53 research outputs found
The use of Ligasure Vessel Sealing System in Ivor Lewis esophagectomy
No full textAbstract Background This study investigated the results of the LigaSure Vessel Sealing System (LVSS), which has been routinely used in esophageal resections in our clinic since 2006. Methods For this purpose, 60 patients who underwent Ivor Lewis esophagectomy were included in the study. The results were compared with the patients who underwent stomach mobilising procedure and esophagectomy with conventional methods (conventional group) before 2006 and the patients who underwent LVSS (group of LigaSure) in surgical cases after 2006. The cases were compared particularly in terms of intraoperative bleeding, operative time, duration of postoperative hospital stay, intraoperative complications, mortality, and morbidity. Results Of the patients, 34 (% 56.6) were female and 26 (43.3%) were male, and the range of the age was between 33 and 78, and the mean age of the patients was 52.73 ± 11,617. While the amount of intraoperative bleeding was 321.864 ± 575.00 ml in the conventional group, this was found to be 370.31 ± 238.456 ml in the LigaSure group (p = 0.007). In the statistical evaluation of the operative time, the mean duration was determined as 310.00 ± 24.795 minutes in the conventional group, whereas it was determined as 265.16 ± 31.353 minutes in the LigaSure group (p = 0.001). Conclusions The use of LVSS was associated with a significant reduction in the operative time and the rate of intra-operative complications.</p
Rib resection using a Gigli saw under thoracoscopic guidance
No full textIntroduction: Despite the advantages and expanded indications of video-assisted thoracoscopic surgery, the open surgical approach is commonly preferred for the surgical treatment of rib lesions. Such an approach could lead to disadvantageous results such as increased postoperative pain and prolonged hospital stay. Despite all these handicaps, thoracoscopic resection of isolated rib resection has been reported in a small number of publications. Aim: To compare the clinical outcomes of patients with isolated benign rib pathologies treated with either minimally invasive or open surgery. Material and methods: The medical records of 22 patients undergoing surgery for isolated benign rib pathologies between 2013 and 2017 were reviewed. Variables statistically compared between the two groups were age, gender, symptoms, lesion size, duration of the surgery, amount of intraoperative bleeding, conversion to open surgery, volume and duration of the drainage, postoperative complications, length of hospital stay, pathological diagnosis, follow-up period, recurrence, duration of narcotic analgesic usage and pain according to visual analog scale evaluation. Results: The thoracoscopic approach was superior to conventional surgery in terms of drainage volume, time to drain removal, morbidity, hospital stay, narcotic analgesic treatment duration and postoperative pain scores. All thoracoscopic procedures were concluded successfully, and conversion to open surgery was not required. During the mean 14-month follow-up period, no recurrence was encountered in either group. Conclusions: This technique is a safe option for isolated benign lesions of the ribs. It is more effective in patient recovery in the postoperative period and in the management of surgical pain
Factors affecting survival in non-small cell lung cancer invading the chest wall
No full textConclusion: The stage of the tumor and histopathological factors such as lymphatic involvement, extrapleural invasion, and rib invasion have been shown to gain importance in improvement of survival, in addition to advancements in surgical techniques. Although there is no consensus on the surgical approach in presence of chest wall invasion, we suggest that "en bloc" resection should be preferred to extra-pleural resection
Uniportal Thoracoscopic Approach For Pulmonary Hydatid Cyst: Preliminary Results
No full textPurpose: Pulmonary hydatid cyst is a preventable parasitary disease with high prevalence in low-medium income countries. Thoracoscopic approach is seen in the literature as small-case groups and multiple-port incisions are observed in these studies. Unlike other thoracoscopic approaches for the surgical treatment, we describe the single-port technique for the first time in our study. We attempt to compare the clinical outcomes and preliminary results of patients with pulmonary hydatid cyst treated with either minimally invasive or thoracotomy. Methods: The medical records of 66 patients undergoing surgery for pulmonary hydatid cyst disease between January 2013 and July 2017 were reviewed. The number of patients who underwent thoracotomy was 48, whereas 18 were managed by single-port video-assisted thoracoscopic surgery. Variables statistically compared between the 2 groups were age, diameter of the cystic, operation time, volume and duration of the drainage, postoperative complications, length of stay, duration of narcotic analgesic usage, and pain score. Results: Thoracoscopic approach was superior to conventional thoracotomy in terms of operation time, drainage volume, time to drain removal, hospital stay, narcotic analgesic treatment duration, and postoperative pain scores. All thoracoscopic procedures were concluded successfully, and conversion to open surgery was not required. No postoperative mortality was seen in either group. During the follow-up period, no recurrence was encountered in either group. Conclusions: Uniportal thoracoscopic approach is a safe option for the treatment of hydatid cyst disease. It can be used as an alternative to thoracotomy, depending on the size and location of the lesion
Clinical analysis of pneumonectomy for destroyed lung: a retrospective study of 32 patients
No full textObjectiveDestroyed lung is whole lung destruction secondary to chronic or recurrent lung infections. This clinical condition can result in irreversible changes in the lung parenchyma. In this study, we aimed to evaluate patients undergoing pneumonectomy with a diagnosis of lung destruction in terms of surgical technique, post-operative morbidity and mortality, and long-term outcomes.MethodsA total of 32 patients that underwent pneumonectomy due to a destroyed lung between 2005 and 2017 were retrospectively reviewed. Age, gender, presenting symptoms, etiologies, localization of the destruction, pre-operative medical history, pre- and post-operative respiratory function tests, intraoperative complications and bleeding volume, morbidity and mortality, length of hospital stay, and long-term follow-up outcomes were reviewed for each patient.ResultsThe study included 32 patients with a mean age of 31.710.8years. All the patients presented with persistent cough, whereas sputum production was presented by 25, hemoptysis by 18, and chest pain by 11 patients. The underlying primary diseases included nonspecific bronchiectasis in 20 (62.5%), tuberculosis in 9 (28.1%), left pulmonary hypoplasia accompanied by Bochdalek hernia in 2 (6.2%), and aspiration of a foreign body lodged in the left main bronchus in 1 (3.1%) patient. Mean operative time was 220.6 +/- 40.2min and mean perioperative bleeding was 450.9 +/- 225.7ml. Post-operative complications occurred in 14.2% of the patients, most commonly including atelectasis associated with stasis of secretions and wound site infection. Mean post-operative hospital stay was 11.8 +/- 2.8days and mean follow-up period was 35.5 +/- 28.3months. A significant clinical improvement was observed in 81.2% of the patients post-operatively.Conclusions Favorable long-term outcomes were obtained in our patients through careful patient selection and appropriate pre-operative work-up and surgical technique
Köy Okullarinda Çalisan Türkçe Ögretmenlerinin Meslek Hayatlarinda Yasadiklari Sorunlar (Mus Ili Örnegi)
No full textBu arastirmanin amaci Mus iline bagli köylerde çalisan Türkçe ögretmenlerinin meslek hayatlarinda yasadiklari sorunlari saptamaktir. Arastirma, köy okullarinda çalisan Türkçe ögretmenlerinin mesleklerini icra ederken kirsal alanda yasadiklari zorluklari belirlemek, meslek hayatlarinda yasadiklari sorunlari belirli basliklar altinda siniflandirmak ve bu dogrultuda kirsal alanda çalisan ve çalisacak olan Türkçe ögretmenlerine meslekî anlamda kolaylik saglamayi hedeflemistir. Arastirmada nitel arastirma yöntemlerinden biri olan görüsme teknigi kullanilmistir. Arastirmanin çalisma grubunu, Mus iline bagli köylerde görev yapmakta olan 12 Türkçe ögretmeni olusturmaktadir. Arastirmaya katilan ögretmenlerin meslekî tecrübeleri farklilik göstermektedir. Arastirmanin verileri, arastirmaci tarafindan hazirlanan yari yapilandirilmis görüsme formu ile toplanmistir. Bu formda yer alan sorular açik uçlu soru niteligindedir. Elde edilen veriler arastirmaci tarafindan betimsel analize göre siniflandirilmis ve kodlanmistir. Çalisma sonucunda kirsal kesimde çalisan Türkçe ögretmenlerinin Türkçe ögretiminde birçok sorunla karsilastigi tespit edilmistir. Bu sorunlardan dinleme, konusma, okuma ve yazma dört temel beceri ile ilgili sorunlar olarak belirlenirken okul idaresi, veli, sosyal çevre ve sosyal hayat ise dis faktörler ile ilgili sorunlar olarak belirlenmistir. Özellikle okuma ve yazma egitimi alt basliklarinda ciddi sorunlarin yasandigi bulgulanmistir. Ulasilan sonuçlar alanyazin dogrultusunda tartisilmis ve yasanilan sorunlar dogrultusunda çesitli önerilerde bulunulmustur
Therapeutic strategies for complications secondary to hydatid cyst rupture
No full textObjective: Clinical approach and therapeutic methods are important in cases with complicated hydatid cysts of the lung. This study was designed to retrospectively investigate cases with hydatid cysts, thereby discussing diagnostic methods, treatment modalities, and rates of morbidity and mortality in line with the literature. Methods: 176 cases with perforated hydatid cysts, who presented to our clinic and underwent surgery between 2003 and 2011, were included in the study. There were 71 (40.34%) females and 105 males (59.66%) with a mean age of 27.80 +/- 14.07. The most common symptom was dyspnea (44.31%) and the most common radiological finding was the water lily sign (21.02%). 88.06% of the cases were surgically treated by Cystotomy+closure of bronchial opening+capitonnage, 3.97% by wedge resection, 4.54% by segmentectomy and 3.40% by lobectomy. Results: The cysts exhibited multiple localization in 24 cases (13.63%), bilateral localization in 14 cases (7.95%), with the most common localization (43.75%) being the right lower lobe. While the hydatid cyst rupture occurred due to delivery in three (1.70%), trauma in 11 (6.25%), and iatrogenic causes in seven (3.97%) cases, it occurred spontaneously in the rest of the cases (88.08%). Fourteen of the cases with spontaneously occurring rupture (7.95%) were detected to have received anthelmintic treatment for hydatid cyst during the preoperative period (albendazole). The rate of morbidity was 27.27% and the rate of mortality was 1.13% in our study. Two cases recurred during a one-year follow-up (1.13%). Conclusion: Hydatid cyst rupture should be considered in the differential diagnosis of cases with pleural effusion, empyema, pneumothorax and pneumonia occurring in endemic regions. Symptoms occurring during and after perforation lead to errors in differential diagnosis. Performing the surgery without delay favorably affects postoperative morbidity and mortality. While parenchyma-preserving surgery is preferential, there is a need for resection in perforated hydatid cysts
Clinical analysis of pneumonectomy for destroyed lung: a retrospective study of 32 patients
No full textObjectiveDestroyed lung is whole lung destruction secondary to chronic or recurrent lung infections. This clinical condition can result in irreversible changes in the lung parenchyma. In this study, we aimed to evaluate patients undergoing pneumonectomy with a diagnosis of lung destruction in terms of surgical technique, post-operative morbidity and mortality, and long-term outcomes.MethodsA total of 32 patients that underwent pneumonectomy due to a destroyed lung between 2005 and 2017 were retrospectively reviewed. Age, gender, presenting symptoms, etiologies, localization of the destruction, pre-operative medical history, pre- and post-operative respiratory function tests, intraoperative complications and bleeding volume, morbidity and mortality, length of hospital stay, and long-term follow-up outcomes were reviewed for each patient.ResultsThe study included 32 patients with a mean age of 31.710.8years. All the patients presented with persistent cough, whereas sputum production was presented by 25, hemoptysis by 18, and chest pain by 11 patients. The underlying primary diseases included nonspecific bronchiectasis in 20 (62.5%), tuberculosis in 9 (28.1%), left pulmonary hypoplasia accompanied by Bochdalek hernia in 2 (6.2%), and aspiration of a foreign body lodged in the left main bronchus in 1 (3.1%) patient. Mean operative time was 220.6 +/- 40.2min and mean perioperative bleeding was 450.9 +/- 225.7ml. Post-operative complications occurred in 14.2% of the patients, most commonly including atelectasis associated with stasis of secretions and wound site infection. Mean post-operative hospital stay was 11.8 +/- 2.8days and mean follow-up period was 35.5 +/- 28.3months. A significant clinical improvement was observed in 81.2% of the patients post-operatively.Conclusions Favorable long-term outcomes were obtained in our patients through careful patient selection and appropriate pre-operative work-up and surgical technique
Serum paraoxonase-1 enzyme activities and oxidative stress levels in patients with esophageal squamous cell carcinoma
No full textObjectives: Oxidative stress is well recognized to play a role in the pathogenesis of many diseases, including cancers. Paraoxonase-1 (PON1) is implicated in the elimination of carcinogenic lipid-soluble radicals produced by lipid peroxidation. Reports on PON1 activities in patients with cancer are conflicting. The aim of this study was to investigate serum antioxidant enzyme activities and oxidative stress levels in patients with esophageal squamous cell carcinoma (ESCC)
A long-term study assessing the factors influencing survival and morbidity in the surgical management of bronchiectasis
No full textAbstract Background Although the prevalence of bronchiectasis decreased significantly in developed countries, in less developed and in developing countries, it still represents a significant cause of morbidity and mortality. The aim of this retrospective study is to present our surgical experiences, the morbidity and mortality rates and outcome of surgical treatment for bronchiectasis. Methods We reviewed the medical records of 129 patients who underwent surgical resection for bronchiectasis between April 2002 and April 2010, at Van Training and Research Hospital, Thoracic Surgery Department. Variables of age, sex, symptoms, etiology, and surgical procedures, mortality, morbidity and the result of surgical therapy were analyzed retrospectively. Results Mean age was 21.8 year (the eldest was 67 year, the youngest was 4 years-old). Male/female ratio was 1.86 and 75% of all patients were young population under the age of 40. Bilateral involvement was 14.7%, left/right side ratio according to localization was 2.1/1. The most common reason for bronchiectasis was recurrent infection. Surgical indications were as follows: recurrent infection (54%), hemoptysis (35%), empyema (6%), and lung abscess (5%). There was no operative mortality. Complications occurred in 29 patients and the morbidity rate was 22.4%. Complete resection was achieved in 110 (85.2%) patients. Follow-up data were obtained for 123 (95%) of the patients. One patient died during follow-up. The mean follow-up of this patient was 9 months. Mean postoperative hospitalization time was 9.15 ± 6.25 days. Significantly better results were obtained in patients who had undergone a complete resection. Conclusions Surgical treatment of bronchiectasis can be performed with acceptable morbidity and mortality at any age. The involved bronchiectatic sites should be resected completely for the optimum control of symptoms.</p
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