Management of chest wall tumors: a single-center experience

eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2017-02-28 2 2 46 49 10.26663/cts.2017.0010 20 article Management of chest wall tumors: a single-center experience Tarık Yağcı 1 Ahmet Üçvet 1 Ezgi Çimen Güvenç 1 Banu Yoldaş 1 Soner Gürsoy 1 Department of Thoracic Surgery, İzmir Dr. Suat Seren Chest Diseases and Thoracic Surgery Health Application and Research Center, University of Health Sciences, İzmir, TurkeyBackground: Primary chest wall tumors (PCWT) constitute 5% of all thoracic tumors. The purpose of this study is to determine the frequency, diagnosis and treatment methods of PCWT in a single-center. Materials and Methods: All patients operated between January 2013 and July 2015 in a single center were retrospectively analyzed and patients having chest wall tumors were included in this study. Results: Among 1073 operations performed during the same period of time, twenty-five patients with primary chest wall tumors were included in this study; 17 were women (68%) and the mean age was 47.6 ± 16.1. The most common symptom was pain (68%). Twenty-four of the lesions were totally excised and reconstructive interventions were added if necessary. Definitive diagnosis was as follows; elastofibroma dorsi in 10 patients (40%), fibrous dysplasia in 3 (12%), and some other rare tumors in the remaining. Twenty-two (88%) of the lesions were benign. Conclusions: It is observed that the frequency of chest wall tumors is not so high, and most of the lesions are benign which can be resected completely. https://cts.tgcd.org.tr/pdf.php?id=20 chest wall tumorsmalignancysurgical treatmentreconstructionelastofibroma dorsi eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2017-02-28 2 2 50 53 10.26663/cts.2017.0011 21 article Diagnosis and treatment of spontaneous pneumomediastinum is not complicated Hatice Eryiğit Ünaldı 1 Kadir Burak Özer 1 Murat Ersin Çardak 2 Mehmet Ünaldı 3 Attila Özdemir 1 Recep Demirhan 1 Department of Thoracic Surgery, Kartal Dr. Lütfi Kırdar Education and Research Hospital, University of Health Sciences, Istanbul, TurkeyDepartment of Thoracic Surgery, Fatih Sultan Mehmet Education and Research Hospital, University of Health Sciences, Istanbul, Turkey Department of Emergency Medicine, Göztepe Education and Research Hospital, Medeniyet University, Istanbul, TurkeyBackground: Spontaneous pneumomediastinum is a rare and usually benign finding in young male patient without a history. When subcutaneous emphysema occurs, the patient and medical physicians feel uneasy about the view of face and neck. We review our clinical experience with spontaneous pneumomediastinum in this study. Materials and Methods: We performed a retrospective analysis of demographic features, complaints, precipitating factors and length of hospital stay of patients with spontaneous pneumomediastinum. Results: Fourteen patients with spontaneous mediastinum were identified, included 10 males. Mean age was 25.4 ± 8.9. Chest pain was the most common complaint. All patients underwent chest-x ray and thoracic computed tomography. Only one esophagogram was done. The patients were discharged uneventfully between 3 and 6 days (mean 3.5 ± 1.25). A 12-month follow-up revealed no recurrence of pneumomediastinum in any of the patients. Conclusions: Spontaneous pneumomediastinum is a benign entity and generally treated with conservative management. Chest-x ray and thoracic computed tomography are useful tools for diagnosis of the pneumomediastinum. Additional investigation procedures should be performed selectively. https://cts.tgcd.org.tr/pdf.php?id=21 pneumomediastinumspontaneoussubcutaneous emphysema eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2017-02-28 2 2 54 57 10.26663/cts.2017.0012 22 article Atypical pulmonary hydatidosis lesions mimicking other lung lesions Ülkü Yazıcı 1 Serdar Özkan 2 Özgür Ömer Yıldız 3 Private Thoracic Surgeon, Ankara, TurkeyDepartment of Thoracic Surgery, Medova Hospital, Konya, TurkeyDepartment of Thoracic Surgery, Yenimahalle State Hospital, Ankara, TurkeyBackground: Hydatid cyst disease, which is mostly caused by Echinococcus granulosus, may result in high morbidity rates particularly in endemic regions, and mortality depending on its size and on the organs where it is located. While the disease can be diagnosed radiologically because of typical symptoms, it becomes more difficult to distinguish it from lung malignancies as the cysts get complicated. Materials and Methods: 15 cases of pulmonary hydatid cyst that underwent clinical and radiological examinations and surgery after being diagnosed as lung abscess and lung cancer between 2008 and 2014 were retrospectively reviewed. Results: Radiological features of the 80% of the cases in thoracic CT were mimicking tumour in the form of thick walled cavitary lesion, hilar mass, cystic necrotic solid mass or solid mass; and 20% of them had radiological features mimicking abscess in the form of thin walled cavitary lesion. Lobectomy was performed for one case, wedge resection was performed for two cases and cystotomy-capitonnage was performed for 12 cases. Conclusions: It should be kept in mind that pulmonary hydatid cyst clinically and radiologically may mimic lung cancer and lung abscess. https://cts.tgcd.org.tr/pdf.php?id=22 Hydatid cyst diseaselung abscesslung cancer eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2017-02-28 2 2 58 63 10.26663/cts.2017.0013 23 article A rare post-operative thoracic surgery complication: chylothorax Tevfik İlker Akçam 1 Önder Kavurmacı 1 Ahmet Kayahan Tekneci 1 Ayşe Gül Ergönül 1 Kutsal Turhan 1 Alpaslan Çakan 1 Ufuk Çağırıcı 1 Department of Thoracic Surgery, School of Medicine, Ege University, Izmir, TurkeyBackground: Chylothorax is defined as the accumulation of chyle in the pleural space. In this report, we discuss the demographic features of patients with post-operative chylothorax, and the treatment approaches used to emphasize the importance of this complication for thoracic surgery. Materials and Methods: Medical records of 13 patients operated between January 2001 and July 2017, and who were diagnosed with chylothorax in the post-operative period, were retrospectively evaluated. Patients" demographic features, type of surgeries, results of histopathological examination, day of chylothorax diagnosis, and treatment results were recorded. Results: Eight male patients (61.5%) and 5 female patients (38.5%) were included in the study. Chylothorax developed after lobectomy in 9 patients (62.23%), total pleurectomy in 2 patients (15.38%), bilobectomy in 1 patient (7.69%), and pneumonectomy in 1 patient (7.69%). Oral nutrition was discontinued immediately after chylothorax diagnosis, and patients were followed-up with parenteral nutrition. A conservative approach was used in 11 patients (84.61%). Two patients (15.39%) did not respond to medical treatment, and underwent surgery. All patients were successfully treated chylothorax. Conclusions: Chylothorax is a rare but serious post-operative complication after thoracic surgeries. While appropriate conservative treatment leads to recovery in majority of the cases, surgery remains an important option for patients with prolonged drainage and persistent disease. https://cts.tgcd.org.tr/pdf.php?id=23 Chylothoraxthoracic surgerycomplication eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2017-02-28 2 2 64 66 10.26663/cts.2017.0014 24 article Laparoscopic toupet fundoplication for gastroesophageal reflux disease due to postpneumonectomy syndrome Zeynep Bilgi 1 Hakan Ömercikoğlu 2 Çağatay Çetinkaya 2 Hasan Fevzi Batırel 2 Department of Thoracic Surgery, Kars Harakani State Hospital, Kars, TurkeyDepartment of Thoracic Surgery, Faculty of Medicine, Marmara University, İstanbul, TurkeyPostpneumonectomy syndrome is a rare condition caused by rotational displacement of mediastinum over time after pneumonectomy. Usually, dynamic airway obstruction is the predominant symptom. We report the case of a 40-year-old lady who underwent left pneumonectomy due to mucoepidermoid carcinoma 3 years ago and presented to our department with recalcitrant gastroesophageal reflux symptoms such as heartburn and odynophagia. She also had objective reflux findings in pH monitorization. Laparoscopic Toupet fundoplication was performed and resulted in symptomatic relief. https://cts.tgcd.org.tr/pdf.php?id=24 Postpneumonectomy syndromelung resectionlung carcinomafundoplicationlaparoscopy eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2017-02-28 2 2 67 69 10.26663/cts.2017.0015 25 article Asymptomatic giant thymic cyst treated with vats Burçin Çelik 1 Selçuk Gürz 1 Muzaffer Elmalı 2 Yurdanur Süllü 3 Department of Thoracic Surgery, School of Medicine, Ondokuz Mayıs University, Samsun, TurkeyDepartment of Radiology, School of Medicine, Ondokuz Mayıs University, Samsun, TurkeyDepartment of Pathology, School of Medicine, Ondokuz Mayıs University, Samsun, TurkeyThymic cysts are rarely seen pathologies among mediastinum. They are benign lesions and constitute 1-2% of all tumors in mediastinum. Seventy nine-year-old patient admits to neurology specialist with nausea and dizziness. In left anterior of mediastinum of the patient, smooth margin, cystic lesion with homogenous liquid density in dimensions of 160x130x83 mm is seen in thorax CT. Video assisted thoracoscopic surgery is applied to the patient with diagnosis of intrathoracic, extrapulmonary cystic lesion and lesion is totally excised. Patient is discharged on third day postoperatively with full recovery. Histopathologic examination of the excised lesion reports that it was thymic cyst. Thymic cysts, rarely seen lesions in mediastinum, can be in large sizes and be asymptomatic. They can be treated surgically using video assisted thoracoscopic surgery. https://cts.tgcd.org.tr/pdf.php?id=25 cystthymussurgeryvideo assisted thoracoscopic surgery eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2017-02-28 2 2 70 72 10.26663/cts.2017.0016 26 article Thoracic splenosis after thoracoabdominal injury sustained 25 years previously Levent Cansever 1 Süleyman Ceyhan 1 Ali Cevat Kutluk 1 Yunus Seyrek 1 Firdevs Atabey 2 Neslihan Akanıl Fener 3 Celalettin İbrahim Kocatürk 1 Mehmet Ali Bedirhan 1 Department of Thoracic Surgery, Yedikule Chest Disease and Surgery Training and Research Hospital, Istanbul, TurkeyDepartment of Chest Disease, Yedikule Chest Disease and Surgery Training and Research Hospital, Istanbul, TurkeyDepartment of Pathology, Yedikule Chest Disease and Surgery Training and Research Hospital, Istanbul, TurkeyThoracic splenosis may occur after blunt or penetrating trauma of the thoracoabdominal region. It is diagnosed in 65% of cases of splenic rupture. Trauma-related splenosis is more frequent in the peritoneum, omentum, and mesenterium. The incidence of intrathoracic splenosis is 18%, and the most common location is the pleural space of the left hemithorax. Thoracic splenosis should be considered as a differential diagnosis in patients with multiple lesions in the left hemithorax and a history of splenic trauma involving thoracoabdominal injury. https://cts.tgcd.org.tr/pdf.php?id=26 surgerytraumathoracoscopy/VATSlung eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2017-02-28 2 2 73 75 10.26663/cts.2017.0017 27 article Is chest x-ray necessary after thoracentesis? bilateral pneumothorax Onur Derdiyok 1 Aysun Kosif Mısırlıoğlu 1 Fatma Tokgöz Akyıl 2 Mine Demir 1 Volkan Baysungur 1 Department of Thoracic Surgery, Süreyyapaşa Chest Disease and Thoracic Surgery, Education and Research Hospital, İstanbul, TurkeyDepartment of Chest Disease, Süreyyapaşa Chest Disease and Thoracic Surgery, Education and Research Hospital, İstanbul, TurkeyCurrently, thoracentesis is used to drain accumulated fluids in chest cavity such as; pleural effusion, hemothorax and chylothorax and also for diagnosis and treatment of diseases. It is a simple and reliable treatment method which can be used for air drainage in partial pneumothorax cases. After thoracentesis, some complications can occur such as pneumothorax, hemothorax, reexpansion pulmonary edema and organ laceration. Among these complications, pneumothorax is the most frequently seen. In this case report we presented a patient with lung cancer where bilateral pneumothorax developed after thoracentesis. https://cts.tgcd.org.tr/pdf.php?id=27 iatrogenicthoracentesispneumothoraxlung cancer eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2017-02-28 2 2 76 80 10.26663/cts.2017.0018 28 article Current status of tracheal tissue engineering Ulaş Kumbasar 1 Serkan Uysal 2 Department of Thoracic Surgery, Hacettepe University, Faculty of Medicine, Ankara, TurkeyDepartment of Thoracic Surgery, Bülent Ecevit University, Faculty of Medicine, Zonguldak, TurkeyManagement of large airway defects is challenging for clinicians due to lack of effective treatment modalities and eventually interest has turned to the field of airway tissue engineering. Considerable progress has been made within the field of airway tissue engineering in recent years and herein we review these recent advances within this field as applied to regeneration and/or replacement of the trachea. Although there are many encouraging researches, we are still far from any routine clinical application of tissue engineered tracheal grafts and it is essential to perform further experimental and clinical researches in order to improve current results and to broaden the clinical application of airway tissue engineering. https://cts.tgcd.org.tr/pdf.php?id=28 Tracheatissue engineeringstem cellregenerative medicineairwaytransplantation