Onder Kavurmaci

İdiyopatik mediastinal fibrozis

Halsizlik ve kilo kaybi sikayetleri ile tetkik edilen 66 yasindaki erkek hastanin gogus bilgisayarli tomografisinde, anterior mediastende, 10 cm boyutlu kitlesel lezyon saptandi. Tanisal amacli operasyona alinan hastaya, sol hemitorakstan videotorakoskopik biyopsi uygulandi. Histopatolojik inceleme sonucunda kesin bir taniya varilamamasi uzerine ayni islem ikinci bir operasyon ile sag hemitoraksa yonelik uygulandi. Yine tani elde edilememesi uzerine hasta tekrar operasyona alinarak mediastinotomi uygulandi. Tum histopatolojik inceleme sonuclari ve klinik bulgulari ile birlikte degerlendirilen olguda idiyopatik mediastinal fibrozis tanisina ulasildi. (MF) olgulari radyolojik olarak malign mediasten tumorleri ile benzerlik gosterebilir ve ayirici tani yapilmasi buyuk onem arz etmektedir.

The prognostic value of carcinoembryonic antigen levels in blood and intraoperative pleural lavage fluid in non-small-cell lung cancer

Introduction There is no specific marker for lung cancer, but, in some lung cancer types, carcinoembryonic antigen (CEA) can reach high levels in the blood and pleural fluid. Aim This study investigated the relationship of CEA levels in blood (CEAB) and intraoperative pleural lavage fluid (CEAP) in non-small-cell lung cancer (NSCLC) with the type, stage, and extent of lung cancer. Material and methods A total of 50 patients, who underwent surgery at our clinic due to NSCLC (group I) or benign lung pathology (group II), were assessed. For this prospectively designed study, 25 consecutive patients were included in each group, and their CEAB and CEAP levels were investigated. Results When the levels of CEAP were compared, the average value of group I (1.35 ng/ml) was significantly higher than the average value of group II (0.04 ng/ml) (p = 0.027). When CEA levels were examined separately, and average values were taken according to surgical pathology results, both CEAB and CEAP levels of adenocarcinoma patients were found to be higher than those of the other groups. This difference was only significant for the level of CEAP (p = 0.026). Conclusions Although the average CEAB levels of patients with adenocarcinoma were higher than those of patients with other histopathological types, this difference was not statistically significant. However, we found that CEAP levels were significantly higher in patients with adenocarcinoma. These results have led us to consider that CEAP elevation is a more sensitive marker than the elevation of CEAB.

Is the Risk of Postoperative Atrial Fibrillation Predictable in Patients Undergoing Surgery Due to Primary Lung Cancer

BACKGROUND Atrial fibrillation (AF) is a type of cardiac arrhythmia which is commonly seen following lung resection. There is currently no algorithm which can predict which patients will develop postoperative AF (PAF). The present study aims to identify the risk factors for the development of PAF and high-risk patients with PAF along with multiple risk factors. MATERIALS AND METHODS A total of 887 patients, who underwent lung resection due to primary lung malignancy at our clinic between January 2000 and December 2016, were retrospectively analysed. Group 1 (n=44) consisted of the patients who developed PAF and Group 2 (n=843) consisted of the patients without PAF. Age and sex of the patients, comorbidities, previous diagnosis of malignancy, and surgery-related variables were evaluated using statistical methods for their effects on the development of AF. A score was assigned to each identified risk factor and scores of the patients were calculated. The risk of developing PAF was evaluated based on this scoring system. RESULTS We found that ≥60 years of age and the diagnosis of chronic obstructive pulmonary disease (COPD) were significant risk factors for the development of PAF (p<0.05). The risk of developing PAF was not associated with male sex, previous history of malignancy, presence of comorbidities, and the type of surgery applied. There was an increased risk of AF with increasing scores in the risk calculation system. CONCLUSION Advanced age and the presence of COPD were found to be associated with an increased risk of developing PAF. In addition we found a significant increase in the risk of developing PAF in the presence of multiple factors, although they did not reach statistical significance alone.