Publications by authors named "Cemal Asim Kutlu"

28 Publications

  • Page 1 of 1

COVID-19 pneumonia following double-sleeve lobectomy for lung cancer.

Gen Thorac Cardiovasc Surg 2021 Mar 30;69(3):577-579. Epub 2020 Sep 30.

Department of Thoracic Surgery, Bahcesehir University School of Medicine, Merdivenköy, 23 Nisan Sok. No:17, Kadıköy, 34732, Istanbul, Turkey.

Here, we report a 54-year-old man who underwent double-sleeve left upper lobectomy for lung cancer and his postoperative course was complicated with COVID-19 pneumonia. Five days after his discharge from hospital, he was re-admitted with mild fever and bilateral multiple ground glass opacities on his chest CT. PCR testing confirmed COVID-19 infection and he was treated according to policies established by our nation's health authority. He is still receiving adjuvant chemotherapy and remains well at 3 months after the operation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11748-020-01500-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7524866PMC
March 2021

Combined Off-Pump Coronary Artery Bypass Grafting and Lung Resection in Patients with Lung Cancer Accompanied by Coronary Artery Disease.

Braz J Cardiovasc Surg 2018 Sep-Oct;33(5):483-489

Yuzuncu Yil University School of Medicine Gaziosmanpasa Hospital, Department of Thoracic Surgery, Istanbul, Turkey.

Introduction: Optimal surgical approach for the treatment of resectable lung cancer accompanied by coronary artery disease (CAD) remains a contentious issue. In this study, we present our cases that were operated simultaneously for concurrent lung cancer and CAD.

Methods: Simultaneous off-pump coronary artery bypass surgery (OPCABG) and lung resection were performed on 10 patients in our clinic due to lung cancer accompanied by CAD. Demographic features of patients, operation data and postoperative results were evaluated retrospectively.

Results: Mean patient age was 63.3 years (range 55-74). All patients were male. Six cases of squamous cell carcinoma, three of adenocarcinoma and one case of large cell carcinoma were diagnosed. Six patients had single-vessel CAD and 4 had two-vessel CAD. Three patients underwent OPCABG at first and then lung resection. The types of resections were one right pneumonectomy, three right upper lobectomies, one right lower lobectomy, three left upper lobectomies, and two left lower lobectomies. Reoperation was performed in one patient due to hemorrhage. One patient developed intraoperative contralateral tension pneumothorax. One patient died due to acute respiratory distress syndrome at the early postoperative period.

Conclusion: Simultaneous surgery is a safe and reliable option in the treatment of selected patients with concurrent CAD and operable lung cancer.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.21470/1678-9741-2018-0126DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6257540PMC
March 2019

Low protein content of drainage fluid is a good predictor for earlier chest tube removal after lobectomy.

Interact Cardiovasc Thorac Surg 2014 Oct 3;19(4):650-5. Epub 2014 Jul 3.

Department of Thoracic Surgery, Sureyyapasa Chest Diseases and Thoracic Surgery Teaching and Research Hospital, Istanbul, Turkey.

Objectives: Owing to the great absorption capability of the pleura for transudates, the protein content of draining pleural fluid may be considered as a more adequate determinant than its daily draining amount in the decision-making for earlier chest tube removal. In an a priori pilot study, we observed that the initially draining protein-rich exudate converts to a transudate quickly in most patients after lobectomies. Thus, chest tubes draining high-volume but low-protein fluids can safely be removed earlier in the absence of an air leak. This randomized study aims to investigate the validity and clinical applicability of this hypothesis as well as its influence on the timing for chest tube removal and earlier discharge after lobectomy.

Methods: Seventy-two consecutive patients undergoing straightforward lobectomy were randomized into two groups. Patients with conditions affecting postoperative drainage and with persisting air leaks beyond the third postoperative day were excluded. Drains were removed if the pleural fluid to blood protein ratio (PrRPl/B) was ≤0.5, regardless of its daily draining amount in the study arm (Group S; n = 38), and patients in the control arm (Group C; n = 34) had their tubes removed if daily drainage was ≤250 ml regardless of its protein content. Patients were discharged home immediately or the following morning after removal of the last drain. All cases were followed up regarding the development of symptomatic pleural effusions and hospital readmissions for a redrainage procedure.

Results: Demographic and clinical characteristics as well as the pattern of decrease in PrRPl/B were the same between groups. The mean PrRPl/B was 0.65 and 0.67 (95% CI = 0.60-0.69 and 0.62-0.72) on the first postoperative day, and it remarkably dropped down to 0.39 and 0.33 (95% CI = 0.33-0.45 and 0.27-0.39) on the second day in Groups S and C, respectively, and remained below 0.5 on the third day (repeated-measures of ANOVA design, post hoc 'within-group' comparison of the first postoperative day versus second and third days; P < 0.002). Eleven of 38 (29%) and 16 of 27 (59%) patients' chest tubes were, respectively, removed on the first and second postoperative days in Group S, but only two of 34 (6%) and ten of 32 (31%) patients, respectively, had their chest tubes removed in Group C (two-tailed Fisher's exact test, P = 0.02 and 0.005 for the first and the second postoperative days, respectively). On the third postoperative day, daily drainage remained ≥250 ml in 22 (65%) patients, among whom, 17 (77%) would have their chest tubes removed on the PrRPl/B value in Group C. However, drains could not be removed due to the high protein content of draining fluid despite the acceptable volume of daily drainage in only three (27%) of 11 cases in Group S (McNemar's paired proportions test, P = 0.009). The mean chest tube removal time (2.1 ± 0.9 vs 2.9 ± 1.0 days; P < 0.001) and the median hospital stay [3 days (IQR: 1-3) vs 4 days (IQR: 2-4), P < 0.003] were significantly shorter in Group S. None of the patients required a redrainage procedure due to a persistent and symptomatic pleural effusion.

Conclusions: Regardless of the daily drainage, chest tubes can safely be removed earlier than anticipated in most patients after lobectomy if the protein content of the draining fluid is low.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/icvts/ivu207DOI Listing
October 2014

[Transplantation in pulmonary hypertension].

Authors:
Cemal Asim Kutlu

Anadolu Kardiyol Derg 2010 Sep;10 Suppl 2:39-41

Süreyyapaşa Göğüs Hastaliklari, Göğüs Cerrahisi Eğitim ve Araştirma Hastanesi, Göğüs Hastaliklari Bölümü, Istanbul, Türkiye.

Pulmonary hypertension is one of the indications for lung transplantation. Recent advances on medical management of the disease have dramatically decreased the number of patients who required lung transplantation. In reported series, single or double lung transplantation have been successfully undertaken by many transplant centers. In patients, whose cardiac functions are irreversibly damaged heart-lung transplantation remains as an only option for long term survival. Transplantation should only be considered in those patients who are having optimal medical support and relatively good condition for a major operation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5152/akd.2010.129DOI Listing
September 2010

Management of bilateral pneumothoraces after talc pleurodesis and unilateral lung volume reduction surgery.

Interact Cardiovasc Thorac Surg 2010 May 1;10(5):830-2. Epub 2010 Feb 1.

Sureyyapasa Chest Diseases and Thoracic Surgery Teaching and Research Hospital, Istanbul, Turkey.

Lung volume reduction surgery (LVRS) is one of the surgical options in the treatment of advanced emphysema and may also be considered as a 'bridge' operation to lung transplantation in selected patients. Although its long-term effects are still debatable, some patients significantly benefit from this operation. Secondary spontaneous pneumothorax is one of the commonest complications of severe emphysema that necessitates an emergency drainage procedure. However, there is no satisfactory information regarding the management of this complication occurring after LVRS in the literature. This paper reports a case of bilateral pneumothorax three months after a unilateral LVRS that was performed following a contra-lateral talc pleurodesis for recurrent pneumothorax.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1510/icvts.2009.224931DOI Listing
May 2010

The role of integrated positron emission tomography and computed tomography in the assessment of nodal spread in cases with non-small cell lung cancer.

Interact Cardiovasc Thorac Surg 2010 Feb 19;10(2):200-3. Epub 2009 Nov 19.

Department of Thoracic Surgery, Sureyyapasa Chest Disease and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.

Integrated positron emission tomography and computed tomography (PET/CT) scanning has become the standard for oncologic imaging. We sought to determine the role of PET/CT in mediastinal non-small cell lung cancer staging. One hundred and twenty-seven consecutive patients were enrolled in the study where PET/CT was performed due to pathologically defined non-small cell carcinoma from a single center. They all underwent complete resection with a thoracotomy and systemic lymph node dissection (SLND) between October 2005 and January 2007. Postoperative pathology results of lymph node stations regarding the nodal spread and stage were compared with clinical stage obtained by PET/CT. The sensitivity, specificity, accuracy, negative predictive value (NPV) and positive predictive value (PPV) of PET/CT in N2 cases were determined to be 72.0%, 94.4%, 92.7%, 97.7% and 49.2%, respectively. Maximum standard uptake (SUV(max)) cut-off value for mediastinal N2 involvement in PET/CT was obtained by applying 'receiver operating characteristic' (ROC) analysis that was set to 5.2. Correct stage with PET/CT was established in 76.3% of cases. Staging of non-small cell lung cancer (NSCLC), according to the PET/CT for which we determined 97.79% NPV, we consider that thoracotomy without preoperative mediastinal invasive staging in cases of negative mediastinal involvement in PET/CT can be certainly performed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1510/icvts.2009.220392DOI Listing
February 2010

Malignant invasive thymoma in the posterior mediastinum.

Ann Thorac Surg 2009 Apr;87(4):1274-5

Department of Thoracic Surgery, Maltepe University, Istanbul, Turkey.

We present a rare case of malignant invasive thymoma (type A) arising from the posterior mediastinum. A 17-year-old girl was referred to our clinic after detection of a mass on a chest roentgenogram. Thoracoscopy showed a lobulated, pale yellowish mass located in the posterior compartment together with several foci in the lung parenchyma. The tumor and parenchymal foci were totally resected through a left minithoracotomy. Postoperative pathology revealed malignant invasive thymoma type A.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.athoracsur.2008.08.011DOI Listing
April 2009

A novel technique for bronchopleural fistula closure: an hourglass-shaped stent.

J Thorac Cardiovasc Surg 2009 Jan 29;137(1):e46-7. Epub 2008 Aug 29.

Department of Thoracic Surgery, Sureyyapasa Chest Disease and Chest Surgery Research and Training Hospital, Istanbul, Turkey.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jtcvs.2008.03.059DOI Listing
January 2009

Latero-lateral slide tracheoplasty for upper airway stenosis: an 8-year follow-up.

J Thorac Cardiovasc Surg 2009 Jan 2;137(1):e44-6. Epub 2008 Jun 2.

Department of Thoracic Surgery, Sureyyapasa Chest Diseases and Chest Surgery Teaching and Research Hospital, Istanbul, Turkey.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jtcvs.2008.03.041DOI Listing
January 2009

Video-assisted thoracoscopy for spontaneous pneumothorax after pneumonectomy.

Heart Lung Circ 2009 Aug 29;18(4):299-301. Epub 2008 May 29.

Maltepe University, Department of Thoracic Surgery, Istanbul, Turkey.

In this paper, we present 3 patients who had previously undergone pneumonectomy and then presented with a spontaneous pneumothorax. The indication for pneumonectomy was tuberculosis and NSCLC in 2 and 1 patient, respectively. The interval between the surgery and development of pneumothorax was 2, 4, and 11 years. On admission, 2 of the 3 patients were in extreme respiratory distress requiring urgent chest tube insertion. In all patients we undertook elective video-assisted thoracoscopy with complete preparation for cardiopulmonary support on the side. Bullectomy and/or diathermy ablation for apical bullae and blebs were performed concomitantly with total parietal pleurectomy. The postoperative course was uneventful in the patients, and they remain on routine follow-up for up to 6-12 months without any complaints. Our experience suggests that emphysematous changes in the remaining lung should be carefully inspected during long-term follow-up after pneumonectomy. Video-assisted thoracoscopic (VAT) pleurectomy appears to be a good option for the management of spontaneous pneumothorax only if it is performed by a dedicated multidisciplinary team with various cardiopulmonary support facilities on the side.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.hlc.2008.03.083DOI Listing
August 2009

Mediastinal mapping with positron emission tomography/computed tomography.

Ann Thorac Surg 2008 Apr;85(4):1457

Medica Imaging Centre, Sureyyapasa, Turkey.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.athoracsur.2007.07.028DOI Listing
April 2008

End-to-side bronchial anastomosis using the continuous suture technique.

J Thorac Cardiovasc Surg 2008 Mar;135(3):708-9

Department of Thoracic Surgery, Sureyyapasa Chest Diseases and Thoracic Surgery Teaching and Research Hospital, Istanbul, Turkey.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jtcvs.2007.11.015DOI Listing
March 2008

Pleural chondroma.

Asian Cardiovasc Thorac Ann 2008 Jan;16(1):90

Department of Thoracic Surgery, Sureyyapasa Thoracic & Cardiovascular Diseases Teaching Hospital, Istanbul, Turkey.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/021849230801600125DOI Listing
January 2008

Squamous cell carcinoma in a postpneumonectomy cavity.

Ann Thorac Surg 2008 Jan;85(1):333-4

Deparment of Thoracic Surgery, Sureyyapasa Chest Diseases and Chest Surgery Research and Training Hospital, Istanbul, Turkey.

A 55-year-old woman was referred to our department with the diagnosis of a bronchopleural fistula and empyema. Her medical history revealed that she had undergone a left pneumonectomy 25 years prior due to a destroyed lung associated with tuberculosis. Open drainage and a biopsy was performed because of the large mass detected on thoracic computed tomography. Postoperative pathology revealed squamous cell carcinoma.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.athoracsur.2007.08.038DOI Listing
January 2008

Management of acquired bronchobiliary fistula: 3 case reports and a literature review.

J Cardiothorac Surg 2007 Dec 3;2:52. Epub 2007 Dec 3.

Department of Thoracic Surgery, Sureyyapasa Chest Diseases and Thoracic Surgery Teaching and Research Hospital, Istanbul, Turkey.

Bronchobiliary fistula (BBF), which often presents with bilioptysis, is an abnormal communication between the bronchial system and biliary tree. It is a complication associated with a high mortality rate and requires a well-planned management strategy. Although hydatid disease is still the leading cause, extensive surgical interventions and invasive procedures of the liver have altered the profile of patients in recent decades. This paper presents 3 cases of BBF and reviews the literature regarding the treatment options generally mandated by clinical presentation and the underlying disease.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/1749-8090-2-52DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2217537PMC
December 2007

Giant carcinoid tumor mimicking pulmonary sequestration.

Ann Thorac Surg 2007 Oct;84(4):1375-6

Department of Thoracic Surgery, Sureyyapasa Chest Diseases, Chest Surgery Training and Research Hospital, Istanbul, Turkey.

A 42-year-old woman who previously underwent two consecutive thoracotomies for a lower lobe mass in her right lung was referred to our clinic for further management. Both procedures were abandoned due to excessive bleeding. Computed tomographic angiography demonstrated an infra-diaphragmatic systemic arterial supply of the mass similar to pulmonary sequestration. However the lobe had a normal venous drainage to the left atrium. Then a right lower lobectomy was undertaken through a hemi-clamshell incision, and histopathology revealed an atypical carcinoid tumor. The patient was discharged home after a satisfactory postoperative period. She still remains disease free at 14 months follow-up.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.athoracsur.2007.05.041DOI Listing
October 2007

How does definition of 'complete resection' conduct surgical management of non-small cell lung cancer?

Interact Cardiovasc Thorac Surg 2006 Oct 1;5(5):643-5. Epub 2006 Jun 1.

Department of Thoracic Surgery, Sureyyapasa Chest Diseases, Thoracic and Cardiovascular Surgery Teaching and Research Hospital, Istanbul, Turkey.

The term 'complete resection' is traditionally defined as a desired surgical procedure if a considerable survival benefit is anticipated in patients with NSCLC. From a surgeon's viewpoint, it is therefore of great importance in patient selection for thoracotomy. In this setting, one might assume that well-known definitions of Naruke and Mountain with different meanings would subsequently result in a number of conflicting influences. As a result, patient selection criteria for surgery, the role and reliability of invasive staging procedures and futile thoracotomy rates are unavoidably conducted by the definition preferred. Interpretation of the outcomes from the series with different attitudes may also be misleading. Thus, outset of the surgical management of NSCLC should be based on the definition and preferences associated with complete resection. To conclude, if we could depict a universally accepted definition of complete resection which could also easily be attributable to the existing guidelines; contribution of surgery would have been more clearly outlined among other treatment modalities. This will in turn, not only eliminate most of the confusion that a surgeon might have in his/her mind regarding the matter, but might also provide a more stronger evidence for the role of surgery in the long term.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1510/icvts.2006.130690DOI Listing
October 2006

Antibiotics are not needed during tube thoracostomy for spontaneous pneumothorax: an observational case study.

J Cardiothorac Surg 2006 Nov 13;1:43. Epub 2006 Nov 13.

Department of Thoracic Surgery, Sureyyapasa Chest and Cardiovascular Diseases Teaching and Research Hospital, Istanbul, Turkey.

Background: Usefulness of prophylactic antibiotics following tube thoracostomy remains controversial in the literature. In this study, we aimed to investigate the consequences of closed tube thoracostomy for primary spontaneous pneumothorax without the use of antibiotics.

Methods: One-hundred and nineteen patients underwent tube thoracostomy for primary spontaneous pneumothorax. None of them received prophylactic antibiotic treatment. Eight patients with prolonged air leak undergoing either video assisted thoracoscopic surgery or thoracotomy were excluded.

Results: Of the remaining 111 (104 male and 7 female), 28 (25%) patients developed some induration around the entry site of chest tube that settled without further treatment. White blood cell count was high without any other evidence of infection in 12 (11%) patients and returned to its normal levels before discharge home in all. There was also some degree of fever not lasting for more than 48 hours in 8 (7%) patients. Bacterial cultures from suspected sites did not reveal any significant growth in these patients.

Conclusion: Prophylactic antibiotic treatment seems avoidable during closed tube thoracostomy for primary spontaneous pneumothorax. This policy was not only cost-effective but also prevented our patients from detrimental properties of unnecessary antibiotic use, such as development of drug resistance and undesirable side effects.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/1749-8090-1-43DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1647271PMC
November 2006

Pleural flap to prevent lobar torsion: A novel technique.

Eur J Cardiothorac Surg 2006 Dec 18;30(6):943-4. Epub 2006 Oct 18.

Department of Thoracic Surgery, Sureyyapasa Chest and Cardiovascular Diseases Teaching and Research Hospital, Istanbul, Turkey.

Lobar torsion is reported as very rare but sometimes catastrophic complication if overlooked during the early postoperative period following a lobectomy, though it is totally preventable. In this novel technique, a piece of parietal pleural flap is harvested from the posterior wall of the chest using a hook diathermy while keeping its upper border as close to the apex as possible. Finally, distal end of the flap is secured to the upper edge of the lobe using a fine monofilament absorbable suture. This procedure not only protects the lobe from rotation but also maintains continuous expansion of the lung in the early postoperative period and may, therefore, be a good option to prevent such a serious complication in selected patients following a lobectomy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ejcts.2006.09.015DOI Listing
December 2006

[The clinical approach to the isolated traumatic hemothorax.].

Ulus Travma Acil Cerrahi Derg 2005 Oct;11(4):306-9

Yedikule Chest Diseases and Chest Surgery Research and Teaching Hospital, 3. Clinics of Surgery, Istanbul, Turkey.

Background: The aim of this study was to evaluate the systematic approach to the isolated traumatic hemothorax.

Material And Methods: The treatment modalities of 103 cases with isolated hemothorax was analyzed retrospectively between 1995 and 2003.

Results: We observed 103 isolated hemothorax cases. Eighty eight of them were male and 15 were female. The mean age was 39.4 years. The hemothorax was left sided at 41 cases, right sided at 60 cases and bilateral at 2 cases. Fifty three (51,4%) penetrating, forty nine (47,5%) blunt, and one (0,9%) iatrogenic traumas with resultant hemothoraxes were investigated. We performed tube thoracostomy in ninety nine cases. One case required an urgent thoracotomy. We operated twenty one cases and thoracoscopy was performed for six of them. The conservative approach was sufficient for eighty two patients. Mortality was seen in only one case (0,9%), because of a multiorgan failure. The mean rate of the hospital stay was 8,7 days. During operation, we explored for major pulmonary and systemic artery injury.

Conclusions: The decision of exploration or conservative treatment must be made according to the patient stabilization status after the thoracostomy tube insertion. Thoracoscopic evacuation of blood clots from hemothoraxes must be attempted during the early posttraumatic stages, especially in cases refractory to classical drainage methods.
View Article and Find Full Text PDF

Download full-text PDF

Source
October 2005

Decision-making for lung resection in patients with empyema and collapsed lung due to tuberculosis.

J Thorac Cardiovasc Surg 2005 Jul;130(1):131-5

Department of Thoracic Surgery, Yedikule Hospital for Chest Diseases and Chest Surgery, Jakki Yelen Cad. 17/12, Sişli 80200, Istanbul, Turkey.

Objective: Collapsed lung with associated empyema is a different clinical entity from destroyed lung . A low perfusion rate of the diseased lung is usually considered an indication for pneumonectomy in patients undergoing thoracotomy for tuberculosis. Such a criterion may not adequately reflect the functional capacity of the underlying parenchyma when the lung is collapsed.

Methods: One hundred twenty-seven patients underwent thoracotomy for tuberculosis at our hospital between 1998 and 2003. Among these, 5 (4%) patients who had a collapsed lung for more than 3 months and pleural infection were the subjects of this study. Surgery was considered after at least a 3-month course of regular antituberculous treatment. Despite no perfusions in 2 patients and 8%, 10%, and 15% perfusion rates for the remaining 3 patients, decortication alone was intentionally performed, and any kind of resectional operation was avoided.

Results: The lung gradually filled the hemithorax between 5 and 12 days after surgery in 4 patients. The remaining patient required a thoracomyoplasty 8 weeks after the initial operation. Repeated perfusion scans 1 and 2 years after decortication continued to show no perfusion in patients who had had no preoperative perfusion. All patients were symptom free on regular follow-up between 10 months and 4.5 years.

Conclusions: It seems that the outcome is unpredictable in terms of lung expansion after decortication, which is a relatively simple procedure compared with other surgical options. We think that the risk of rethoracotomy is acceptable, considering the devastating complications and high mortality rates of resectional surgery in the treatment of such patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jtcvs.2004.08.040DOI Listing
July 2005

Carcinoma in situ from the view of complete resection.

Lung Cancer 2004 Dec;46(3):383-5

World Health Organisation (WHO) defined three types of preinvasive epithelial lesions, one of which is preinvasive bronchial squamous lesions consisting of dysplasia and carcinoma in situ (CIS). It is not clear whether or not CIS at the bronchial resection margin is to be considered as incomplete resection in the literature. Follow-up data of such patients using autofluorescence bronchoscopy proved that CIS regresses without further treatment in significant number of patients. It is therefore reasonable to accept any reported CIS lesion on frozen-section examination as complete clearance of the tumor and thus further resection may not be warranted.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.lungcan.2004.05.008DOI Listing
December 2004

[Urgent partial sternotomy for the treatment of iatrogenic vascular injury to the thoracic outlet: a report of two cases].

Ulus Travma Acil Cerrahi Derg 2004 Jul;10(3):205-7

Department of General Surgery, Yedikule Teaching Hospital for Chest Diseases and Thoracic Surgery, Istanbul, Turkey.

Two patients underwent surgery for iatrogenic vascular injuries at the thoracic outlet. Injuries occurred during mediastinoscopy in one patient (male, aged 60 years) and removal of a Portovac catheter in the other (female, aged 49 years). We performed partial sternotomy in both cases to expose the proximal of a. carotis communis and vena cava superior, respectively. After distal and proximal control of the vessels, the injured vessel was primarily sutured in the first patient, and the tip of the catheter was removed through a venotomy incision in the latter. No postoperative complications occurred in both patients. Partial sternotomy incision provides an appropriate and quick access to the injured vessels and surrounding structures at the thoracic outlet.
View Article and Find Full Text PDF

Download full-text PDF

Source
July 2004

Late complication of extended cervical mediastinoscopy.

Can J Surg 2004 Jun;47(3):223-4

Yedikule Hospital for Chest Disease and Thoracic Surgery, Istanbul, Turkey.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3211823PMC
June 2004

Acute lung injury and acute respiratory distress syndrome following pneumonectomy.

Authors:
Cemal Asim Kutlu

Eur J Cardiothorac Surg 2003 Sep;24(3):469; author reply 469-70

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/s1010-7940(03)00386-5DOI Listing
September 2003

Surgical treatment of pulmonary hydatid cysts: is capitonnage necessary?

Ann Thorac Surg 2002 Jul;74(1):191-5

Department of Thoracic Surgery, Yedikule Hospital for Chest Disease and Thoracic Surgery, Zeytinburnu, Istanbul, Turkey.

Background: Hydatid disease of the lung caused by Echinococcus granulosus is frequently encountered in Mediterranean countries. The ideal surgical method for treating this disease is still unknown.

Methods: Between 1994 and 2001, 71 patients with pulmonary hydatid cysts were treated surgically. There were 41 male and 30 female patients with a mean age of 30.2 years (range, 5 to 70 years). Cystotomy and closure of bronchial openings were performed in all patients. Obliteration of the residual cavity by imbricating sutures from within (capitonnage) was achieved in 39 patients (group 1). There were 34 patients with intact cysts and 37 patients with at least one complicated cyst. The average diameter of the cysts was 6.4 cm, and the mean number of cysts per patient was 1.4. The surgical outcome was assessed in group 1 patients and in patients who had undergone closure of bronchial openings without capitonnage (group 2; n = 32). The groups were comparable in regard to clinical characteristics.

Results: There was no mortality. The total hospitalization time (mean +/- standard error of the mean) was 5.0 +/- 5.0 days for group 1 and 5.9 +/- 6.9 days for group 2 (p = 0.91). Stay in the intensive care unit was 1.64 +/- 1.22 days in group 1 and 1.60 +/- 1.52 days in group 2 (p = 0.90). The duration of air leak was 2.56 +/- 4.73 days in group 1 and 2.38 +/- 4.74 days in group 2 (p = 0.87). There was no significant difference between groups in the development of empyema (1 patient in group 2 only) and prolonged air leak (5 patients in group 1 and 4 in group 2). There was also no significant difference in the rate of recurrence (3 patients in group 1 only).

Conclusions: We conclude that capitonnage provides no advantage in operations for pulmonary hydatid cysts.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/s0003-4975(02)03643-3DOI Listing
July 2002

Modified slide tracheoplasty for the management of tracheobroncopathia osteochondroplastica.

Eur J Cardiothorac Surg 2002 Jan;21(1):140-2

Department of Surgery, Yedikule Chest Surgery Centre, Saydam Sok. 20/1, Levent 80600, Istanbul, Turkey.

In this paper we report a case with tracheobroncopathia osteochondroplastica presented with a long segmental tracheal stenosis. Modified slide tracheoplasty was undertaken for the management of the stenosis. In our modification, the oblique tracheal cut was performed from left to right to widen the latero-lateral dimension of tracheal lumen. We assume that preservation of the lateral longitudinal vessels of the trachea results in better healing at the suture line. Postoperative course was uneventful and the patient remains on clinical follow-up for 15 months without any problem.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/s1010-7940(01)01080-6DOI Listing
January 2002