Morbidity, mortality and survival rates of non-small cell lung cancer patients who underwent lobectomy with pulmonary artery reconstruction compared to those of the patients who underwent pneumonectomy

eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2020-01-27 5 1 1 9 10.26663/cts.2020.0001 97 article Morbidity, mortality and survival rates of non-small cell lung cancer patients who underwent lobectomy with pulmonary artery reconstruction compared to those of the patients who underwent pneumonectomy Hüseyin Ulaş Çınar 1 Celalettin Kocatürk 2 Levent Cansever 3 Süleyman Ceyhan 4 Mehmet Ali Bedirhan 3 Department of Thoracic Surgery, Medicana International Hospital, Samsun, TurkeyDepartment of Thoracic Surgery, Istinye University Medical Faculty, Liv Hospital Ulus, Istanbul, TurkeyDepartment of Thoracic Surgery, University of Health Sciences, Yedikule Chest Diseases and Thoracic Surgery Education and Research Center, Istanbul, TurkeyDepartment of Thoracic Surgery, Bezmialem Vakif University, Istanbul, TurkeyBackground: Pulmonary artery reconstruction can be preferred as an alternative to pneumonectomy, to spare the functional lung parenchyma in lung cancer. This study aimed to evaluate the morbidity, mortality and survival rates of the patients who had undergone pulmonary artery reconstruction due to central non-small cell lung cancer (NSCLC) and also to compare their data with those of the patients who had undergone pneumonectomy. Materials and Methods: In this study, 88 patients who underwent pneumonectomy (group PN) and 20 patients who underwent standard or sleeve lobectomy (double sleeve) with pulmonary artery reconstruction (group PAR) for NSCLC with stages I-IIIA between January 2005 and December 2010 were evaluated retrospectively. The morbidity and mortality rates, durations of the hospital and intensive care unit stay, 5-year and mean survival rates of the homogenous patient groups were analyzed comparatively. Results: The postoperative morbidity rate was 30% in the PAR group and 53% in the PN group (p = 0.77). The bronchial complication rate was 0% in the PAR group and 15% in the PN group (p = 0.04). The 30-day mortality rate was 5% in the PAR group and 5.6% in the PN group (p = 1). The median follow-up period for all patients was 31.5 months (range: 0-84 months) and total 5-year survival was 56.2%. In early-stage tumors (stage I + stage II), total 5-year survival rate was 64% in the PAR group and 60% in the PN group (p = 0.7). In late-stage tumors (stage III), total 5-year survival rate was 52% in the PAR group and 30% in the PN group (p = 0.04). No local recurrence was observed in either group during the follow-up period. Conclusions: In central lung tumors, to avoid pneumonectomy, major anatomical lung resection with pulmonary artery reconstructions can safely be performed with acceptable morbidity and mortality rates. Oncological outcomes of pulmonary angioplasty procedures regarding survival and local recurrence are not worse than those of pneumonectomy. Even in advanced stage lung tumors, these procedures can be an alternative to more radical operations such as pneumonectomy. https://cts.tgcd.org.tr/pdf.php?id=97 pulmonary artery resectionpulmonary angioplastylung cancerbronchoplastypneumonectomy eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2020-01-27 5 1 10 15 10.26663/cts.2020.0002 98 article Investigation of clinical and genetic data of pectus excavatum in dysmorphological children: a single-center experience Ahmet Dumanlı 1 Muhsin Elmas 2 Department of Thoracic Surgery, Afyonkarahisar Health Science University, Afyonkarahisar, TurkeyDepartment of Genetics, Afyonkarahisar Health Science University, Afyonkarahisar, TurkeyBackground: Pectus excavatum (PE) is one of the most common chest wall deformations. However, the pathogenesis of the disease is not completely understood and the results of the researches remain inconsistent. There are not enough studies in the literature investigating the most common anomalies accompanying PE. Thus, in this study, we aimed to evaluate the prenatal, natal, postnatal, genetic and clinical findings associated with congenital PE. Materials and Methods: Eighteen patients with PE (10 males, 8 females) who admits Afyonkarahisar Health Sciences University were included in the study between 2012 and 2018. Patients were investigated clinically, radiologically and genetically to determine the etiology and risk factors of PE. PE is accompanied by several anomalies and has many systemic effects. The ages of the study patients who applied to the dysmorphology clinic and included in the study ranged between 0 and 18. The findings and genetic results of approximately 120 piece dysmorphological parameters of prenatal, natal and postnatal periods of PE patients were investigated. Results: Five parameters associated with PE were recorded in this study, which include intrauterine growth retardation (IUGR), high Beighton score, hypotonia, cryptorchidism and microcephaly. Conclusions: Treatment of PE requires a detailed and multidisciplinary approach. https://cts.tgcd.org.tr/pdf.php?id=98 microcephalyfunnel chestNoonan syndrome eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2020-01-27 5 1 16 22 10.26663/cts.2020.0003 99 article Prognostic factors associated with morbidity and mortality after surgery for postintubation tracheal stenosis Altan Ceritoğlu 1 Celal Bugra Sezen 1 Cemal Aker 1 Oguz Girgin 1 Hasan Akın 1 Department of Thoracic Surgery, University of Health Sciences, Yedikule Chest Diseases and Thoracic Surgery Education and Research Center, Istanbul, TurkeyBackground: In this study, we reviewed the treatment, follow-up, and prognostic factors associated with complications in patients who underwent tracheal resection due to postintubation tracheal stenosis (PETS), in light of the literature. Materials and Methods: Twenty-five patients who were operated for PETS between June 2012 and June 2017 were retrospectively evaluated. The patients’ postoperative complications and prognostic factors affecting mortality were examined. Results: There was 11 female (44%) and 14 male (56%) patients. Eight patients (32%) had comorbidities. The mean prolonged intubation time was 47.4 ± 55.0 minutes. Eight patients (32%) developed postoperative morbidity. The main prognostic factors associated with morbidity were the length of the stenotic area and the presence of endocrine and respiratory comorbidities (p<0.05). Tracheal fistulae were observed in 2 patients. The postoperative mortality rate was 8% (n=2). One patient with fistula died on postoperative day 2, while another patient died at postoperative three months due to cardiac failure. No significant factor was identified in relation to the development of tracheal fistulae. Conclusions:The most important factor associated with complications was the presence of endocrine comorbidities. Although tracheal surgery results in high rates of postoperative morbidity and mortality, we believe these risks can be reduced by experienced surgeons and appropriate patient selection. https://cts.tgcd.org.tr/pdf.php?id=99 tracheal stenosispostintubationsurgery eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2020-01-27 5 1 23 30 10.26663/cts.2020.0004 100 article Does sericin pleurodesis increase the basic fibroblastic growth factor and high-sensitive c-reactive protein levels in rat plasma? Alkin Yazicioglu 1 Serkan Uysal 2 Almila Senat 3 Tuba Sahinoglu 4 Mehmet Furkan Sahin 1 Cemile Biçer 3 Özcan Erel 3 Erdal Yekeler 1 Department of Thoracic Surgery, Ankara City Hospital, Ankara, TurkeyDepartment of Thoracic Surgery, Hacettepe University, Faculty of Medicine, Ankara, TurkeyDepartment of Biochemistry, Yildirim Beyazit University, Faculty of Medicine Ankara, TurkeyDepartment of Thoracic Surgery, Konya Numune Hospital, Konya, TurkeyBackground: This study investigates whether or not sericin pleurodesis increases basic fibroblastic growth factor (bFGF) and high-sensitive C-reactive protein (hs-CRP) levels in rat plasma. Materials and Methods: A total of 42 adults, male, 12-week-old Wistar albino rats were obtained for the study. The rats were divided randomly into three groups, as sericin, talcum powder, and control group. After the administration of an anesthetic, the agents were administrated through a left thoracotomy. The rats were sacrificed 12 days later through cardiac puncture. The bFGF and hs-CRP levels were examined in plasma. Results: The mean rat plasma bFGF levels were 251.7 pg/mL in the sericin group (range: 101 to 821 pg/mL), 72.3 pg/mL in the talcum powder group (range: 24 to 131 pg/mL), and 133.1 pg/mL in the control group (range: 32 to 320 pg/mL). A significant difference was noted in the results of a Scheffe test between the sericin and talcum powder groups (p < 0.05, p = 0.046). Mean rat plasma hs-CRP levels were 1.038 ng/mL in the sericin group (range: 0.677 to 2.815 ng/mL), 1.343 ng/mL in the talcum powder group (range: 0.606 to 5.662 ng/mL), and 0.945 ng/mL in the control group (range: 0.586 to 1.261 ng/mL), indicating no significant difference among the groups. Conclusions: It was found that bFGF levels were significantly higher in the sericin pleurodesis group than in the talcum powder group, indicating the biochemical success of intrapleural sericin administration in inducing pleurodesis. On the other hand, hs-CRP, a marker of inflammation, was not found to be significant, indicating that hs-CRP returns to normal levels due to its short half-life. https://cts.tgcd.org.tr/pdf.php?id=100 sericinfibroblastfibrosisgrowth factorC-reactive proteinpleurodesis eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2020-01-27 5 1 31 35 10.26663/cts.2020.0005 101 article Does frozen section increase false negativity in cervical mediastinoscopy during mediastinal lymph node staging compared to paraffin section? Volkan Erdoğu 1 Muzaffer Metin 1 Adnan Sayar 2 Songül Büyükkale 2 Ali Kılıçgün 3 Serda Kanbur Metin 4 Atilla Pekçolaklar 5 Necati Çıtak 6 Halide Nur Ürer 7 Atilla Gürses 1 Department of Thoracic Surgery, University of Health Sciences, Yedikule Chest Diseases and Thoracic Surgery Education and Research Center, Istanbul, TurkeyDepartment of Thoracic Surgery, Memorial Şişli Hospital, Istanbul, TurkeyDepartment of Thoracic Surgery, Bolu Abant İzzet Baysal University, Faculty of Medicine, Bolu, TurkeyDepartment of Thoracic Surgery, University of Health Sciences, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, TurkeyDepartment of Thoracic Surgery, Bursa City Hospital, Bursa, TurkeyDepartment of Thoracic Surgery, University of Health Sciences, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, TurkeyDepartment of Pathology, University of Health Sciences, Yedikule Chest Diseases and Thoracic Surgery Education and Research Center, Istanbul, TurkeyBackground: Cervical Mediastinoscopy (CM) is the most important invasive method in mediastinal lymph node staging. Lymph nodes dissected via CM can either be sent to frozen section (FS) for analysis allowing thoracotomy to be performed on the same session, or to paraffin section (PS) where thoracotomy is performed as a separate session (as a separate operation). This study compares the falsenegative ratio of mediastinoscopic FS and PS analysis. Materials and Methods:454 patients with primary lung cancer who have undergone CM between January 2003 and December 2005 have been retrospectively analysed. This study evaluates whether FS analysis increases the false-negative rate of lymph node biopsies. Results: 160 cases from the PS group and 113 cases from the FS group were included in the study. The mean age of the patients was 56.4 years (range 28-77 years). There were 260 men and 13 women. In the PS group, mean thoracotomy time after CM was 9.9 days. False negativity of CM in the PS and the FS groups was found to be 9.2% and 8%, respectively. Conclusion: There was no statistically significant difference in terms of false negativity between FS and PS in mediastinal staging (p = 0.598). https://cts.tgcd.org.tr/pdf.php?id=101 Frozen sectionparaffin sectionlung cancer staging eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2020-01-27 5 1 36 39 10.26663/cts.2020.0006 102 article Thoracoscopic resection of a mediastinal lymphangioma: a rare case Mustafa Vedat Doğru 1 Umut Kilimci 1 Celal Buğra Sezen 1 Seyyit İbrahim Dinçer Halide Nur Ürer 2 Department of Thoracic Surgery, University of Health Sciences, Yedikule Chest Diseases and Thoracic Surgery Education and Research Center, Istanbul, TurkeyDepartment of Pathology, University of Health Sciences, Yedikule Chest Diseases and Thoracic Surgery Education and Research Center, Istanbul, TurkeyLymphangiomas are often congenital benign tumors that are formed by abnormal proliferation and development of lymphatic tissues. Although it may be localized in all lymphatic chain regions, intrathoracic localization has been reported rarely. Here we present a case of a 24-year-old non-smoker male patient admitted to our clinic with an incidentally found well-circumscribed radioopacity located in the right upper zone of the mediastinal region detected on routine chest x-ray. The computerized thorax tomography revealed a thin layered, fine-lined lesion with cystic content of 8x6 cm, located at the right paratracheal level. The patient underwent a video-assisted thoracoscopic excision of the cyst, and lymphangioma was confirmed based on the histopathologic examination. Although various alternative treatment methods such as chemotherapy, radiotherapy, sclerosing therapy, and laser therapy are used in the treatment of lymphangioma However, their effects on the treatment vary widely in the reported publications. https://cts.tgcd.org.tr/pdf.php?id=102 cystic lymphangiomamediastinumvideo-assisted thoracoscopic surgeryminimally invasive surgery eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2020-01-27 5 1 40 42 10.26663/cts.2020.0007 103 article What you don’t want to see after a superior sulcus tumor resection?: a tension pneumocephalus Serkan Yazgan 1 Soner Gürsoy 1 Ahmet Üçvet 1 Arkın Acar 1 Özgür Samancılar 1 Füsun Özer 2 Department of Thoracic Surgery, University of Health Sciences, Dr Suat Seren Chest Diseases and Surgery Medical Practice and Research Center, İzmir, TurkeyDepartment of Neurosurgery, University of Health Sciences, Tepecik Medical Practice and Research Center, Izmir, TurkeyA case of tension pneumocephalus following a superior sulcus tumor resection is presented. The symptoms, diagnostic methods, and treatment options are discussed and reviewed. https://cts.tgcd.org.tr/pdf.php?id=103 pneumocephaluscomplicationsuperior sulcus tumor eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2020-01-27 5 1 43 45 10.26663/cts.2020.0008 104 article A rare case: castleman’s disease Ezgi Çimen Çelik 1 Tarık Yağcı 2 Ahmet Üçvet 1 Soner Gürsoy 1 Zekiye Aydoğdu 3 Department of Thoracic Surgery, University of Health Sciences, İzmir Dr. Suat Seren Chest Diseases and Thoracic Surgery Health Application and Research Center, İzmir, TurkeyThoracic Surgery Clinic, Kastamonu State Hospital, Kastamonu, TurkeyDepartment of Pathology, University of Health Sciences, İzmir Dr. Suat Seren Chest Diseases and Thoracic Surgery Health Application and Research Center, İzmir, TurkeyCastleman’s disease is angiofollicular lymph node hyperplasia that occurs as a result of abnormal proliferation of plasma cells and B lymphocytes in lymphoid tissues. It has been shown to be associated with HHV-8 and HIV infections and may be unicentric or multicentric. This case is presented due to its rareness, good prognosis after complete surgery for unicentric type, and dramatically improved symptoms. https://cts.tgcd.org.tr/pdf.php?id=104 Castleman’s diseasemediastinal massHHV-8/HIV eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2020-01-27 5 1 46 49 10.26663/cts.2020.0009 105 article A rare case of giant thymolipoma Şenol Ürek 1 İrfan Yalçınkaya 1 Abdurrahim Gördebil 1 Department of Thoracic Surgery, University of Health Sciences, Süreyyapasa Chest Disease and Thoracic Surgery Training and Research Hospital, Istanbul, TurkeyThymolipoma is one of the benign pathologies of the mediastinum that may reach large sizes over time and even become a giant mass that fills the hemithorax. It may cause respiratory distress and even failure, and may be accompanied by myasthenia gravis or other clinical conditions. Surgical excision of the mass provides both diagnosis and treatment. https://cts.tgcd.org.tr/pdf.php?id=105 mediastinumthymolipomasurgery eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2020-01-27 5 1 50 53 10.26663/cts.2020.00010 106 article Videothoracoscopic resection of a posterior mediastinal parathyroid adenoma in a patient with aberrant subclavian artery Hüseyin Mestan 1 Nevzat Sertbaş 1 Serkan Yazgan 1 Özgür Samancılar 1 Ahmet Üçvet 1 Soner Gürsoy 1 Dr. Suat Seren Chest Disease and Thoracic Surgery Training and Research Hospital, Department of Thoracic Surgery, Izmir, TurkeyApproximately 25% of the patients have an ectopic location of the parathyroid gland. In some cases, hyperfunctional parathyroid glands may extend into the mediastinum that requires mediastinal surgical exploration. A 66 years old woman presented with fatigue and raised serum calcium and parathormone levels. Thorax computed tomography revealed a mediastinal mass and an aberrant right subclavian artery (ARSA) which is the most common vascular anomaly of the aortic arch was demonstrated. The mediastinal mass was evaluated in favor of parathyroid adenoma by parathyroid scintigraphy. Videothoracoscopic resection of the adenoma was performed safely. https://cts.tgcd.org.tr/pdf.php?id=106 videothoracoscopyparathyroid adenomaaberrant subclavian artery