A quantitative method to evaluate rest periods and respiratory functions in the recovery process of chest trauma cases: peak expiratory flow rate measurement

eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2023-03-28 8 1 1 7 10.26663/cts.2023.001 186 article A quantitative method to evaluate rest periods and respiratory functions in the recovery process of chest trauma cases: peak expiratory flow rate measurement Sercan Aydın 1 Alpaslan Çakan 2 Seda Kahraman Aydın 2 Önder Kavurmacı 3 Ayşe Gül Ergönül 2 Tevfik İlker Akçam 2 Ali Özdil 2 Kutsal Turhan 2 Ufuk Çağırıcı 2 Department of Thoracic Surgery, İzmir Democracy University, Buca Seyfi Demirsoy Education and Research Hospital, Izmir, TurkeyDepartment of Thoracic Surgery, Ege University School of Medicine, Izmir, TurkeyDepartment of Thoracic Surgery, University of Health Sciences, Bozyaka Education and Research Hospital, Izmir, TurkeyBackground: In this study, the factors that had an effect on the recovery of respiratory functions of the patients with chest trauma were investigated, and it is aimed to question the adequacy of the follow-up and rest periods with a different method. Materials and Methods: One hundred and eighty patients with chest trauma hospitalized in our thoracic surgery department between August 2018 and December 2019 were analyzed. The effective factors on their recovery to normal respiratory functions were investigated using “Peak Expiratory Flow-meter” (PEF-meter). PEF values were recorded on the first three days of hospitalization and on the 10th, 40th and 70th days after their discharges. Results: We examined when the chest trauma patients were able to reach a PEFR value of 80% (PEF80) as done in bronchial asthmatics. Pneumothorax, lung laceration, presence of pneumomediastinum and tube thoracostomy were found to delay achieving a PEF80. It was found that the location of the fracture, rather than the number of rib fractures, was effective in improving respiratory functions. Non-smokers were seen to have a higher capacity to return to normal respiratory activity after trauma. Conclusions: In case of fractures occurring on the anterior and lateral of the ribs and in the situation of the presence of pneumothorax, pneumomediastinum, lung laceration, tube thoracostomy and smoking history pain management and follow-up should be handled more detailed. It should be taken into account that these cases may require longer rest period and disability/incapacity reports should be prepared bearing this in mind. https://cts.tgcd.org.tr/pdf.php?id=186 peak expiratory flow ratepneumothoraxpulmonary function testrib fracturessmokethoracic injuries eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2023-03-28 8 1 8 15 10.26663/cts.2023.002 187 article Seven-year retrospective analysis of pleural effusion cytologies and cytohistopathological correlation Selma Erdogan Duzcu 1 Seyma Ozturk 1 Department of Pathology, Bolu Abant Izzet Baysal University, Medical School, Bolu, TurkeyBackground: The cytological examination of pleural effusions is a quick and effective diagnostic method used to elucidate the etiology. The aim of this study is to reveal cytopathological diagnosis distributions by retrospectively examining seven-year pleural cytology and analyze cyto-histopathological correlations in cases with biopsy in this study. Materials and Methods: In this study, 545 pleural fluid aspiration materials that resulted as Bolu Abant İzzet Baysal University İzzet Baysal Training and Research Hospital between 2014 and 2020 were evaluated retrospectively. The evaluation results were divided into four groups as inconclusive, negative for malignancy, suspected malignancy, and malignant cytology. The biopsy diagnoses of 64 cases were grouped as inadequate, benign, and malignant. Sensitivity and specificity values were calculated by looking at the relationship between cytology and biopsy diagnoses. Results: According to the cytology diagnoses, 435 cases (79.8%) were negative for malignancy, 43 cases (7.9%) were malignant, 32 cases (5.9%) were suspected of malignancy, and 35 cases (6.4%) were inconclusive. When the diagnoses of the cases with both cytology and biopsy analyses were compared, the sensitivity of the cytology was 96.7%, the specificity was 91.2%, the positive predictive value was 90.6%, and the negative predictive value was 96.7%. The biopsy and cytology results were found to be compatible (p < 0.05) Conclusions: Pleural effusion develops due to different etiologies, and the cytological examination of pleural fluid is an important diagnostic method for malignancy. In our region, the most common cause of pleural effusion is benign pathologies which are consistent with data in the literature. The correlations between cytology- and biopsy-based diagnosis results were found high. https://cts.tgcd.org.tr/pdf.php?id=187 Pleural effusionmalignancypleural effusion cytologypathologyretrospective eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2023-03-28 8 1 16 22 10.26663/cts.2023.003 188 article Prevalence and radiologic features of elastofibroma dorsi: a CT study Behice Kaniye Yılmaz 1 Rüştü Türkay 1 Sevim Özdemir 1 Türkan İkizceli 1 Tuba Selçuk Can 1 Nurdan Göçgün 1 Bahar Atasoy 2 Department of Radiology, Haseki Research and Training Hospital, Radiology, İstanbul, TurkeyDepartment of Radiology, Başakşehir Çam and Sakura City Hospital, İstanbul, TurkeyBackground: The study aimed to examine the prevalence and radiological features of Elastofibroma Dorsi (ED), detected incidentally in patients who underwent CT for various reasons. Materials and Methods: A total of 8378 chest CT examinations were reviewed retrospectively for ED from January 2019 to April 2020. Lesion side, thickness, density, and whether stated in the initial report were examined. Results: Of the 8378 patients, 87 patients (1.03%) (41 women and 46 men) had a total of 114 ED. There was no significant difference in the mean age of ED patients regarding gender (p < 0.001). When the ages of the patients included in the study with (n = 87, 52.0 ± 14.7) and without ED (n = 8291, 42.0 ± 15.2) were compared, there was a statistically significant difference (p < 0.001). The rate of bilateral ED was 31%. A positive correlation was determined between mean ED thickness and age (p = 0.001 and p = 0.041 for right and left, respectively). It was noted that none of the patients were diagnosed in the first radiological report. Conclusions: ED is a slow-growing non-neoplastic, soft tissue tumor with a typical periscapular location. Being aware of this entity will prevent the need for advanced diagnostic evaluation. The characteristic appearance of these lesions will reduce unnecessary biopsy and surgery with increased radiologist awareness of their recognition. https://cts.tgcd.org.tr/pdf.php?id=188 elastofibroma dorsiprevalencecomputed tomographysoft tissue neoplasms eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2023-03-28 8 1 23 31 10.26663/cts.2023.004 189 article Impact of covid-19 pandemic on non-small cell lung cancer: a retrospective study Selçuk Gürz 1 Ayşen Taslak Şengül 1 Mehmet Gökhan Pirzirenli 1 Yasemin Büyükkarabacak 1 Burçin Çelik 1 Necmiye Gül Temel 1 Caner İşevi 1 Ahmet Başoğlu 1 Department of Thoracic Surgery, Ondokuz Mayis University Faculty of Medicine, Samsun, TurkeyBackground: The most important treatment method in non-small cell lung cancer (NSCLC) is surgery. Detection of the disease at an early stage is one factor that determines the prognosis. This study investigates the impact of the novel coronavirus disease pandemic on the diagnosis and surgical treatment of NSCLC. Materials and Methods: Between March 2019 and March 2021, a total of 163 patients (142 males, 21 females, mean age 62.3 ± 7.8 years; range, 39 to 78 years) diagnosed with NSCLC who underwent surgery were retrospectively analyzed. The patients were divided into two groups according to COVID-19 pandemic period such as before (Group 1) and after (Group 2) March 2020. Demographic characteristics, symptoms, diagnostic method, pathological diagnosis, stage, surgical treatment method, and developing complications of patients were recorded. Results: During the investigation of COVID-19, NSCLC was detected among 16.8% (n = 17) of the patients who underwent surgery. The number of NSCLC patients who underwent surgery during the pandemic period increased by 62.9% compared to the pre-pandemic period. (p=0.338). Despite patients with Stage 1 disease (30.6% vs. 9.9%, p = 0.007) and the rate of open surgery was significantly decreased (82.3% vs. 52.5%, p < 0.001) during the pandemic period for patients diagnosed with NSCLC, those who underwent surgery were most frequently determined on stage 1A when compared with the pre-pandemic period. In contrast, the video-assisted thoracoscopic surgery approach increased (17.7% vs. 47.5%, p < 0.001), and a statistically significant difference was found between the distributions of surgical procedures. Conclusions: In the novel coronavirus pandemic, thorax computed tomography used for lung assessment affected the detection rate of NSCLC. The importance of VATS pulmonary resections increased in this period, thus shortening the hospital stay of the patients. https://cts.tgcd.org.tr/pdf.php?id=189 COVID-19non-small cell lung cancerpandemicthoracic surgery eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2023-03-28 8 1 32 36 10.26663/cts.2023.005 190 article Pulmonary hydatid cyst disease: a retrospective study Kadri Ceberut Department of Thoracic Surgery, TOGU Medical School, Tokat, TurkeyBackground: Although the disease progression can be silent, the pulmonary hydatid cyst (HC) may be considered a life-threatening disorder. The mainstay of pulmonary HC treatment is still surgical removal of the cyst. In the current study, we evaluated the results of surgery in patients with pulmonary HC. Materials and Methods: Thirty pulmonary HC patients who underwent surgery between 2007 and 2020 were analyzed retrospectively. The symptoms, cyst features, surgical procedures, and postoperative findings were recorded. The patients were divided into two subgroups: complicated cyst hydatid (CHC) and simple hydatid cyst (SHC). Results: Thirteen cases were diagnosed as complicated HC with rupture into the pleural or bronchial cavity (CHC group, 43.4%), whereas 17 cases (56.6%) involved intact cysts (SHC group). Cystotomy and capitonnage were performed in the majority of the patients (n = 24, 80.0%). No mortality was observed during the one-year follow-up period. Conclusions: Surgical management is an effective and safe method for the treatment of pulmonary HC. https://cts.tgcd.org.tr/pdf.php?id=190 pulmonary hydatid cystcomplicated cystsurgeryoutcomes eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2023-03-28 8 1 37 44 10.26663/cts.2023.006 191 article A thoracic surgery consensus statement for performing thoracic surgery in sars-cov-2 pandemic Akif Turna 1 İsmail Sarbay 1 Ahmet Demirkaya 2 Korkut Bostancı 3 Deniz Sansar 4 Mehmet Yıldırım 5 Department of Thoracic Surgery, Istanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty, İstanbul, TurkeyDepartment of Thoracic Surgery, Beykent University Faculty of Medicine, İstanbul, TurkeyDepartment of Thoracic Surgery, Marmara University Faculty of Medicine, Istanbul, TurkeyDivision of Thoracic Surgery, Yedikule Teaching Hospital for Chest Diseases and Thoracic Surgery, Istanbul, TurkeyDivision of Thoracic Surgery, Dr. Siyami Ersek Hospital for Cardiothoracic Surgery, Istanbul, TurkeyBackground: Spreading to almost all countries in the world, the COVID-19 pandemic impacted healthcare and prevented or postponed major thoracic surgeries. In this study, members of the Turkish Society of Thoracic Surgery report a consensus reached by the members for providing thoracic surgery safely during the COVID-19 pandemic. Materials and Methods: In this study, a questionnaire included categories of questions aimed to explore the aspect and perspectives of the professionals in the field. The survey was distributed through the email platform of the National Association which includes active members of the society and it was kept open between the 8th of April and the 7th of May 2021. Results: Eighty members of the national association completed the survey. Most of the respondents were academic surgeons from university hospitals (43.8%) or teaching hospitals for thoracic surgery (36.3%). Almost all respondents agreed that patients with lung cancer and prolonged air leaks should be operated during the pandemic (98.8% and 96.3% respectively). The majority required that patients should be quarantined at the hospital or home up to 1 week before surgery. Academic surgeons statistically significantly more frequently thought that the quarantine period was unnecessary (p = 0.045). Most respondents indicated that stage IA to IIIA lung cancer patients should be operated. All respondents agreed that patients can be operated on provided that a PCR-negative swab test. Most of the professors thought elective surgeries should be delayed 1 to 4 weeks while some surgeons believed the delay should be more than a month (p = 0.028). Conclusions: Thoracic surgery services for patients with thoracic should be maintained during the COVID-19 pandemic. We as thoracic surgeons are responsible to perform good surgical management of patients during this and any future pandemic. https://cts.tgcd.org.tr/pdf.php?id=191 COVID-19thoracic surgeryconsensusreportsurvey eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2023-03-28 8 1 45 51 10.26663/cts.2023.007 192 article A retrospective analysis of chest wall deformities incidentally detected in emergency department patients: an observational study Osman Sezer Çınaroğlu 1 Mehmet Göktuğ Efgan 1 Hasan Ersöz 2 Department of Emergency Medicine, Ataturk Research and Training Hospital, Katip Celebi University, İzmir, Turkey.Department of Thoracic Surgery, İzmir Katip Çelebi University, Faculty of Medicine, İzmir, TurkeyBackground: The most frequently observed chest wall deformities are pectus excavatum and pectus carinatum. The purpose of this observational study was to examine the prevalence of chest wall deformities in adult patients presenting for various reasons to the emergency department in our institution, a regional reference center for chest deformities, the demographic characteristics of patients with such malformations, emergency presentation symptoms, and the effects of deformities on patients’ psychological state. Materials and Methods: Two hundred forty cases presented to the İzmir Katip Çelebi University Atatürk Training and Research Hospital tertiary emergency department and meeting the inclusion criteria were investigated retrospectively. The cases’ demographic data, presence of family histories of similar deformities, presenting symptoms, deformity depths, Haller indices, and patients’ psychological deformity levels were determined and subjected to statistical analysis. Results: The prevalence of pectus excavatum among the patients presenting to our center was 1/308, while the prevalence of pectus carinatum was 1/698. The patients’ mean age was 24.75 years, and 84.6% were men. The accompanying psychological deformity was present in only 28.33% of cases. The presence of family history was determined at 38.8%. The patients’ mean Haller Index value was 3.16, and the mean depth of deformity was 2.5 cm. Haller Index values were significantly higher among patients with moderate or severe psychological deformity than in the other patients (p < 0.001). The Haller Index exhibited a high correlation with depth of deformity (p < 0.001) and a negative correlation with patients’ body mass index values (p = 0.024). Conclusions: Chest wall deformities are a very common societal health problem, one that exhibits psychological effects and familial predisposition, and that can lead to various physiological problems. Familial disposition levels may vary among societies. Adult patients begin to tolerate the presence of low body mass index and psychological deformity. Prospective studies are now needed for greater clarification of these issues. https://cts.tgcd.org.tr/pdf.php?id=192 pectus excavatumpectus carinatumchest wall anomaliespsychological deformityHaller Index eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2023-03-28 8 1 52 57 10.26663/cts.2023.008 193 article Efficacy of thoracic ultrasonography in thoracostomy tube removal Kerim Tülüce 1 Nur Hürsoy 2 Gökçen Sevilgen 1 Hasan Türüt 1 Department of Thoracic Surgery, Recep Tayyip Erdoğan University, School of Medicine, Rize, TurkeyDepartment of Radiology, Recep Tayyip Erdoğan University, School of Medicine, Rize, TurkeyBackground: Tube thoracostomy is the most commonly performed procedure in thoracic surgery. Followup with daily chest X-ray is performed for both pneumothorax patients and postoperative patients, but residual pneumothorax can often be missed on portable imaging in supine position. This study aimed to evaluate the efficacy and safety of ultrasonography and chest X-ray by comparing these two methods in chest tube removal and thus determine whether ultrasonography is suitable for routine use in thoracic surgery clinics. Materials and Methods: This prospective study included a total of 28 patients who underwent tube thoracostomy in our center between December 2019 and December 2020 due to spontaneous pneumothorax (n = 16) or after wedge resection for different indications (n = 12). Chest X-ray and thoracic ultrasonography were performed before and after chest tube removal. The efficacy of thoracic ultrasonography compared to chest X-ray in the detection of residual pneumothorax was evaluated using specificity, sensitivity, positive predictive value (PPV), and negative predictive value (NPV). Results: Twenty-four (85.7%) of the patients were male. The mean age was 40.25 ± 19.75 years (median, 39.5). Tube thoracotomy was performed on the right side in 18 patients (64.3%). Ultrasonography before tube removal had a PPV of 50%, NPV of 100%, sensitivity of 100%, and specificity of 96.3%. After tube removal, ultrasonography had a PPV of 100%, NPV of 96%, sensitivity of 75%, and specificity of 100%. Conclusions: The results of our comparison of chest X-ray and thoracic ultrasonography examinations performed before and after chest tube removal showed that thoracic ultrasonography was as effective as chest X-ray and can be used safely in clinics. https://cts.tgcd.org.tr/pdf.php?id=193 Thoracic ultrasonographytube thoracostomypneumothorax eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2023-03-28 8 1 58 62 10.26663/cts.2023.009 194 article Coexistence of an esophageal bronchogenic cyst and a thyroglossal duct cyst: a case report and review of literature H. Gülistan Bozdağ 1 Serdar Kalemci 2 Arife Zeybek 1 Department of Thoracic Surgery, Muğla Sıtkı Koçman University, School of Medicine, Muğla, TurkeyDepartment of Anesthesia, Kocaeli Health and Technology University, European Vocational College, Kocaeli, TurkeyAn esophageal bronchogenic cyst is a rare form of a bronchogenic cyst, a foregut developmental anomaly in embryological age. Herein, we present a case that underwent surgery for the complicated mediastinal esophageal bronchogenic cyst and a thyroglossal duct cyst, another anterior foregut anomaly at the neck. Bronchogenic cysts should be operated on as early as possible due to the complications and a detailed and radiological examination should be kept in mind for other foregut anomalies that may accompany it. To the best of our knowledge, this is the first case reported as the coexistence of two foregut anomalies. https://cts.tgcd.org.tr/pdf.php?id=194 esophageal bronchogenic cystthyroglossal duct cystforegut anomalies eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 2023-03-28 8 1 63 67 10.26663/cts.2023.0010. 195 article Fatal pulmonary sequestration supplied by the pulmonary artery in a neonate.. Omer Faruk Demir 1 Omer Onal 2 Oguzhan Turan 2 Department of Thoracic Surgery, Ankara Atatürk Sanatorium Training and Research Hospital, Ankara, TurkeyDepartment of Thoracic Surgery, Faculty of Medicine, University of Erciyes, Kayseri, TurkeyPulmonary sequestration is defined as a segment of the lung that is supplied by one or more systemic arteries and has no connection with normal bronchial structures. This rare lung condition is basically classified into two different types: extralobar sequestration (ELS), which has its own pleura, and intralobar sequestration (ILS), which is in structural continuity with normal lung tissue. While aberrant arterial supply is usually derived from the thoracic aorta, abdominal aorta, celiac artery, splenic artery, and intercostal artery, it can also rarely be provided from the subclavian, left gastric, phrenic, and coronary arteries. This patient group can be asymptomatic but may present with complaints such as cough, fever, hemoptysis, and chest pain when symptomatic. Surgery is currently the treatment of choice for such patients. Here, we present a rare and fatal case of pulmonary sequestration supplied by the pulmonary artery in a neonate who was born at 32 weeks of gestation weighing 1980 g, required mechanical ventilatory support, and was operated on while intubated on the 32nd day of birth to provide curative treatment. https://cts.tgcd.org.tr/pdf.php?id=195 pulmonary sequestrationcongenital diseasespulmonary arterial supplysurgery