Experience of Lung Surgery in the COVID-19 Pandemic

Objective: During the pandemic, elective cases other than those requiring emergency thoracic surgery were postponed. Depending on the magnitude of the impact the pandemic posed on hospitals and clinics, there have been changes in the number and variety of cases of thoracic surgery. The intention behind conducting this study was to share the experiences gained by a thoracic surgery clinic during the pandemic period. Methods: Altogether, 214 patients were included in the study. Patient data that were recorded included those on age, gender, lung pathology, duration of hospital stay, positivity for COVID-19, survival, and causes of death. Results: Of the 214 patients operated on, 12 died during the postoperative period. Eight of these patients died due to their primary disease and one died due to gastrointestinal bleeding, whereas the remaining three patients died due to COVID-19 infection. Conclusions: If opportunities and facilities favorable for the administration of surgical treatment are made available, surgical treatment services can be offered safely to all patient

Maligniteyi taklit eden pulmoner arteriyovenöz malformasyon: Olgu sunumu

Pulmonary arteriovenous malformations (AVM) are congenital lesions and are often arise in the lower lobes due to abnormal capillary development. Forty-two years old male patient presented with hemoptysis and he was referred to our clinic with the suspicion of malignancy. Postero-anterior chest roentgenogram revealed homogenous opacity on the right perihilar zone. Computed tomography revealed a mass which was located at the right upper lobe. For the dia gnosis and staging 18F-FDG PET- CT was obtained. The mass was 6.5x5x4.5 cm and showed increased FDG uptake, 2,97. The lesion was considered as a large PAVM because of the linear density showing luminal contrast enhancement which was located between the lesion and right upper pulmonary vein. Dynamic contrast enhaced tomography revealed a solid mass with a suspicion of PAVM with thrombotic occlusion. Pulmonary angiography was free of AVM and fistulae. The patient underwent right upper lobectomy. Pathologic studies were consistent with pulmonary AVM. This case is presented because of upper lobe involvement, normal pulmonary angiography and the need of surgical operation as the only diagnostic tool

Evaluation of Platelet Parameters in Patients with Pulmonary Hydatid Cyst

Background: Echinococcosis is a near-cosmopolitan zoonosis caused by adult or larval stages of tapeworms (cestodes) into the genus Echinococcus (family Taeniidae). It was demonstrated that platelets were capable of killing parasites independent from leukocytes. Purpose: The aim of our study was to examine mean platelet volume (MPV), platelet mass (PM) and platelet count (PC), which are practical indicators of platelet activity in preoperative and postoperative periods of the patients with hydatid cyst. Methods: In this retrospective study we evaluated 72 patients admitted to clinic of chest surgery with a diagnosis of pulmonary hydatid cyst in our hospital between January, 2006, and October, 2008. The MPV, PC, and PM were evaluated by complete blood count. PM was calculated by multiplying MPV and PLT. Results: Preoperative MPV values (mean: 8.07, std. dev.: 0.83) of the patients was found to be significantly higher than postoperative MPV values (mean: 7.78, std. dev.: 0.87) (p= 0,002). Preoperative PM values (median: 2456.75, min-max: 1013.70-5046.60) was found to be higher when compared to postoperative PM values (median: 2280.80, min-max: 134.20-4042.60) (p= 0,039). PC values were not significantly different between two periods (Preoperative PC mean values: 320.48, std. dev.: 98.42 and postoperative PC mean values: 307.29, std. dev.: 96.45, p= 0.286). Conclusion: In this study, we demonstrated that there were no statistical difference in PC for both periods but, in preoperative period MPV and PM were found statistical higher than postoperative period. We suggest that MPV and PM may be considered as inflammatory markers for hydatid cyst. MPV and PM can be used for following of patients with hydatid cyst

Is surgical plication necessary in diaphragm eventration?

Diaphragm plication surgery is conducted to remove dyspnea, which results from mediastinal shift, atelectasia, and ventilation/perfusion dyssynchrony in lungs that occur because of an eventrated diaphragm. This study aims to determine whether diaphragm plication has any effect on respiration by analyzing the patients' changing values in the respiratory function test (RFT) after plication surgery. Sixteen patients who underwent diaphragm plication surgery in our clinic because of plication eventration or paralysis were examined prospectively. Diaphragm eventration values were assessed using a calculation method that uses posteroanterior pulmonary radiographies taken during patient admission and control, then, these data were recorded. The amount of changes in the eventration levels and in restrictive respiratory failure parameters—forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC) of RFTs—conducted in pre- and postoperative control periods were compared using statistical analysis methods. The compatibility between the amounts of RFT changes was examined through a satisfaction survey—using a questionnaire that consisted of multiple choice questions with answer options such as “better, ” “the same, ” and “worse”—to understand preoperative and postoperative symptom levels in the 12th month of postoperative control. According to postoperative levels, a decrease between 19% and 23% was observed in eventration amounts within the 1st postoperative month, 6th postoperative month, and 12th postoperative month. In addition, the highest average increase in FEV1 liter (lt) values was 0.2 lt and 0.25 in FVC (lt) values. Researchers of this study believe that more distinctive decisions need to be taken while identifying patients for surgery in unilateral diaphragm eventrations, especially in the adult patient group, surgical option should be used for cases in which the eventrated diaphragm results in mediastinal shift and respiratory failure

Is surgical plication necessary in diaphragm eventration?

Background: Diaphragm plication surgery is conducted to remove dyspnea, which results from mediastinal shift, atelectasia, and ventilation/perfusion dyssynchrony in lungs that occur because of an eventrated diaphragm. This study aims to determine whether diaphragm plication has any effect on respiration by analyzing the patients' changing values in the respiratory function test (RFT) after plication surgery. Methods: Sixteen patients who underwent diaphragm plication surgery in our clinic because of plication eventration or paralysis were examined prospectively. Diaphragm eventration values were assessed using a calculation method that uses posteroanterior pulmonary radiographies taken during patient admission and control; then, these data were recorded. The amount of changes in the eventration levels and in restrictive respiratory failure parameters—forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC) of RFTs—conducted in pre- and postoperative control periods were compared using statistical analysis methods. The compatibility between the amounts of RFT changes was examined through a satisfaction survey—using a questionnaire that consisted of multiple choice questions with answer options such as “better,” “the same,” and “worse”—to understand preoperative and postoperative symptom levels in the 12th month of postoperative control. Results: According to postoperative levels, a decrease between 19% and 23% was observed in eventration amounts within the 1st postoperative month, 6th postoperative month, and 12th postoperative month. In addition, the highest average increase in FEV1 liter (lt) values was 0.2 lt and 0.25 in FVC (lt) values. Conclusion: Researchers of this study believe that more distinctive decisions need to be taken while identifying patients for surgery in unilateral diaphragm eventrations, especially in the adult patient group; surgical option should be used for cases in which the eventrated diaphragm results in mediastinal shift and respiratory failure

Progressive subcutaneous emphysema. A rare finding: Pneumorrhachis

Pneumorrhachis is a rare phenomenon which may be caused by trauma, intracraneal infection, pneumomediastinum or iatrogenic factors. Presence of air in the spinal canal is reported in most cases. In this article, we report a case with PR in the spinal canal without any neurological deficit, which developed secondary to subcutaneous emphysema

Synchronous Bilateral Multiple Typical Pulmonary Carcinoid Tumors: A Unique Case with 10 Typical Carcinoids

Bilateral multiple typical carcinoid tumors of the lung are uncommon malignancies. We discuss the case of a 64 year-old female with a nonproductive cough as the initial symptom. Thoracic computed tomography revealed multiple nodular lesions on both sides, which were initially misdiagnosed as multiple metastases of the lung with an unknown primary. After resection of nodules in the right hemithorax, pathologic examination revealed a typical carcinoid tumor. Bilateral sequential thoracotomy was performed and all ten nodules, (six on the right side and four on the left side), were treated by sublobar resection due to poor respiratory function. Pathological examination revealed all nodules to be typical carcinoid tumors. Following the resections, the patient has remained disease-free for ten months

Management of Massive Hemoptysis: Analyses of 58 Patients.

The objective was to describe changing patterns of etiological factors and treatment modalities for massive hemoptysis