Serpil Sevinc

An unusual emergency condition in pregnancy: pneumothorax. Case series and review of the literature

The term ‘pneumothorax’ was first coined by Itard and then Laennec in 1803 and 1819, respectively, and refers to air in the pleural cavity [1]. Primary spontaneous pneumothorax usually occurs in young healthy male population. Most common pathology is the rupture of an apical subpleural bleb [2]. Secondary spontaneous pneumothorax is associated with primary lung pathology, and the most common cause is chronic obstructive pulmonary disease [2]. Pneumothorax is rare during pregnancy [3]. The suitable birth method and the management are also challenging. In this study, we present the largest series reported to date of the management of pneumothorax in pregnancy, together with a review of the relevant literature. Five patients treated for spontaneous pneumothorax occurred during pregnancy or as a complication of vaginal delivery are presented. Case reports

Prediction of postoperative pulmonary complications in lung cancer surgery: Is proportion of emphysema important?

OBJECTIVE: Preoperative evaluation in thoracic surgery is highly important to determine surgical suitability, estimate postoperative pulmonary complications, and for patient follow-up. However, there is neither a definite explanation about the possible complications nor a gold standard method. MATERIALS AND METHODS: In this study, 297 patients undergoing anatomic lung resection for primary lung carcinoma were retrospectively evaluated. To form a homogeneous group, all factors that increase the rate of pulmonary complication were excluded except emphysema. Patients who did not meet these criteria were removed from the study. The study continued with 104 other patients. This patient subgroup was divided into groups according to Goddard Classification– Score (GdCS). The correlation between GdCS and other variables was statistically investigated. RESULTS: According to the GdCS of 104 patients, the patient distribution was as follows: 10 patients (9.6%) were G0, 28 patients (26.9%) were G1, 42 patients (40.4%) were G2, 22 patients (21.2%) were G3, and 2 patients (1.9%) were G4. Thirty-five (33.6%) of 104 patients had a pulmonary complication during the postoperative follow-up. The average drainage time was longer for higher GdCS scores, and the rate of exposition to a pulmonary complication was higher in the patients with increased GdCS. CONCLUSION: In view of these findings, Goddards scoring for chronic obstructive pulmonary disease-emphysema patients was considered likely to be an indicative parameter in the preoperative evaluation and postoperative follow-up of thoracic surgery patients.

Prolonged Air Leakage in Secondary Spontaneous Pneumothorax: Is Proportion of Emphysema Important?

Prolonged air leakage is the most common complication that can cause severe problems in cases of secondary spontaneous pneumothorax (SSP). The purpose of this study was to explore whether Goddard Classification Score (GCS) can be a marker of prolonged air leakage, particularly during the post‐operative period, for patients with emphysema.

Video-assisted thoracoscopic surgery (VATS) right upper lobectomy for non-small-cell lung cancer with an azygos lobe.

Although it is not a pathologically significant entity, cases of azygos lobe (AL) are interesting due to the difficulty of performing video-assisted thoracoscopic surgery (VATS) procedures in the affected patients and the presence of a congenital malformation. Currently, videothoracoscopic surgery has advanced to such a level that most thoracic procedures can be performed with video assistance. However, some technical difficulties may arise in cases with anatomical anomalies such as AL. This report presents the case of a patient with an azygos lobe who underwent videothoracoscopic lung resection due to the presence of non-small-cell lung carcinoma in the upper lobe of the right lung.

Sleeve lung resection for non-small cell lung cancer after induction therapy: A safe method

Objective: Sleeve lung resections for patients with non-small cell lung cancer (NSCLC) after induction therapy may cause increase in mortality and morbidity. Cases which went thorough sleeve resection are divided into two groups and reviewed retrospectively. Group A is cases without induction therapy and Group B is cases operated after induction therapy. Methods: The patients with non-small cell lung cancer went thorough sleeve resection between 2005 and 2015 are evaluated retrospectively. In Group A 62 (75.6%) and in Group B 20 (24.4%) patients operated with sleeve lung resection are included in this study. Demographic data, type of operation, postoperative mortality, morbidity and survival rate is compared and analyzed. Results: Male population of Group A and Group B is 94% and 95% with the mean age of 59.8±9.5 and 56.3±9.0 respectively. Right upper sleeve lobectomy was most commonly performed in both groups (Group A 69%, Group B 75%). Technique of bronchial anastomosis was continuous saturation for all cases. In Group A 81% and in Group B 91% of the cases, the line of anastomosis supported with pleural tissue. Postoperative complications are detected as 20 (%32.2) in Group A and 6 (%30) in Group B. Intraoperative mortality was 2 in Group A (3.2%). The mean follow-up was 76 months for Group A and 70 months for Group B with a five year survival rate of 61.3% and 60.5% respectively. There was no significant difference statistically. Conclusions: The morbidity and mortality incidences of sleeve resection were similar in NSCLC patients with or without induction therapy. Sleeve resection after induction therapy could be counted as a safe operative technique.

Elastofibroma dorsi: A rare tumor of chest wall

Objective: Elastofibroma dorsi (ED) is a benign solid and rare connective tissue tumor. It has a slow growth rate and most commonly it is placed under the scapula. Generally it is detected unilaterally but in 10% of cases bilateral placement is found. In this study, it is aimed to analyze the clinical specialties and management of treatments with the use of former studies in literature. Methods: Mean age in this study is 57.2 (37-71). 12 female and 6 male patients are included. Most frequent complaint was back pain. ED is found on the right side in 9 patients, on the left side in 7 patients and bilateral placement in two patients. It is detected as connective tissue lesion under the scapula with the help of computerized tomography or MRI. In 8 cases it is found simultaneously with malignancy (5 lung cancers, 3 metastatic lung cancers) and ED excision was made with proper lung resection. Pathological results were reported as elastofibroma dorsi for all lesions. Results: Because ED is a rare condition and difficult to identify during physical examination; it must be included in differential diagnosis. Also most common and advised method of treatment is total surgical resection.

Fistulization of hydatid mediastinal cyst to the anterior thoracic wall

Echinococcosis/hydatidosis is a frequent parasitic and zoonotic disease in the population engaged with agriculture and stockbreeding. It is seen most frequently in the liver and lung in adults. Mediastinal location of the disease is very rare. In this study we aimed to present a 31-year-old man having hydatid disease in the anterior mediastinum fistulated to the skin in the right subclavicular region, together with the literature. The patient was operated on through a partial sternotomy incision, and excision of the cyst and the fistula was performed.

Fistulization of hydatid mediastinal cyst to the anterior thoracic wall: case report.

Echinococcosis/hydatidosis is a frequent parasitic and zoonotic disease in the population engaged with agriculture and stockbreeding. It is seen most frequently in the liver and lung in adults. Mediastinal location of the disease is very rare. In this study we aimed to present a 31-year-old man having hydatid disease in the anterior mediastinum fistulated to the skin in the right subclavicular region, together with the literature. The patient was operated on through a partial sternotomy incision, and excision of the cyst and the fistula was performed.

CASE REPORT Fistulization of hydatid mediastinal cyst to the anterior thoracic wall: case report

Echinococcosis/hydatidosis is a frequent parasitic and zoonotic disease in the population engaged with agriculture and stockbreeding. It is seen most frequently in the liver and lung in adults. Mediastinal location of the disease is very rare. In this study we aimed to present a 31-year-old man having hydatid disease in the anterior mediastinum fistulated to the skin in the right subclavicular region, together with the literature. The patient was operated on through a partial sternotomy incision, and excision of the cyst and the fistula was performed.

Contralateral pneumothorax after pneumonectomy

Contralateral pneumothorax after pneumonectomy is a rare critical condition with high morbidity and mortality rates. In this study, a case of contralateral pneumothorax in the postoperative period which occured soon after left pneumonectomy for non-small cell lung carcinoma is presented with the related literature.