eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2017-12-27 2 3 81 84 10.26663/cts.2017.0019 29 article Ulaş Kumbasar 1 Yigit Yılmaz 2 Mesut Melih Özercan 2 Burcu Ancın 2 Erkan Dikmen 2 Rıza Doğan 1 Department of Thoracic and Cardiovascular Surgery, Hacettepe University, Ankara, TurkeyDepartment of Thoracic Surgery, Hacettepe University, Ankara, Turkey<b>Background:</b> The aim of this study is to evaluate the effects of fibrin sealant spraying on postoperative air leak in patients undergoing pulmonary resection for non-small cell lung cancer<p> <b>Materials and Methods:</b> Data of twenty-two patients who had undergone pulmonary resection (fibrin sealant group) were compared with a matched control cohort of nineteen patients (control group) retrospectively.<p> <b>Results:</b> Prolonged air leak was seen in fewer patients (n = 2; 10.5%) in fibrin sealant group compared to the control group (n = 4; 18.2%; p = 0.668). Apical chest tube removal time was also lower in fibrin sealant group (3 vs. 4 days; p= 0.01). Postoperative basal drain removal time, total chest tube drainage amount and intensive care unit stay time were similar between the groups (p = 0.945, p = 0.895 and p = 0.452, respectively).<p> <b>Conclusions:</b> Fibrin sealant application cannot replace an exact and precise surgical technique. However, they may be helpful particularly in small air leakages when the air leakage cannot be assured by routine surgical methods. https://cts.tgcd.org.tr/pdf.php?id=29 air leaklung resectionfibrin sealant eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2017-12-27 2 3 85 90 10.26663/cts.2017.0025 30 article Mehmet Ünal 1 Özgür Samancılar 1 Barış Gülmez 1 Serkan Yazgan 1 Tarık Yağcı 1 Ahmet Üçvet 1 Soner Gürsoy 1 Department of Thoracic Surgery, University of Health Sciences, Dr Suat Seren Chest Diseases and Surgery Medical Practice and Research Center, Izmir, Turkey<b>Background:</b> The aim of this study is to examine the recurrence rates and their causes after axillary thoracotomy and VATS for the treatment of primary spontaneous pneumothorax (PSP).<p> <b>Materials and Methods:</b> Patients who were operated due to PSP in our department between January 2011 and December 2016 were analysed retrospectively. Differences in age, sex, operation side, number of chest tubes inserted during operation, duration of postoperative drainage, need for Heimlich valve system, smoking habit and recurrence were examined between two groups of patients, who underwent axillary thoracotomy and VATS.<p> <b>Results:</b> Among 180 patients operated during this period, 98 (54.4%) patients underwent VATS, and 82 (45.6%) patients underwent axillary thoracotomy. The recurrence rate was 6.1% (n=6) in VATS patients, while it was 8.5% (n=7) after axillary thoracotomy, and the difference was not statistically significant (p=0.533). Eight of 13 patients with recurrences were found to be active smokers in the postoperative period. It was found that active smoking increased the incidence of recurrences from 3.6% to 19%, and the difference was statistically significant (p=0.001).<p> <b>Conclusions:</b> We conclude that patients diagnosed with PSP can be operated by videothoracoscopy since there was no significant difference in the recurrence rates after VATS and axillary thoracotomy, and VATS is a more minimally invasive surgical intervention and causes less incision scar compared to axillary thoracotomy. Because of the significant increase in the postoperative recurrence rates, smoking cessation should be recommended to the patients with PSP and necessary precautions should be taken for this purpose. https://cts.tgcd.org.tr/pdf.php?id=30 primary spontaneous pneumothoraxVATSaxillary thoracotomyrecurrence eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2017-12-27 2 3 91 93 10.26663/cts.2017.0021 31 article Kemal Karapınar 1 Özkan Saydam 1 Muzaffer Metin 2 Atilla Gürses 1 Celal Buğra Sezen 1 Department of Thoracic Surgery, Yedikule Chest Diseases and Surgery Education and Research Hospital, Istanbul, TurkeyDepartment of Thoracic Surgery, Okan University, Istanbul, TurkeyPulmonary venous thrombosis is a rare condition, often seen after lung transplantation, malignancies, fungal infections and sclerosing mediastinitis. It is a life threatening complication which may develop after a thoracic surgery operation. Here we present a patient who underwent a right lower bilobectomy for bronchiectasis, and developed postoperative thrombosis of the right upper pulmonary vein which resulted in a lober gangrene. The patient was discharged uneventfully three weeks after a completion pneumonectomy. This case report aims to discuss the possible cause of this condition, which was not related to a surgical complication, and also to emphasize the importance of rapid a diagnosis and management. https://cts.tgcd.org.tr/pdf.php?id=31 pulmonary venous thrombosispulmonary gangrenevasculitiscompletion pneumonectomy eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2017-12-27 2 3 94 95 10.26663/cts.2017.0022 32 article Murat Öncel 1 Hüseyin Yıldıran 2 Gökçe Yıldıran 3 Güven Sadi Sunam 1 Department of Thoracic Surgery, Selcuk University Medical Faculty, Konya, TurkeyThoracic Surgery Clinic, Konya Numune State Hospital, Konya, TurkeyDepartment of Plastic Reconstructive and Aesthetic Surgery,Selcuk University Medical Faculty, Konya, TurkeyPectus excavatum and pectus carinatum are the most common congenital chest wall deformities among others. The current surgical treatment involves insertion of a pectus bar to correct the deformity. It is a minimal invasive technique with minimal incisions but a scar tissue might be seen similar to all surgical interventions. This is an unintended result after surgery. In minimal invasive repairment of pectus deformities, we recommend scar revision after the removal of bar to achieving a good aesthetic outcome. https://cts.tgcd.org.tr/pdf.php?id=32 pectus deformityscarsurgery eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2017-12-27 2 3 96 99 10.26663/cts.2017.0023 33 article Ali Cevat Kutluk 1 Celalettin İbrahim Kocatürk 1 Yunus Seyrek 1 Neslihan Akanıl Fener 2 Department of Thoracic Surgery, Yedikule Chest Disease and Surgery Training and Research Hospital, Istanbul, Turkey Department of Pathology, Yedikule Chest Disease and Surgery Training and Research Hospital, Istanbul, TurkeyExtramedullary plasmacytoma (EMP) is a plasma cell neoplasm of soft tissue without bone marrow involvement or other systemic characteristics of multiple myeloma. A 68 year-old male presented with haemoptysis of 3 months. Computed thorax tomography (CT) revealed a 3x5 cm pleural mass adjacent to right lower lobe. The mass was diagnosed as pleural plasmacytoma. https://cts.tgcd.org.tr/pdf.php?id=33 extramedullary plasmacytomamultiple myelomaVATSradiotherapy eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2017-12-27 2 3 100 102 10.26663/cts.2017.0024 34 article Ezgi Çimen Güvenç 1 Ahmet Üçvet 1 Özgür Samancılar 1 Soner Gürsoy 1 Department of Thoracic Surgery, University of Health Sciences, İzmir Dr. Suat Seren Chest Diseases and Thoracic Surgery Health Application and Research Center, İzmir, TurkeyPulmonary sequestration is a congenital anomaly which receives its blood supply from systemic circulation It has no connection with normal tracheobronchial system, and located in a pulmonary lobe. These lesions should be treated promptly by surgery. Minimally invasive techniques may be preferred for resection. In the 32-year-old female patient, a lobulated, well-circumscribed mass lesion with a diameter of approximately 4 cm was detected on the posterior basilar segment of the left lower lobe. Besides, an aberrant artery which originated from the thoracic aorta and feeding the lesion was found. It was preoperatively observed that the arterial supply of the lesion was approximately 2 cm in diameter, originating from thoracic descending aorta. Venous drainage was through the pulmonary vein. Since intraoperative findings proved intrapulmonary sequestration to be necessary, left lower lobectomy was performed by VATS. The final pathology result was also reported as intralobar sequestration. This case is presented due to its rare occurrence and the use of minimally invasive techniques. https://cts.tgcd.org.tr/pdf.php?id=34 intralobar sequestrationVATSminimally invasive surgery eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2017-12-27 2 3 103 110 10.26663/cts.2017.0020 35 article Elif Yakşi 1 Osman Yakşi 2 Department of Physical Medicine and Rehabilitation, Yedikule Chest Diseases and Chest Surgery Training and Research Hospital, Istanbul, TurkeyDepartment of Chest Surgery, Düzce Faculty of Medicine, Düzce, TurkeyThoracotomy is one of the most painful surgical procedures known. Chronic pain in the postoperative period after thoracotomy is a common complication. Post-thoracotomy pain syndrome (PTPS) is a chronic pain with neuropathic and non-neuropathic components, continuing after 2 months of thoracotomy, causing disability by affecting the daily activities and functions of patients. Patients generally describe neuropathic symptoms such as hyperalgesia, allodynia, hypoesthesia at the site of the incision or related dermatomes. Etiology includes preoperative, intraoperative and postoperative factors. Although the mechanism of PTPS formation is not clear yet, the most common cause is the intercostal nerve injury. PTPS treatment is complex because of the neuropathic component of the pain. The risk of PTPS formation can be reduced by controlling early pain before the onset of the disease. When pain occurs, medical treatments are implemented and also minimally invasive interventional procedures could be performed if necessary. https://cts.tgcd.org.tr/pdf.php?id=35 ThoracotomyChronic painNeuropathic pain