Bronchoscopic destruction of endobronchial lung tumors

eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2021-12-03 6 3 88 93 10.26663/cts.2021.0018 145 article Bronchoscopic destruction of endobronchial lung tumors Huseyin Yildiran 1 Guven Sadi Sunam 1 Atilla Can 1 Department of Thoracic Surgery, Selcuk University Medical Faculty, Konya, TurkeyBackground: Bronchoscopy is a safe and reliable intervention for the management of airway diseases. Airway patency is particularly important for patients with endobronchial tumors. The aim of this study was to report the effects of rigid bronchoscopy on the prognosis of endobronchial lung tumors causing bronchial obstruction. Materials and Methods: The study included 38 patients who were referred to our clinic during 2009– 2019 following radiological or bronchoscopic diagnosis of endobronchial lesions and who were at the stage of diagnosis and treatment for lung malignancy. Their demographic characteristics, clinical complaints, pathologic diagnoses, stages of primary lung cancer, preoperative and postoperative radiological findings, and bronchoscopy results were retrospectively evaluated and recorded. Results: A total of 29 males and 9 females were included in the study. The most common complaints observed were cough in 16 patients (42.1%) and shortness of breath in 12 (31.5%). Overall, 28 patients (73.6%) had primary pulmonary malignancy, 6 (15.7%) had benign diseases, 2 (5.2%) had primary tracheal malignancy, and 2 (5.2%) had metastasis of non-pulmonary malignancy. Full endobronchial patency was achieved in 23 patients (60.5%), whereas partial patency was achieved in 10 (26.3%). Radiological regression of opacities was observed with symptomatic relief of clinical complaints in all patients who achieved partial or full patency. Conclusion: Bronchoscopic destruction of an endobronchial lesion causing tracheobronchial obstruction is critical for improving acute respiratory distress, avoiding the development of lung damage, and preventing delayed treatment in malignant cases. https://cts.tgcd.org.tr/pdf.php?id=145 dyspneaobstructionbronchustrachea eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2021-12-03 6 3 94 102 10.26663/cts.2021.0019 146 article Work-related strain and the prevalence of burnout syndrome in thoracic surgeons and research assistants in turkey Burçin Çelik 1 Sevgi Canbaz 2 Ondokuz Mayıs University Medical School, Department of Thoracic Surgery, Samsun, TurkeyIstanbul University, Istanbul Medical School, Department of Public Health, Istanbul, TurkeyBackground: Burnout syndrome (BS) is a slowly progressing clinical condition that can have negative effects on work life and cause serious social and economic losses. Our hypothesis in this study is that the working conditions of thoracic surgeons affect work-related stress and burnout levels (emotional exhaustion, depersonalization, personal success). The aim of our study is to determine work-related strain and the prevalence of BS among the thoracic surgeons and research assistants in our country. Materials and Methods: Following the approval of the local ethics committee, 298 professionals were included in this cross-sectional survey study conducted between 01 December 2016 and 31 March, 2017. In addition to the 26 questions examining socio-demographic and work life sent via e-mail, participants were also sent the Work-Related Strain Inventory and the Maslach Burnout Inventory. Results: 81.9% of the participants were male and the age average was found to be 42.0 ± 7.6 (26-63) years. Participants consisted of 112 specialist physicians, 47 research assistants, 29 doctor lecturers/chief assistants, 59 associate professors, 51 professors, while 40.9% were working in university hospitals. The study found that there is no difference in terms of gender in the subscales of Work-Related Strain Inventory and the Maslach Burnout Inventory (p = 0.564, 0.760, 0.359 and 0.579 respectively), and that the score from Work-Related Strain Inventory increased in line with increased academic status, while physicians working at the university got higher scores from Work-Related Strain Inventory (p ˂ 0.0001). It was established that research assistants, and thoracic surgeons working in state hospitals and teaching hospitals had high scores in the emotional exhaustion (p < 0.001) and depersonalization subscales (p<0.001) of the Maslach Burnout Inventory, while professors and those working in university hospitals had higher personal accomplishment scores (p < 0.012). Conclusion: In the study, it was found that professors had higher point at Work-related Strain Inventory and personal accomplishment scores, whereas lower point at emotional burnout and depersonalization scores than in other academic titles. As a result, job-related strain was found to be significantly higher among academics with high workloads. https://cts.tgcd.org.tr/pdf.php?id=146 burnout syndromespecialistthoracic surgeonwork-related strain eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2021-12-03 6 3 103 107 10.26663/cts.2021.0020 147 article The parenchyma-protecting effect of carvacrol in pulmonary contusion induced in rats Osman Yakşi 1 Songül Peltek Özer 2 Department of Thoracic Surgery, Bolu Abant Izzet Baysal University, Bolu, TurkeyDepartment of Pathology, Bolu Abant Izzet Baysal University, Bolu, TurkeyBackground: Pulmonary contusion is a potentially life-threatening clinical manifestation frequently seen in acute thoracic trauma. It can be life-threatening if diffuse in nature. This study investigated the tissue damage-reducing effect of carvacrol, an antioxidant, in rats with induced lung damage. Materials and Methods: Twenty-one female Wistar Albino rats weighing 240-320 g were used in the study. Pulmonary contusion was induced with the application of 2.25 joules of energy with a modification of the isolated bilateral pulmonary contusion model. Lung tissues of rats administered two doses of oral 50 mg/kg carvacrol were then subjected to histopathologic examination. Results: Congestion, alveolar destruction, alveolar hemorrhage, and leukocyte infiltration were subjected to histopathologic examination in all lung sections. The amount of alveolar hemorrhage was significantly lower in the carvacrol group compared with the control and trauma groups (p = 0.033). Congestion, leukocyte infiltration, and destruction also decreased, albeit statistically insignificantly, in the carvacrol group. Conclusion: The antioxidant carvacrol significantly prevented alveolar hemorrhage in pulmonary contusion developing following trauma. Congestion decreased, and no leukocyte infiltration developed in the carvacrol group. However, it did not affect destruction. https://cts.tgcd.org.tr/pdf.php?id=147 carvacroltraumalungpulmonary contusion eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2021-12-03 6 3 108 113 10.26663/cts.2021.0021 148 article The importance of thoracic surgery clinics for emergency medicine: a retrospective analysis of consultations İsmail Ertuğrul Gedik 1 Okan Bardakçı 2 Timuçin Alar 1 Department of Thoracic Surgery, Çanakkale Onsekiz Mart University Faculty of Medicine, Çanakkale, TurkeyDepartment of Emergency Medicine, Çanakkale Onsekiz Mart University Faculty of Medicine, Çanakkale, TurkeyBackground: Thoracic Surgery serves as a consultant for many specialties of medicine. In this study, we aimed to analyze the basic characteristics of the consultations requested by the Department of Emergency Medicine to the Department of Thoracic Surgery in a university hospital. Materials and Methods: This study includes the retrospective analysis of emergency medicine consultations of patients over the age of 18 to the Thoracic Surgery Clinics of Çanakkale Onsekiz Mart University (COMU) Faculty of Medicine between 01/03/2014 and 01/03/2020. The cases were analyzed in two groups: the consultations requested with the initiative of the emergency medicine physician (Group A) and consultations requested as per recommendations of other physicians (Group B). Results: Of 486 consultations that met the inclusion criteria, 434 (89.3%) consultations were requested as per the recommendations of the emergency medicine physicians (Group A) and 52 (11.7%) were requested as per the recommendations of other physicians (Group B). No thoracic surgical diagnosis was established in 107 (22%) consultations. When compared between the two groups, no thoracic surgical pathology was found in 55 (12.6%) consultations from Group A and 52 (100%) consultations from Group B (p < 0.001). Conclusion: In our study, no thoracic surgical diagnosis was established in more than 20% of consultations requested by the emergency service. We believe that adding formal rotation training to thoracic surgery during the residency training of emergency medicine, which is the first specialty that meets emergency applications, will lead the diagnosis and treatment of thoracic surgical emergencies faster and more accurately. https://cts.tgcd.org.tr/pdf.php?id=148 consultationthoracic surgeryemergency medicinethoracic traumaresidency training eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2021-12-03 6 3 114 121 10.26663/cts.2021.0022 149 article The comparison of the acute physiology and chronic health evaluation ii, sequential organ failure assessment and american society of anesthesiologists physical status classification scores in the prediction of morbidity and mortality after lung surgery Yücel Özgür 1 Cemal Aker 2 Department of Anesthesiology and Reanimation, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, TurkeyDepartment of Thoracic Surgery Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, TurkeyBackground: This study compared three commonly used scoring systems, the Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA), and American Society of Anesthesiologists physical status classification (ASA), in the prediction of post-operative mortality and morbidity after lung resection. Materials and Methods: Adult patients admitted to the surgical intensive care unit (ICU) after lung resection between January 2018 and January 2020 were retrospectively evaluated. Results: The study included 509 patients with a mean (SD) age of 59.9 (11.7) years; 421 of the patients were men (82.7%). The average ICU length of stay was 4.2 ± 6.9 days. Preoperative ASA scores were I-II in 73.5% and III-IV in 26.5% of the patients. The mean (SD) postoperative APACHE II score was 9.42 (4.23) and SOFA score was 1.04 (2.08). The area under the curve (AUC) in receiver operating characteristic analysis of postoperative complications was 0.772 for APACHE II and 0.690 for SOFA. The AUC values of APACHE II and SOFA scores for mortality were 0.925 and 0.944, respectively. Conclusions: Our comparison of these scoring systems showed that SOFA was the best predictor of morbidity and mortality after lung resection. SOFA predicted the development of complications significantly better than both APACHE II and ASA. SOFA also predicted mortality better than ASA and APACHE II, although the difference was not significant for APACHE II. SOFA and APACHE II scores can be used to predict mortality and morbidity in patients lung resection surgery. https://cts.tgcd.org.tr/pdf.php?id=149 Acute Physiology and Chronic Health Evaluation II ScoreSequential Organ Failure Assessment Scorecomplicationmortalitylung resection eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2021-12-03 6 3 122 124 10.26663/cts.2021.0023 150 article An inappropriate localization of a zoonotic disease: infraclavicular, infrapectoral hydatic cycst Funda Cansun 1 Canberk Heskiloğlu 2 Department of Thoracic Surgery, Sanliurfa Medical Practice and Research Center, Sanliurfa, TurkeyDepartment of Thoracic Surgery, University of Health Sciences, Dr. Suat Seren Chest Diseases and Surgery Medical Practice and Research Center, İzmir, TurkeyHydatid cyst is a zoonotic disease that is common worldwide. Turkey is an endemic region for hydatid cyst due to the widespread farming and animal husbandry. Echinococcus granulosus is the most common infestation species in humans, and humans are the incidental intermediate host. The cyst formed by this zoonotic cause is expected to be localized in either lungs or the liver, depending on the part of the life cycle in humans. Soft tissue or intramuscular presence of the cyst is rare. Herein, we present a hydatid cyst case with an unusual localization. https://cts.tgcd.org.tr/pdf.php?id=150 hydatid cystparasitosisthoraxsurgical treatmentechinococcoses eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2021-12-03 6 3 125 128 10.26663/cts.2021.0024 151 article Catamenial pneumothorax with liver herniation Betül Bahar Kazak 1 Gökhan Kocaman 1 Süleyman Gökalp Güneş 1 Bülent Mustafa Yenigün 1 Hakan Kutlay 1 Department of Thoracic Surgery University, Ankara University, School of Medicine, Ankara, TurkeyCatamenial pneumothorax (CP) is a special type of pneumothorax occurring in women of reproductive age related with the menstrual cycles. In most cases patients are misdiagnosed as primary spontaneous pneumothorax and are admitted to the hospital with recurrences. CP is mostly associated with thoracic endometriosis. Characteristic lesions of the disease include diaphragmatic perforations and also diaphragmatic or pleural spots or nodules in addition to bullae or blebs. There are a few cases in the literature with partial liver herniation from diaphragmatic defects in patients with catamenial pneumothorax. In this study, we present a 45-year-old female patient with the diagnosis of catamenial pneumothorax and herniation of liver from diaphragmatic defects. https://cts.tgcd.org.tr/pdf.php?id=151 catamenial pneumothoraxthoracic endometriosisdiaphragmatic defectsliver herniationvideo assisted thoracoscopic surgery eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2021-12-03 6 3 129 132 10.26663/cts.2021.0025 152 article Periosteal chondroma of rib at adulthood Can Berk Kurt 1 Tibet Uğur Kurak 1 Hamide Sayar 2 Fadime Eda Gökalp Satıcı 2 Erhan Ayan 1 Department of Thoracic Surgery, Mersin University School of Medicine, Mersin, TurkeyDepartment of Pathology, Mersin University School of Medicine Mersin, TurkeyPeriosteal chondroma is a rare, benign, slowly growing cartilaginous tumors. They are found in long and tubular bones, mostly. It occurs in second and third decades of life. Rib is an rare location to found periosteal chondroma. We demonstrates a case report of periosteal chondroma founded in the rib that belongs 44-year-old man. We also examine isocitrate dehydrogenase 1 (IDH-1) mutation of this unusually located periosteal chondroma immunohistochemically and IDH-1 mutation was determined as negative. This article is aimed to present 44 years old man’s periosteal chondroma developed at rib that is an unusual location and age for periosteal chondromas. https://cts.tgcd.org.tr/pdf.php?id=152 ribperiosteal chondromajuxtacortical chondroma eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2021-12-03 6 3 133 136 10.26663/cts.2021.0026 153 article A successfully treated patient with bronchial atresia and tracheal stenosis Bayram Metin 1 Mehmethan Turan 2 Department of Thoracic Surgery, Acıbadem Kayseri Hospital, Kayseri, TurkeyDepartment of Chest Diseases, Acıbadem Kayseri Hospital, Kayseri, TurkeyBronchial atresia is one of the rare congenital bronchopulmonary malformations. The affected bronchus is atresic and usually the upper lobe of the left lung is involved and is not connected to the central airways. In this case report, we present the treatment process of a patient with post-intubation tracheal stenosis, left main bronchial stenosis, and an agenesis of left upper lobe bronchus. https://cts.tgcd.org.tr/pdf.php?id=153 tracheal stenosisbronchial stenosisbronchial atresia eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2021-12-03 6 3 137 140 10.26663/cts.2021.0027 154 article Metastatic tracheal tumor palliated with rigid bronchoscopy and argon plasma coagulation: a case report with video presentation Ahmet Bülent Kargı 1 Ayşe Nimet Karadayı 1 Department of Thoracic Surgery, Okan University, Istanbul, TurkeyMetastasis of tracheobronchial tree is an infrequent and life-threatening condition. Endobronchial metastasis is rare while endotracheal metastasis is extremely rare entity. Renal cell carcinoma (RCC) constitutes approximately 3% of all adult malignancies and metastasizes 30% cases to organs during the course of the disease. Lung is the most common target organ of RCC metastasis and usually bilateral parenchymal metastases are seen as well as tracheobronchial system. Hemoptysis may be the first manifestation and bronchoscopy is useful for both diagnosis and therapy. Argon plasma coagulation (APC) is a choice of current therapeutic techniques to achieve hemostasis from bleeding endobronchial lesions. Here we report a case of 72-year-old man was suffering hemoptysis due to endotracheal metastasis of RCC diagnosed via rigid bronchoscopy and palliated with APC successfully. https://cts.tgcd.org.tr/pdf.php?id=154 tracheal metastasistracheobronchial metastasesrenal cell carcinomaargon plasma coagulationrigid bronchoscopyhemoptysis