A novel and safe technique in closed tube thoracostomy

<p>Abstract</p> <p>Background</p> <p>Tube thoracostomy (TT) is the most commonly performed surgical procedure in thoracic surgery clinics. The procedure might have to be repeated due to ineffective drainage in patients with tube malposition (TM), in whom the drain is not directed to the apex or located in the fissure. Trocar technique, which is used to prevent TM, is not recommended because of its potential for severe complications.</p> <p>Methods</p> <p>The study involved 180 patients who required TT application for any etiology within one year. The patients were divided into two groups as Group A, who had undergone classical surgical technique (n = 90) and Group B, who had undergone a combination of surgery and trocar techniques (n = 90). The groups were compared for TM, the effect of TM on the drain removal, and other insertion related complications.</p> <p>Results</p> <p>In Group A, 23 patients had TM, 4 of whom developed associated ineffective drainage, while the patients in Group B had no insertion related complications (p = 0.001). The mean drain removal time of the patients with TM was 5 ± 2.25 days. In the patients who did not develop TM, it was 3.39 ± 1.18 days (p = 0.001).</p> <p>Conclusions</p> <p>The modified combination technique is a reliable method in preventing TM and its potential complications.</p

Aort yaralanması riski oluşturan kaburga kırığı

A 50-year-old female patient was referred to emergency department with findings of shortness of breath and flail chest after a traffic accident. Her chest and abdomen computed tomography scan showed left hemopneumothorax, suspicious splenic bleeding, and multiple rib fractures. The fractured edge of the left sixth rib was posing a laceration threat against the descending aorta. After diagnostic laparotomy, left thoracotomy was performed, the fractured rib edge was resected before occurrence of any aortic injury, and the flail chest was stabilized. This article aims to draw attention to the importance of early intervention in posterior rib fractures posing injury threat against aorta and explain the possible mechanism

Traumatic pulmonary pseuodocysts: two case reports

Traumatic pulmonary pseudocyst (TPP) is a rare complication, sometimes encountered after blunt thoracic trauma and even more rarely following penetrating injuries. It is more common among pediatric and young adult patients. Although TPP is usually benign in nature, complications associated with hemoptysis and secondary infection may develop. The treatment is conservative. In this report, we present two rare cases of TPP occuring after a high-speed accident and a stab wound injury, where conservative treatment provided good outcomes

A case of radiation-induced sternal malignant fibrous histiocytoma treated with neoadjuvant chemotherapy and surgical resection

<p>Abstract</p> <p>Background</p> <p>Primary sternal malignant fibrous histiyocytoma (MFH) is highly rare. Effective treatment modality is surgical resection with wide margins. However, to date, the effects of radiotherapy or chemotherapy has not been clearly defined.</p> <p>Case presentation</p> <p>Herein, we aimed to present a 50-year old female patient with MFH occurred in the radiotherapy field who had had surgical procedure for breast cancer 19 years ago and had followed by radiotherapy. Neoadjuvant chemotherapy was applied for MFH due to cardiac and mediastinal vascular invasion. Wide resection was carried out for the mass after having been decreased in size following neoadjuvant chemotherapy.</p> <p>Conclusion</p> <p>Neoadjuvant chemotherapy was an effective method. In planning the surgical resection, the size of the tumor before chemotherapy should be considered as the initial size and surgical margins should be determined accordingly.</p

Myastenia Gravis için timektomi yapılan hastaların postoperatif birinci ve beşinci yıl sonuçlarının karşılaştırılması

Amaç: Myastenia gravis hastalarının tedavisinde timektominin etkinliği tartışmalıdır. Bu çalışmada myastenia graviste uzun dönem takip sonuçlarına göre timektomi etkinliğinin araştırılması amaçlandı.Gereç ve Yöntemler: Ocak 1995 ile Ocak 2004 arasında myastenia gravis nedeniyle sternotomi ve ekstended timektomi uygulanan 27 hastanın birinci ve beşinci yıllardaki klinik sonuçları istatistiksel olarak karşılaştırıldı.Bulgular: Hastaların postoperatif birinci ve beşinci yıllardaki klinik sonuçları arasında istatistiksel fark saptanmadı.Sonuçlar: Uzun dönem sonuçlarının iyi olması nedeniyle timektomi myastenia gravis tedavisinde güvenilir bir yöntemdir. Timektomi sonrası birinci ve beşinci yıllar sonunda elde edilen sonuçlar arasında farklılık yokturAim: The efficiency of thymectomy for treating patients with Myasthenia gravis is a controversial issue. Thus, this study aimed to investigate the efficiency of thymectomy in the treatment of myasthenia gravis based on long-term follow-up results.Material and Methods: The first and fifth year clinical outcomes of 27 patients who had undergone median sternotomy and extended thymectomy for myasthenia gravis between January 1995 and January 2004 were compared statistically.Results: No statistically significant differences were found between the postoperative first and fifth year clinical outcomes of the patients.Conclusions: Thymectomy is a reliable method in the treatment of myasthenia gravis with respect to its long-term outcomes. The outcomes obtained at the end of the first and fifth year of thymectomy are not differen

Tracheal adenoid cyctic carcinoma mimicking bronchial asthma

Adenoid cystic carcinomas are rare tracheal tumors that can mimic bronchialasthma. We describe the characteristics of 2 patients with adenoid cystic carcinomawho presented with symptoms suggestive of bronchial asthma of 2 years duration.Biopsy specimens revealed that the lesions were adenoid cystic carcinoma of thetrachea. Both patients underwent collar incision and median sternotomy, thetumors were resected, and the tracheas were reconstructed primarily. Postoperativeradiotherapy was given. Their postoperative clinical courses were uneventful andno local recurrences were seen at the 1-year follow-up

Cerrahi olarak tedavi edilen dev ve daha küçük boyuttaki akciğer kist hidatiklerinin karşılaştırmalı analizi

Amaç: Bu çalışmanın amacı akciğerin dev kist hidatiklerinin daha küçük boydaki hidatik kistlerle karşılaştırılmasıdır.Gereç ve Yöntem: Akciğer kist hidatiği nedeniyle ameliyat edilen 62 hasta geriye dünük olarak değerlendirildi. Hastalar dev kist hidatik (Grup A, n=23) ve daha küçük çapta olanlar (Grup B, n=39) olmak üzere iki gruba ayrıldı. Gruplar yaş, cinsiyet, semptomlar, kist yerleşimi ve sayısı, preoperative komplikasyonlar, uygulanan cerrahi girişim şekli, postoperative uzamış hava kaçağı, göğüs tüpü alınma günü, postoperative komplikasyonlar, hastanede kalış süresi, morbidite ve mortalite açısından karşılaştırıldı.Bulgular: Yaş, cinsiyet, kist yerleşim yeri açısından anlamlı fark saptanmadı ((P = 0.925, P = 0.293, P = 0.179). Grup A'da 21 (%91) vakada kistler tek , Grup B'de vakaların yaklaşık 1/3'ünde birden fazla kist saptandı. Kistleri tek olması anlamlı bulundu (P = 0.005). Grup A'da 13 (%56) vakada kistotomi + kapitonaj yapılırken, Grup B'de 8 (%20) vakada yapılmıştı. Kistotomi + kapitonaj yöntemi Grup B'de Grup A'ya göre anlamlı olarak yüksekti. Uzamış hava kaçağı Grup A'da 8 (%20), Grup B'de 2 (%5) vakada gözlendi. Ortalama göğüs tüpü çekilme günü Grup A'da 4.57 ± 2.48 gün, Grup B'de 2.49 ± 1.63 gün ve hastanede kalış süresi Grup A'da 8.48 ± 3.39 gün ve Grup B'de 5.69 ± 1.80 gün olup her iki parametre istatistiksel olarak anlamlıydı (P < 0.001 ve P < 0.001). Postoperatif komplikasyonlar Grup A'da iki, Grup B'de üç vakada gözlendi. Her iki grupta da mortalite yoktu. Sonuçlar: Dev akciğer kistlerinin soliter görülme ihtimali fazla, ortalama göğüs tüpü çekilme ve hastanede kalış süresi uygulanan operasyondan bağımsız olarak uzamıştır. Kapitonajlı veya kapitonajsız yöntemlerin uygulandığı her iki grupta küratif cerrahi girişimlerin sonuçları mükemmeldirAim: We aimed to compare several features of giant hydatid cysts of the lung, with smaller cysts both treated surgically. Material and Method: A retrospective evaluation of 62 patients operated for hydatid cysts of lung were done. The patients were divided into two groups whether the pulmonary cyst was giant (group A, n = 23) or smaller in diameter (group B, n = 39). The groups were compared for age, gender, clinical symptoms, cyst location and number, preoperative complication, type of surgical procedure performed, postoperative prolonged air leak, chest tube removal day, postoperative complications, duration of hospitalization, morbidity and mortality. Results: No significant difference was detected between mean age, gender and site of location of the cyst (P = 0.925, P = 0.293, P = 0.179). Twenty-one (91%) of the cases had solitary cyst in group A, whereas nearly 1/3 had multiple cysts in group B. Solitary predominance for giant hydatid cysts was significant (P = 0.005). Cystotomy plus non-capitonnage method was performed in 13 (56%) cases in group A and, 8 (20%) cases in group B. The frequency of cystotomy plus capitonnage method was significantly higher in group B compared to group A (P = 0.004). Prolonged air leak was seen in 5 (22%) cases in group A and 2 (5%) cases in group B. Mean chest tube removal time was 4.57 ± 2.48 days in group A and 2.49 ± 1.63 days in group B. Duration of hospitalization was 8.48 ± 3.39 days in group A and 5.69 ± 1.80 in group B and the difference for both parameters were significant statistically (P < 0.001 and P < 0.001). Postoperative complications other than prolonged air leak were seen in two cases in group A and three cases in group B. There was no mortality in either groups. Conclusions: The giant hydatid cysts had a predominance to be solitary and mean chest tube removal time and duration of hospitalization was prolonged independent from type of operation performed. Conservative surgical interventions, whether capitonnage or non-capitonnage methods were performed, had excellent outcomes in both group