde toraks (göğüs kafesi) ve falanks ve pelvis kemiklerinde tipik deformiteler ile karakterizedir. Yenidoğan döneminde dar ve yatay yerleşimli kaburgalar nedeni ile akciğer ekspansiyonu sağlanamaz; bu da, birçok olguda alveolar hipoventilasyon ve nihayetinde yenidoğan ve bebek ölümlerine neden olur. Sternoplasti ile eksternal distraksiyon, ulnar uzatma için tasarlanan kaydırılan parmak fiksatör ile ilk kez ekibimiz tarafından bir yenidoğanda kullanılan, Jeune sendromu tedavisinde yeni bir tekniktir. Bu yaklaşımın geliştirilip yaygınlaştırılarak uygulanması ile yenidoğanlarda hayat kurtarıcı olabileceği kanısındayız.
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