Clinical evaluation of intrapericardial pneumonectomies applied in non-small cell lung cancer

eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 0000-00-00 10 1 1 7 10.26663/cts.2025.001 247 article Clinical evaluation of intrapericardial pneumonectomies applied in non-small cell lung cancer Bahar Ağaoğlu Şanlı 1 Volkan Karaçam 2 Fatma Mutlu 2 Berfin Kızıldağ Aktaş 2 Dündar Özalp Karabay 3 Aydın Şanlı 2 Department of Thoracic Surgery, Izmir City Hospital, İzmir, TurkeyDepartment of Thoracic Surgery, Faculty of Medicine, Dokuz Eylül University, İzmir, TurkeyDepartment of Cardiovascular Surgery, Faculty of Medicine, Dokuz Eylül University, İzmir, TurkeyBackground: In non-small cell lung cancer (NSCLC), pulmonary artery, pulmonary vein, pericardium, or atrium involvement is not considered as an inoperability criterion, although it negatively affects the disease prognosis. In these patients accepted as local disease, intrapericardial pneumonectomy can be performed to leave a safe surgical margin. In this study, patients diagnosed with NSCLC who underwent intrapericardial pneumonectomy were subjected to clinical evaluation. Materials and Methods: We retrospectively evaluated NSCLC patients who were diagnosed as T3- T4 and N0-N1 with preoperative invasive staging, who responded to neoadjuvant treatment for T4N2 disease, or who were considered persistent N2 and underwent intrapericardial pneumonectomy for intrapericardial pulmonary artery (PA) and pulmonary vein (PV) invasion. Results: Thirteen patients underwent intrapericardial left pneumonectomy and 7 patients underwent intrapericardial right pneumonectomy. The median overall survival (OS) value of the patients included in the study was found to be 22.3 months, 95% CI (Confidence Interval) (5.6-39.0). The 1-month postoperative survival rate was 90%, the 6-month survival rate was 88%, the 1-year survival rate was 84%, and the 3-year survival rate was 35%. The assessment of the 5-year survival rate was conducted among 13 cases who successfully completed the 5-year follow-up period, revealing a median OS of 35,0 months and a 5-year survival rate of 23%. Patients who did not receive pre-op neoadjuvant therapy, patients who underwent right pneumonectomy and patients with squamous histopathology had a lower median OS and higher HRs for mortality. Conclusions: In NSCLC patients who underwent intrapericardial pneumonectomy, right pneumonectomy, lymph node involvement, lymphovascular invasion, and lack of neoadjuvant treatment were evaluated as poor prognostic factors. https://cts.tgcd.org.tr/pdf.php?id=247 intrapericardial pneumonectomynon-small cell lung cancerthoracic surgery eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 0000-00-00 10 1 8 14 10.26663/cts.2025.002 248 article Clinical and diagnostic significance of supraclavicular lymph node biopsy Merve Bıyıklı 1 Murat Kılıç 1 Department of Thoracic Surgery, İnönü University Turgut Özal Medical Center, Malatya, TurkeyBackground: Lymphadenopathy occurs due to the proliferation of inflammatory or neoplastic cells within the lymph node or the invasion of the lymph node. Surgical biopsy of supraclavicular lymph nodes in patients with suspected malignancy or lymphadenopathy serves as a valuable tool for determining the treatment plan and cell type. Today, supraclavicular lymph node excision holds an important place in tissue sampling as it is a minimally invasive procedure associated with low morbidity and acceptable diagnostic yield. Moreover, these minimally invasive procedures can be more advantageous as they provide more tissue compared to needle biopsy, with fewer complications. Materials and Methods: In this study, we reviewed our experience with supraclavicular excisional lymph node biopsy in patients suspected of having supraclavicular lymph node metastasis. Detailed medical histories were obtained for all cases, and comprehensive general physical and systemic examinations were performed. Results: The aim of the study is to evaluate the diagnostic utility, accuracy, and impact on survival of excisional lymph node biopsy in the diagnosis of suspected supraclavicular lymph node metastasis based on histopathological findings. We conclude that excisional biopsy is valuable for accurate diagnosis and appropriate treatment planning when supraclavicular lymph nodes are detected in radiological examinations, even if they are not palpable. Conclusions: Excisional biopsy is a method that can be safely performed in palpable peripheral lymphadenopathies and does not carry a significant risk of morbidity. It is believed that excisional biopsy of the supraclavicular lymph node has the potential to shorten the time from presentation to diagnosis, thereby saving time and costs in the invasive staging process. https://cts.tgcd.org.tr/pdf.php?id=248 supraclavicularlymph nodeexcisional biopsymetastasis eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 0000-00-00 10 1 15 18 10.26663/cts.2025.003 249 article A rare esophageal foreign body found in a patient with mental retardation: safety needle Sami Karapolat 1 Omer Topaloglu 2 Alaaddin Buran 1 Department of Thoracic Surgery, Karadeniz Technical University Faculty of Medicine, Trabzon, TurkeyDepartment of Thoracic Surgery, Recep Tayyip Erdoğan University Faculty of Medicine, Rize, TuEsophageal foreign bodies are emergency cases mostly involving intellectually disabled individuals. An 18-year-old intellectually disabled female patient presented to our clinic complaining about irritability, dysphagia and hypersalivation. Her posteroanterior chest x-ray showed an opacity caused by a safety needle. In her rigid esophagoscopy, a safety needle with an open point was seen, which was localized in the first constriction of her oesophagus. The open sharp point of the safety needle was pulled towards the lumen, held with forceps, bent from its tip towards the clasp, and the pin was removed without any complications. The patient was allowed oral intake of food next day and was discharged without any problems. Esophageal foreign bodies seen in patients with mental retardation may be atypical non-food foreign bodies. Careful endoscopic removal of particularly sharp-pointed objects such as safety needle will prevent complications. https://cts.tgcd.org.tr/pdf.php?id=249 foreign bodyesophagusrigid esophagoscopy eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 0000-00-00 10 1 19 21 10.26663/cts.2025.004 250 article Endobronchial management of a rare complication associated with pleural catheter Selcuk Gurz 1 Necmiye Gul Temel 2 Ayşen Sengul 1 Department of Thoracic Surgery Ondokuz Mayıs University, Faculty of Medicine, Samsun, TurkeyDepartment of Thoracic Surgery, Samsun University, Faculty of Medicine, Samsun, TurkeyCatheter thoracostomy is a common method of pleural effusion; however, complications can occur. This case study describes a rare complication where the catheter extended from the bronchial system into the trachea, with management performed through an endobronchial approach. During catheter thoracostomy, insertion of the catheter under ultrasound guidance at the site of the highest pleural fluid accumulation minimized complications. With hemoptysis, selective bronchial block application with a balloon catheter is a reliable method for treatment. https://cts.tgcd.org.tr/pdf.php?id=250 cathetercomplicationpleural effusion eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 0000-00-00 10 1 22 24 10.26663/cts.2025.005 251 article Branchial cleft cyst with subcarinal and posteroinferior mediastinal localization: what would be your most likely interpretation based on preoperative images? Rasih Yazkan 1 Suleyman Emre Akin 1 Hasan Emre Yildirim 1 Busra Karakas 2 Hasan Ekrem Camas 1 Department of Thoracic Surgery, Faculty of Medicine, Suleyman Demirel University, Isparta, TurkeyDepartment of Thoracic Pathology, Faculty of Medicine, Suleyman Demirel University, Isparta, TurkBranchial cleft cysts are common head and neck lesions in children; however, their occurrence in the mediastinum, particularly at lower levels, is extremely rare. When located in the posterior mediastinum, these cysts may cause symptoms such as dysphagia and dyspnea due to compressive effects. Therefore, although uncommon, mediastinal localization should be considered in the differential diagnosis of cystic mediastinal masses. https://cts.tgcd.org.tr/pdf.php?id=251 mediastinal cystbranchial cleft cystimages eng Turkish Society of Thoracic Surgery Current Thoracic Surgery 2548-0316 0000-00-00 10 1 25 28 10.26663/cts.2025.006 252 article Advanced age chest wall hamartoma and typical carcinoid tumor: a very rare coexistence Rasih Yazkan 1 Muhammed Samet Ozdemir 1 Suleyman Emre Akın 1 Hasan Ekrem Camas 1 Özgecan Afacan 2 Department of Thoracic Surgery, Faculty of Medicine, Suleyman Demirel University, Isparta, TurkeyDepartment of Thoracic Pathology, Faculty of Medicine, Suleyman Demirel University, Isparta, TurkeyChest wall hamartoma is a rare pathology in adults, usually presenting at birth or in early infancy. They may present with compression symptoms depending on their localization. Although it is rare to be recognized with late-onset symptoms in adults, it requires differential diagnosis with other malignant and benign tumors of the chest wall. Histologically, carcinoid tumors are classified into two subgroups as typical and atypical. Atypical carcinoids have an aggressive course and have the potential for metastasis and recurrence. Typical carcinoids are low grade malignancies. Although the prognosis of carcinoid tumors after surgical resection is reported to be good, a variable prognosis has been reported. The size of the tumor, histological type, nodal involvement, and distant metastasis are thought to affect the prognosis. Herein we present an elderly patient with chest wall hamartoma and typical carcinoid, in the light of literature. https://cts.tgcd.org.tr/pdf.php?id=252 chest wallcarcinoid tumorhamartoma