Akciğer hid atik kistinin güncel tedavisi ve komplikasyonları

Amaç: Bu çalışmada, akciğer hidatik kisti tanısıyla cerrahi tedavi uygulanan hastaların ilk başvuru şikayetlerinin ve ameliyat sonuçlarının irdelenmesi ve ayrıca karaciğer hidatik kist oranının belirlenmesi amaçlanmıştır. Yöntemler: Çalışmaya, 2004-2008 yılları arasında akciğer hidatik kisti tanısı ile öpere edilen toplam 70 hasta dahil edildi. Bu hastaların klinik, radyolojik ve cerrahi tedavi ile ilgili özellikleri retrospek-tif olarak değerlendirildi. Bulgular: Hastaların 30'unda kist/kistler perfore, 40 hastada intakt idi. 70 hastanın 35'i sağ 29'u sol da yerleşimli üç hastada ise bilateral akciğer kisti bulunmaktaydı. Hastaların 49'una kistektomi ve kapito-naj (%70) operasyonu uygulanırken, yedi hastaya kistektomi iki hastaya ise wedge rezeksiyon uygulandı. Perfore kistlerin %23'ü (7 hasta) hastaneye klinik ve radyolojik olarak pnömotoraks/hidropnö-motoraks bulgularıyla başvurdu. Hastaların dokuzunda komplikasyon gelişirken en sık görülen komplikasyon atelektazi idi. Sonuç: Akciğer kist hidatiğinin güncel tedavisinde parankim koruyucu cerrahi yaklaşım etkili ve güvenilir bir tedavi seçeneğidir. Eşlik eden karaciğer kubbe kistlerine aynı seansta müdahale edilebilmektedir. Perfore kistlerin pnömotoraks bulgularıyla acil kliniklere başvurabilecekleri akılda tutulmalıdır.Aim: In this study, we aimed to investigate the first presenting complaints and operative results of patients who were operated for lung hydatid cyst and to determine the rate of co-existing liver hydatid cysts. Methods: Seventy patients who had been operated for lung hydatid cyst between 2004 and 2008 were included in the study. Clinical, radiological and surgical data of these patients were evaluated retrospectively. Results: The cyst(s) were perforated in 30 patients and were intact in 40 patients. They were right-sided in 35 patients, left-sided in 29, and bilateral lung cysts in three patients. Of the patients, 49 (70%) had undergone cystotomy and capitonage, seven patients-cystotomy, and two patients had undergone wedge resection. Of the perforated cysts, 23% presented with clinical and radiological findings of pneumothorax. Complications were observed in nine patients and the most common complication was atelectasis. Conclusion: Parenchyma-sparing surgery is a safe and effective treatment modality for lung hydatid cysts. Accompanying liver dome cysts can be intervened at the same session. The rate of cases with perforated cysts presenting to emergency clinics with findings of pneumothorax should not be overlooked

Current Therapies for Pulmonary Hydatid Cyst and its Complications

Aim: In this study, we aimed to investigate the first presenting complaints and operative results of patients who were operated for lung hydatid cyst and to determine the rate of co-existing liver hydatid cysts. Methods: Seventy patients who had been operated for lung hydatid cyst between 2004 and 2008 were included in the study. Clinical, radiological and surgical data of these patients were evaluated retrospectively. Results: The cyst(s) were perforated in 30 patients and were intact in 40 patients. They were right-sided in 35 patients, left-sided in 29, and bilateral lung cysts in three patients. Of the patients, 49 (70%) had undergone cystotomy and capitonage, seven patients-cystotomy, and two patients had undergone wedge resection. Of the perforated cysts, 23% presented with clinical and radiological findings of pneumothorax. Complications were observed in nine patients and the most common complication was atelectasis. Conclusion: Parenchyma-sparing surgery is a safe and effective treatment modality for lung hydatid cysts. Accompanying liver dome cysts can be intervened at the same session. The rate of cases with perforated cysts presenting to emergency clinics with findings of pneumothorax should not be overlooked. (The Me di cal Bul le tin of Ha se ki 2011; 49: 105-9

An adenocarcinonna developed in tuberculosis cavity

WOS: 000287543100031PubMed: 20570163

Is Pectus Excavatum a Risk Factor for Spontaneous Pneumothorax? “Haller Index Measurements in Patients with Primary Spontaneous Pneumothorax”

Aim. In this study, we aimed to retrospectively investigate whether pectus excavatum (PE) is a risk factor for the development of primary spontaneous pneumothorax (PSP) and to determine its role in the etiology of the disease. Materials and Methods. Chest-computed tomography (CT) of the patients who were treated for spontaneous pneumothorax between January 2015 and December 2017 in our clinic was examined, and their Haller indices were measured (group I). The patients in the control group who underwent chest CT for other reasons during the same period and were in the same age with the group I were also included in the study (group II) Results. In group I, for patients with PE, the mean Haller index was 2.41, while it was 2.09 in the control group (group II). There was a significant difference between the two groups. Conclusions. PE deformities in the chest wall may predispose to the development of spontaneous pneumothorax, and PE may be among the etiologic factors of spontaneous pneumothorax. Therefore, there is a need for studies involving larger patient groups

Trakeal yaralanma sonucu gelişen pnömomediastinum ve epidural pnömotozisin acil tedavi yaklaşımı: Olgu sunumu

Epidural pnömatozis epidural boşlukta hava bulunmasıdır. Epidural pnömatozis acil tıp pratiğinde nadir rastlanılan bir durumdur. On yaşında bisiklet kazası sonucu servikal travma geçiren hastada klinik olarak subkutan amfizem, radyolojik olarak pnömotoraks, pnömomediastinum ve epidural pnömatozis geliştiği izlendi. Hastaya sol tüp torakostomi kapalı sualtı drenajı takibinde pretrakeal fasyanın açılması işlemi uygulandı. Yeterli düzelme izlenmemesi üzerine trakea eksplore edildi ve primer onarım yapıldı. Bu tedaviler sonrası epidural pnömatozis, pnömomediastinum ile birlikte tamamen geriledi. Bu olgu epidural pnömatozisin çok nadir görülmesi ve trakea yaralanmalarında akla getirilmesi amacıyla sunulmuştur.The presence of air in epidural space is called epidural pneumatosis. Epidural pneumatosis is a rarely encountered phenomenon in emergency medicine practice. A 10-year-old patient was admitted with cervical trauma due to a bicycle accident. Subcutaneous emphysema, pneumothorax, pneumomediastinum and epidural pneumatosis were detected. Pretracheal fasciotomy after tube thoracostomy and closed underwater drainage were performed. Since sufficient clinical improvement could not be observed, tracheal exploration and primary repairment were performed. Only after these interventions, epidural pneumatosis and pneumomediastinum completely regressed. The case is presented due to its rarity and with the purpose to remind clinicians of epidural pneumatosis in tracheal injuries

The Running of a Thoracic Surgery Clinic in a State Hospital: Two Year Experience in Şanliurfa State Hospital

Amaç: Ülkemiz genelinde diğer cerrahi branşlara göre daha sonradan kurulan göğüs cerrahisi bilim dalının bir devlet hastanesindeki işleyişini incelemek. Metod: Şanlıurfa Devlet Hastanesi Göğüs Cerrahisi Kliniğinde Temmuz-2006 ile Temmuz- 2008 arasında opere edilen hastaların kayıtları retrospektif olarak incelendi. Bulgular: Yaşları 8 ay ile 77 (ort:32,2) arasında değişen 242si erkek, 117si kadın 359 hastaya 390 operasyon uygulandı. En sık preoperatif tanılar 61 künt toraks travması, 58 kist hidatik, 46 spontan pnömotoraks, 29 delici kesici alet yaralanması, 22 ampiyem, 21 yabancı cisim aspirasyonu, 12 bronşektazi, 10 akciğer kanseriydi. Operasyonların 209i lokal, 181si genel anestezi altına uygulandı. Lokal anestezi altında da en çok tüp torakostomi (n180), genel anestezi altında en çok 64 sağ torakotomi, 43 sol torakotomi, 2 bilateral torakotomi, 35 rijid bronkoskopi uygulandı. Sonuç: Bir devlet hastanesinde göğüs cerrahisi kliniğini aktif olarak işletirken karşılaşılan en önemli sorunlar yeterli ekipman ve deneyimli yardımcı personel eksikliği ve diğer branşların göğüs cerrahisi hakkındaki bilgi eksikliğidir.Background: We aimed to analyze the running of a thoracic surgery department in a state hospital. Methods: The records of patients who had been operated between July-2006 and July-2008 in Thoracic Surgery Clinic of Şanlıurfa State Hospital were retrospectively analyzed. Results: Three-hundred-ninety operations were applied to 359 patients whose ages were between 8 months and 77 years. The most common diagnoses were 61 blunt chest trauma, 58 hydatid cyst, 46 spontaneous pneumothorax, 29 penetrant chest injury, 22 empyema, 21 foreign body aspiration, 12 bronchiectasis and 10 lung cancer. Of the operations 209 were under local anesthesia and 181 under general anesthesia. The most commonly tube thoracostomy (180 cases) under local anesthesia and 109 thoracotomy under general anesthesia were performed. Conclusion: The encountered most important problems during the active run are the lack of enough equipment and experienced auxiliary staff and, lack of knowledge about thoracic surgery by other clinicians

İntrapulmoner Paraganglioma

Sir, Paragangliomas are rare tumors originating from paraganglionic tissue that extends from the skull base to the pelvic diaphragm. Although they can be asymptomatic, they can also cause symptoms by secreting catecholamines or with local expansion. They can also be the component of many hereditary diseases. These tumors are reported in various rare localisations, which include lung parenchyma.1 The first primary pulmonary paraganglioma (PP) case was reported by Heppleston in 1958.2 The number of cases diagnosed till date is less than 50 in the English literature

Our cases of sarcoidosis diagnosed by mediastinoscopy; Western black sea experience [Mediastinoskopi ile tanı konulan sarkodioz olgularımız; Batı karadeniz deneyimi]

Aim: Sarcoidosis is a multisystemic disease, characterized by noncaseating granuloms, the aetilogy remains unknown. We have stated that sarcoidosis diagnosis used by mediastinoscopy and our patients evaluated by stage and clinical features. Material and Method: 38 cases with a diagnosis of sarcoidosis by mediastinoscopy in our, clinics (University Hospitals of Western Black Sea) were retrospectively analyzed. Cases was staging according to posteroanterior chest x-rays. Admission complaints,Pulmonary Function Tests, diagnostic methods, disease stages, co-morbid diseases, clinical and laboratory features of the patients were assessed. Results: 26 of the patients were female, 12 were male. Mean age was 49 and age range was between 24-71 years. Most common complaint at appeal was cough, and the most common radiological stage was 2. The most common biopsy taken from the lymph nodes was right paratracheal (2R, 4R), the least common was the left paratracheal lymph nodes. There was no mortality. Complications developed 3 patients. Discussion: Sarcoidosis diagnoses usually settled was in stage 2 with hilar lymphadenomegalia and lung parenchymal infiltration. Mediastinoscopy in the diagnosis of sarcoidosis with mediastinal lymph node biopsy is an effective procedure with quick results, low morbidity and mortality rates. © 2012, Derman Medical Publishing. All rights reserved

Mediastinoskopi ile tanı konulan sarkodioz olgularımız; Batı Karadeniz deneyimi

Amaç: Sarkoidoz etyolojisi bilinmeyen, sistemik tutulum gösteren ve nonka-zeifiye granülomlarla seyreden bir hastalıktır. Sarkoidoz tanısını mediasti-noskopi ile koyduğumuz hastalarımızı evreleri ve klinik özellikleri bakımından değerlendirdik. Gereç ve Yöntem: Kliniklerimizde (Batı Karadeniz Üniversite Hastanelerinde) mediastinoskopi ile sarkoidoz tanısı alan 38 olgu geriye dö-nük olarak incelendi. Olgular posteroanterior akciğer grafilerine göre evre-lendirildi. Hastaların başvuru şikayetleri, solunum fonksiyon testleri, tanı yön-temleri, evreleri, eşlik eden hastalık varlığı, klinik ve laboratuar özellikleri de-ğerlendirildi. Bulgular: Hastaların 26’sı kadın 12’si erkeklerden oluşmaktaydı. Ortalama yaş 49 yıl iken yaş aralığı ise 24-71 yıl idi. En sık başvuru şikayeti öksürük olarak tespit edildi, en sık radyolojik evre ise evre II idi. En sık sağ pa-ratrakeal lenf nodlarından biopsi (2R,4R) alınırken en az sol paratrakeal lenf nodlarından biopsi alındı. Mortalite izlenmedi. 3 hastada komplikasyon geliş-ti. Sonuç: Sarkoidoz tanısının genelde hiler lenfadenomegali ve akciğer pa-rankiminde infiltrasyonun bulunduğu evre II’de konulduğu görüldü. Sarkoidoz tanısında mediastinoskopi ile mediastinal lenf nodu biopsisi hızlı sonuç veren ve düşük morbidite ve mortalite ile etkili bir yöntemdir.Aim: Sarcoidosis is a multisystemic disease, characterized by noncaseating granuloms, the aetilogy remains unknown. We have stated that sarcoidosis diagnosis used by mediastinoscopy and our patients evaluated by stage and clinical features. Material and Method: 38 cases with a diagnosis of sarcoidosis by mediastinoscopy in our clinics (University Hospitals of Western Black Sea) were retrospectively analyzed. Cases was staging according to posteroanterior chest x-rays. Admission complaints,Pulmonary Function Tests, diagnostic methods, disease stages, co-morbid diseases, clinical and laboratory features of the patients were assessed. Results: 26 of the patients were female, 12 were male. Mean age was 49 and age range was between 24-71 years. Most common complaint at appeal was cough, and the most common radiological stage was 2. The most common biopsy taken from the lymph nodes was right paratracheal (2R, 4R) , the least common was the left paratracheal lymph nodes. There was no mortality. Complications developed 3 patients. Discussion: Sarcoidosis diagnoses usually settled was in stage 2 with hilar lymphadenomegalia and lung parenchymal infiltration. Mediastinoscopy in the diagnosis of sarcoidosis with mediastinal lymph node biopsy is an effective procedure with quick results, low morbidity and mortality rates