An automatic bender for customized pectus bar

eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2020-03-27 5 2 54 58 10.26663/cts.2020.00012 109 article An automatic bender for customized pectus bar Erkan Yildirim 1 Ozgur Kocaturk 2 Kenan K. Kurt 2 Department of Thoracic Surgery, Hisar Intercontinental Hospital, Istanbul, TurkeyInstitute of Biomedical Engineering, Bogazici University, Istanbul, TurkeyBackground: The present invention relates to a medical device that enables the “automatic” bending of the pectus bar. The curved bar is used in the correction of the deformities of the sunken chest (pectus excavatum) and the pigeon’s chest (pectus carinatum). Materials and Methods: Conventionally, the surgeon shapes pectus bars manually during the surgery by trial/error method. In these surgeries, it may not be possible to give the ideal shape manually each time due to the complex anatomy of the patients’ deformity, which might lead to increases in the operation time and the risk of complications (organ injury, bleeding, etc.). The present invention aims to prepare a customized preoperative bent bar by using the CT coordinates of the deformity by the surgeon via a custom software. Besides, as an alternative method, as usual, the novel automated bender can copy a soft metal template. Results: We presented this project to a few national and international companies. A national company has decided to take the project seriously about starting the process of producing the automatic bender to be used in the related field. The patent has protection both nationally and internationally. Conclusions: This patent will probably change the clinical pectus bar bending process providing excellent results with high satisfaction rates for both the patients and the surgeons. https://cts.tgcd.org.tr/pdf.php?id=109 thoracic wallcongenital abnormalitiespatenttomographysoftware eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2020-03-27 5 2 59 63 10.26663/cts.2020.00013 110 article Impact of weather conditions and blood groups on primary spontaneous pneumothorax Tuba Sahinoglu 1 Ozgur Katrancioglu 2 Department of Thoracic Surgery, Konya Numune State Hospital, KonyaDepartment of Thoracic Surgery, Cumhuriyet University School of Medicine, Sivas, TurkeyBackground: Primary spontaneous pneumothorax (PSP) is a clinical condition with an unclear etiology that occurs because of the rupture of pleural bulla or blebs. Several studies indicating the impact of weather conditions on PSP are present. However, the results are varying. The correlation between blood groups and PSP is yet unknown. In this study, we investigated the impact of altering weather conditions atmospheric pressure (AP), temperature, moisture, and wind velocity (WV) and blood groups on PSP. Materials and Methods: Eighty-six patients PSP diagnoses who were under follow-up and treated in our clinic between 2007 and 2015 were included in our study. Patients’ data were retrospectively collected from hospital database patient files. The Regional Directorate of Meteorology provided data on weather conditions. Results: The collected data was examined. According to the results, AP and WV had no significant impact on PSP. Regarding the air temperature, values were statistically significantly high (p = 0.019). When comparing with other blood groups, the blood group with the highest resistance to temperature was type-0. This result was statistically significant (p = 0.029). Conclusions: In this study, we determined that temperatures above 15°C had an unexpected effect on the site of the PSP. Surprisingly, PSP risk was lower in patients with blood type-0 at high temperatures. We suggest that multicenter studies with a more extensive sample size should be conducted to fully understand the impact of air condition and blood type on PSP. https://cts.tgcd.org.tr/pdf.php?id=110 air conditionblood groupprimary spontaneous pneumothorax eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2020-03-27 5 2 64 70 10.26663/cts.2020.00014 111 article The surgical management in pneumonectomy cases for lung cancer treatment Kubilay İnan 1 Merve Şengül İnan 2 Pınar Bıçakçıoğlu 3 Selim Şakir Erkmen Gülhan 3 Koray Aydoğdu 3 Sadi Kaya 3 Göktürk Fındık 3 Department of Thoracic Surgery, Ministry Of Health, Ankara City Hospital, Ankara, TurkeyDepartment of Thoracic Surgery, Gulhane Research and Training Hospital, Ankara, Turkey, Ankara, TurkeyDepartment of Thoracic Surgery, Atatürk Chest Disease and Thoracic Surgery Research and Training Hospital, Ankara, TurkeyBackground: Lung cancer is placed in first rows among all types of cancer in both women and men. Treatment options include surgical resection, chemotherapy, and radiotherapy. The main factor, which determines the treatment, is the stage of the disease. Several factors should be considered when assessing the survey ratios of the patients. Materials and Methods: We retrospectively evaluated the patients that we performed pneumonectomy owing to lung cancer from January 2009 to December 2014. Classical and extended pneumonectomies due to non-small cell lung carcinoma were included in the study while excluding the patients who have given neoadjuvant chemotherapy and radiotherapy. We analyzed patients for age, gender, complaints, symptoms, diagnostic steps, pathological specifics, postoperative complications, and surveys. Results: We evaluated 192 patients retrospectively. The mean age was 58 years. Eight of these patients were female and 184 of them were male. The most common complaint was shortness of breath. We operated 55 patients on right and 137 patients on the left hemithorax. 45 patients were given both chemotherapy and radiotherapy, 79 patients only chemotherapy, 2 patients only radiotherapy, and 66 patients did not take any additional treatment. During the follow-up period, we determined metastases in 15 patients, recurrence in 20 patients, and a second primer tumor in 1 patient. The most common postoperative complication was empyema with fistula. The mean hospital stay was 13 days. 5 years of survival was 35.9%. Conclusions: The five-year overall survival found to be significantly higher compared to the literature. Despite its unwilling morbidity rate and high mortality rate, pneumonectomy is a surgery to prolong survival in selected cases of lung cancer. https://cts.tgcd.org.tr/pdf.php?id=111 lung cancerpneumonectomysurvival eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2020-03-27 5 2 71 79 10.26663/cts.2020.00015 112 article Comparison of anthropometric measurements and pectus index for chest wall deformities Huseyin Yildiran 1 Guven Sadi Sunam 1 Department of Thoracic Surgery, Faculty of Medicine, Selcuk University, Konya, TurkeyBackground: Pectus excavatum (PE) is the most commonly seen chest wall deformity of childhood age. One of the most widely accepted methods in preoperative patient evaluation is the pectus index. In this study, it is aimed to measure the depth perception which is not aesthetic; aimed to establish an objective criteria which is simple, cheap, effective, and can be measured with physical examination or anthropometry instead of radiological examination dependent measurements. Materials and Methods: 18 patients who were admitted to our clinic between May 2015 and August 2016 with complaints of PE deformity and who were planned for surgical repair were included in the study. Sternal deformity’s depth, anthropometric measurements, pectus indexes, echocardiography, and pulmonary function test results and patient symptoms were classified. Results: 18 patients were included in the study. The mean patient age was 14.27 years. One patient had mild mitral insufficiency and a flappy mitral front leaflet. One patient had mitral valve prolapse. No restrictive or obstructive results were observed in the pulmonary function test. There was no significant differences between the pectus index and sternal depth. Conclusions: According to this study, there is a surgical indication in patients whose sternal depth is 1.2 cm and higher, regardless of the pectus index. https://cts.tgcd.org.tr/pdf.php?id=112 depth perceptionpectus excavatumsternum eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2020-03-27 5 2 80 83 10.26663/cts.2020.00016 113 article Is ultrasonography helpful in minor trauma patients with rib fractures? Eren İsmailoğlu 1 Onur Akçay 2 Department of Radiology, Cigli Regional Training Hospital, Izmir, TurkiyeDepartment of Thoracic Surgery, Cigli Regional Training Hospital, Izmir, TurkiyeBackground: The most common injury associated with blunt thoracic trauma is the rib fracture. Outpatients, who had a minor blunt trauma that did not form any complications, present more than half of the rib fractures. Unfortunately, there are several limitations on the chest x-ray. In this study, we investigated the efficacy of ultrasonography in the diagnosis of rib fractures resulting from blunt thoracic trauma. Materials and Methods: Fifty-eight patients who were admitted to the Thoracic Surgery Outpatient Clinic in our center due to minor thoracic trauma between October 2017 and July 2018 were included in the study. All patients underwent chest radiography, and thorax US after a detailed history and physical examination were performed. Results: Of the 58 patients included in the study, 33 (56.9%) were male, and 25 (43.1%) were female, while the mean age was 46.79 ± 15.75 years. While the rib fractures were detected in 24 patients with chest x-ray, US detected rib fractures in 47 patients. The comparison between the two examinations, the superiority of the US in the diagnosis of rib fracture was statistically significant compared to the chest radiography (p < 0,001). Conclusions: We believe that preferring ultrasound instead of thorax CT for its less radiation and lower cost at the next step beyond chest x-ray for patients, who applied to the outpatient clinic with minor trauma and whose general condition is well, is more beneficial. https://cts.tgcd.org.tr/pdf.php?id=113 rib fractureultrasonographychest x-ray eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2020-03-27 5 2 84 86 10.26663/cts.2020.00017 114 article Intrapleural tranexamic acid in persistent malignant hemothorax: a case report Özgür Öztürk 1 Demet Yaldız 2 Arkın Acar 3 Kenan Can Ceylan 3 Şeyda Örs Kaya 3 Funda Cansun 3 Department of Thoracic Surgery, University Of Health Sciences, Tepecik Training and Research Hospital, İzmir, TurkeyDepartment of Thoracic Surgery, Manisa Celal Bayar University, Faculty of Medicine, Manisa, TurkeyDepartment of Thoracic Surgery, University of Health Sciences, Dr. Suat Seren Chest Diseases and Chest Surgery Training and Research Hospital, İzmir, TurkeyHemothorax occurs due to various conditions such as trauma, malignancy, tuberculosis, bullous lung disease, and lung abscess. In patients with malignant hemothorax, stabilization of the clinical condition and treatment of primary disease is of primary importance. A 53-year-old female patient, who had a history of surgery for ovarian cancer and liver metastasis, admitted to the hospital with complaints of shortness of breath. The patient was found to have pleural effusion on the right hemithorax, and a tube thoracostomy was performed. During the clinical follow-up, the amount of drainage did not decrease. Thereby, the patient underwent a video-thoracoscopic evaluation, and chemical pleurodesis was applied intraoperatively. Despite chemical pleurodesis, hemorrhagic drainage continued. Intrapleural tranexamic acid administration was performed to ensure the stabilization of the clinical condition. Immediately days after the intrapleural application of tranexamic acid, the drainage of the fluid decreased and became sero-hemorrhagic. The management of this case made us think that intrapleural tranexamic acid may be an alternative in persistent malign hemothorax. https://cts.tgcd.org.tr/pdf.php?id=114 tranexamic acidmalign effusionpleurahemothorax eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2020-03-27 5 2 87 90 10.26663/cts.2020.00018 115 article A case of relapsing polychondritis developing tracheomalacia Suzan Temiz 1 Omer Faruk Demir 1 Omer Onal 1 Leyla Hasdiraz 1 Fahri Oguzkaya 1 Department of Thoracic Surgery, Faculty of Medicine, University of Erciyes, Kayseri, TurkeyThere are limited data on the relapsing polychondritis (RP). RP is an uncommon autoimmune disorder that is characterized by recurrent inflammation and destruction of the cartilage and connective tissue in various parts of the body with a high risk of misdiagnosis. Here we present a rare case of a 43-year-old female with relapsing polychondritis with tracheal involvement. https://cts.tgcd.org.tr/pdf.php?id=115 autoimmune diseaserelapsing polychondritistracheomalacia eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2020-03-27 5 2 91 94 10.26663/cts.2020.00019 116 article A case report of congenital bronchial diverticulum and bronchogenic cyst presenting with a whistle Hıdır Esme 1 Atilla Can 1 Department of Thoracic Surgery, Konya Training and Research Hospital, Health Sciences University, Konya, TurkeyCongenital diverticula of the left main bronchus are extremely rare in the adult. Bronchial diverticula could act as a reservoir for bronchial secretions and theoretically predispose to repeated respiratory infections. We reported a diverticulum originating from the left main bronchus with recurrent bronchopneumonia and whistling since 15 years of age. Additionally, our case had a paraaortic mediastinal bronchogenic cyst. Physical examination demonstrated whistling in the expiratory phase, which appeared when he was lying on his back or his left side. Flexible bronchoscopy showed a round-shaped lumen of the left main bronchus and bubbling from slits or indentations of the bronchial mucosa in the left main bronchus. Because our patient complained of whistling and history of recurrent bronchopneumonia infection due to bronchial diverticulum, he was operated. To the best of our knowledge, there has been no case of congenital bronchial diverticula localized in the left main bronchus associated with a paraaortic mediastinal bronchogenic cyst in the medical literature. https://cts.tgcd.org.tr/pdf.php?id=116 bronchial diverticulabronchogenic cystwhistling eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2020-03-27 5 2 95 98 10.26663/cts.2020.00020 117 article An interesting chest wall tumor: lung cancer metastasis Huseyin Yildiran 1 Guven Sadi Sunam 1 Osman Akdag 2 Cemil Isik 2 Department of Thoracic Surgery, Selcuk University Medical School, Konya, TurkeyDepartment of Plastic, Reconstructive and Aesthetic Surgery, Selcuk University Medical School, Konya, TurkeyMany treatment options are available for lung cancer, with the highest mortality among males. Pulmonary malignancies can be addressed by a wide spectrum of treatment approaches. Treatment options can be selected according to tumor localization. Chest wall metastasis, as reported in this study, is a very rare clinical condition in which the chest wall generally requires reconstruction after resection of the tumor. https://cts.tgcd.org.tr/pdf.php?id=117 lung cancerchest wallmetastasisreconstruction eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2020-03-27 5 2 99 102 10.26663/cts.2020.00021 118 article Management of pneumothorax in covid-19 pandemic: a report of two cases Önder Kavurmacı 1 Ekin Zorlu 1 Zeki Tuncel Tekgül 2 Murat Arslan 2 Hüseyin Özkarakaş 2 Department of Thoracic Surgery, Bozyaka Training and Research Hospital, İzmir, TurkeyDepartment of Anesthesiology and Reanimation, Bozyaka Training and Research Hospital, İzmir, TurkeyAlthough the information increases about the lung damage and radiological findings of SARS-CoV-2 disease day by day, the development of pneumothorax has been reported as a very rare finding, and our information is limited with a few case reports. Here we present a 54-year-old male and a 71-year-old female patient, who were diagnosed spontaneous pneumothorax while they were treating for SARSCoV- 2 pneumonia. A tube thoracostomy performed to each patient for the treatment of pneumothorax. While one case treated with tube thoracostomy successfully prolonged air leak, developed in other patient. Spontaneous pneumothorax should be kept in mind as a differential diagnosis when a sudden hypoxia finding developed in respiratory parameters of patients with SARS-CoV-2. Additional measures also should be taken for these patients during treatment with tube thoracostomy. https://cts.tgcd.org.tr/pdf.php?id=118 Covid-19severe acute respiratory syndrome coronavirus 2pneumothoraxprolonged air leaktube thoracostomypandemic