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Öğe Air leak grading in primary spontaneous pneumothorax is useful to predict prolonged air leak(2024) Yazgan, Serkan; Yazgan, Serkan; Yoldaş, Banu; Çelik, Ezgi Çimen; Gürsoy, Soner; Şanlı, Bahar AğaoğluBackground: Results of studies to predict prolonged air leak (PAL) after chest tube administration in primary spontaneous pneumothorax (PSP) have been inconsistent and have limited use. In this study, in which we used a scale grading the amount of air leak, we investigated the correlation between the scale and the duration of air leak and its potential to be a predictor of PAL. Materials and Methods: PSP cases (n = 140) requiring chest tube insertion between April 2017 and December 2021 were prospectively studied. We graded the air leak in these patients using a 5-grade scale. We designed eight 'SUM' variants using air leak grades within the first five days after chest tube administration. In this study, PAL was defined as an air leak lasting more than five days. Results: Total PAL occurrence was 29 (20.7%) in this cohort with a mean age of 26.6±8.14 years. Correlation analyses showed that each SUM variable correlated highly with the duration of the air leak, and SUM7to8, the sum of two consecutive values of air leak grades on the fourth day, was proved to be the most powerful predictor. When SUM7to8 ≥ 1, PAL can be predicted with a positive and negative predictive value of 69% and 100%, respectively. The sensitivity and specificity are 100% and 88.3%, respectively. Conclusions: This simple new method of predicting PAL using SUM7to8 has shown that the amount of air leak is a powerful independent predictor of PAL. Therefore, grading air leakage in PSP is a useful method to predict PAL.Öğe Chest wall resection for lung cancer: A 12-year experience in a single center(European Respiratory Soc Journals Ltd, 2021) Üçvet, Ahmet; Batıhan, Güntug; Yazgan, Serkan; Ceylan, Kenan Can; Gürsoy, Soner; Kaya, Şeyda Örs[Abstract Not Available]Öğe The impact of dissection of station 9 on survival and the necessity of pulmonary ligament division during upper lobectomy for lung cancer(Taylor & Francis Ltd, 2021) Yazgan, Serkan; Ücvet, Ahmet; Türk, Yunus; Gürsoy, SonerBackground We conducted this study to investigate the need for dissection of station 9 lymph nodes during upper lobectomy for non-small-cell lung cancer (NSCLC) and to find out the operative results of inferior pulmonary ligament division. Methods A total of 840 patients who underwent upper lobectomy for NSCLC between January 2007 and June 2020 were evaluated retrospectively. The patients were separated into two groups - those having undergone lymph node dissection of station 9 and inferior pulmonary ligament dissection (Group I) and those who did not (Group II). In these groups, the prognostic value of station 9 lymph nodes and postoperative effects (drainage time, prolonged air leak, dead space and length of hospital stay) of ligament division or preservation were analyzed. Results The number of patients with station 9 lymph node metastasis was only one (0.1%) and that was multi-station pN2 disease. Station 9 lymph nodes were found in 675 (80.4%) patients, while 22 (2.6%) patients had no lymph nodes in the dissected material. In the other 143 (17%) patients, the inferior pulmonary ligament and station 9 were not dissected. While 5-year survival was 64.9% in 697 patients of Group I, it was 61.3% in 143 patients of Group II (p = 0.56). There was no statistically significant difference between the groups in postoperative effects of ligament division or preservation. Conclusions In upper lobectomies, status of station 9 does not have a significant impact on patients' survival and lymph node staging. Additionally, preservation or division of the inferior pulmonary ligament has no significant advantage or disadvantage.Öğe Iterative surgical resections in non-small cell lung cancer(Termedia Publishing House Ltd, 2021) Üçvet, Ahmet; Yazgan, Serkan; Samancılar, Özgür; Gürsoy, Soner; Erbaycu, Ahmet Emin; Kömürcüoğlu, BernaIntroduction: We reviewed our surgical preferences and the prognosis for recurrent and second primary tumors in patients who underwent surgical treatment for non-small cell lung carcinoma (NSCLC). Aim: We report our experience with patients undergoing iterative pulmonary resection for lung cancer. Material and methods: Among patients who underwent anatomical resection for primary NSCLC, those who underwent a second surgical resection between 2010 and 2020 due to recurrent or second primary tumor were included in the study. Operative mortality, survival, and prognostic factors were investigated. Results: In total, 77 cases were included: 31 (40.3%) underwent the second resection for the recurrent disease and 46 (59.7%) underwent the second resection for the second primary tumor. Postoperative mortality occurred in 8 (10.4%) patients. All patients with postoperative mortality were in the group that underwent thoracotomy in both surgical procedures. The 5-year survival rate was 46.5%. The 5-year survival of those operated on for recurrent or second primary tumor was 32.8% and 51.1%, respectively (p = 0.81). The 5-year survival rate was 68.8% in patients under the age of 60 years, while it was 27.5% in patients aged 60 years and above (p = 0.004). The 5-year survival was 21.8% in patients with an interval of 36 months or less between two operations and 72.2% in those with a longer interval (p = 0.028). Conclusions: Our study shows that survival results similar to or better than primary NSCLC surgery can be obtained with lower mortality if more limited resections are performed via video-assisted thoracic surgery, especially in young patients. In addition, the prognosis is better in patients with an interval of more than 36 months between two operations.Öğe Iterative surgical resections in non-small cell lung carcinoma(European Respiratory Soc Journals Ltd, 2021) Üçvet, Ahmet; Yazgan, Serkan; Samancılar, Özgür; Gürsoy, Soner; Erbaycu, Ahmet Emin; Kömürcüoğlu, Berna[Abstract Not Available]Öğe Pleural complications and chest tube follow-up in patients with COVID-19(European Respiratory Soc Journals Ltd, 2021) Ceylan, Kenan Can; Batıhan, Güntuğ; Yazgan, Serkan; Gürsoy, Soner; Kıraklı, Sami Cenk; Ataman, SenaIntroduction: It was reported that the SARS-CoV-2 virus primarily affects the lower respiratory system and various pleural complications may accompany coronavirus disease 2019 (COVID-19). Aims and objectives: We aimed to present the characteristics of patients who underwent a chest tube insertion due to pleural complications during COVID-19 disease and the technique we developed to minimize possible contamination from the underwater seal bottle in these patients. Methods: We retrospectively examined the characteristics of patients who developed pleural complications during COVID-19 disease in our hospital between March 11 and May 15, 2020. Results: Between March 11 and May 15, 2020, a total of 342 patients were hospitalized with the diagnosis of COVID-19. Tube thoracostomy was performed in 13 (%3.8) of these patients due to pleural complications. Indications for chest tube placement were: Pneumothorax in six (%46.1) patients, pleural effusion in three (%23) patients, empyema in three (%23) patients, and hemothorax in one patient (%7.6). A high-efficiency particulate air (HEPA) viral filter mounted two bottle technique was used in the follow-up of chest drainsÖğe Results of surgery after neoadjuvant treatment for non-small cell lung cancer(2024) Yagci, Tarik; Ucvet, Ahmet; Yazgan, Serkan; Samancilar, Ozgur; Gürsoy, SonerBackground: In locally advanced non-small cell lung cancer, survival rates achieved only by surgical treatment are unfortunately lower than expected. It’s believed that survival rates can be raised by multimodal therapies including surgery. The purpose of the study is to analyse the results of surgical treatment in patients who underwent surgical resection after neoadjuvant treatment due to locally advanced non-small cell lung cancer. Materials and Methods: The patients who underwent lobectomy or pneumonectomy after neoadjuvant chemotherapy and/or radiotherapy due to locally advanced non-small cell lung cancer were included in this study. The patients were divided into two groups according to oncological treatment indication. Group A included patients who received neoadjuvant therapy due to T disease and group B due to N2 disease. The surgical interventions, pathological results, postoperative complications, mortality, recurrence, 5-year disease-free survival, and overall survival were analysed. Results: 154 patients were included in the study. 142 were men and 12 were women with a mean age of 57.7 ± 16.97 (between 35 and 77). Ninety-six patients received induction therapy due to T disease, and 58 patients due to N2 disease. Pneumonectomy was performed on 41 patients, lobectomy was performed on 113 patients (18 bronchial sleeve resection). Histopathologic results revealed squamous cell carcinoma in 96 (62.3%), adenocarcinoma in 52 (33.8) and large cell carcinoma in 6 (3.9%) patients. A complete response to neoadjuvant treatment was achieved in 19 (Group A, n = 15, group B, n = 4) patients. Postoperative pathologic results showed mediastinal lymph node metastasis in 13 (13.6%) patients in group A and, in 28 (48.3%) patients in group B, which is statistically significant. Prolonged air leak was the most common complication in both groups. Operative mortality was observed in 4 (2.6%) patients. In 82 patients 47 in group A and 35 in group B recurrence or metastasis were detected during the follow-up. 5-year disease-free survival rate was 43.2% in group A and 38.4% in group B. Five- year survival rate was 46.1% in group A and 38% in group B. Conclusions: The patients who achieved a histopathologic complete response following induction therapy had statistically significantly better disease-free and overall survival rates. Pathologically proven lymph node metastasis increased the rate of recurrence or metastasis significantly (p = 0.01). The disease-free and overall survival rate decreased significantly (p = 0.0001, p = 0.0001). It is deducible in light of these findings that patients who received neoadjuvant treatment for N2 achieved better disease-free survival and overall survival.Öğe Surgical and survival outcomes of sleeve lobectomy after neoadjuvant theraphy in lung cancer: With group of 265 patients(European Respiratory Soc Journals Ltd, 2021) Ceylan, Kenan Can; Üçvet, Ahmet; Arabacı, Bengisu; Yazgan, Serkan; Gürsoy, Soner[Abstract Not Available]Öğe Travma sonrası karaciğerin toraksa herniyasyonu: Geç tanı almış diyafragma rüptürü(2021) Acar, Tuba; Gürsoy, SonerKünt veya penetran travmalar sonucunda diyafragmada meydana gelen hasar sonucu karın içiorganların intratorasik bölgeye geçmesi, nadir görülen, iyi bilinen ancak kolaylıkla gözdenkaçabilen önemli bir komplikasyondur. Şiddetli travmalarda erken dönemde hastanın durumustabil olmadığı için tanı atlanabilir. Bu durum tedavide gecikmelere neden olabilir. Bu çalışmada künt toraks travmasından 1,5 ay sonra tanı konulan diyafragma rüptürlü bir olgu sunulmaktadırÖğe Video-assisted thoracoscopic lobectomy and bilobectomy versus open thoracotomy for non-small cell lung cancer: Mortality and survival(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2022) Üçvet, Ahmet; Yazgan, Serkan; Samancılar, Özgür; Türk, Yunus; Gürsoy, Soner; Erbaycu, Ahmet EminBackground: In this study, we aimed to evaluate patients who had non-small cell lung cancer and underwent resection, to investigate our tendency to prefer video-assisted thoracic surgery or open thoracotomy, and to compare 30-and 90-day mortalities and survival rates. Methods: Between January 2013 and January 2019, a total of 706 patients (577 males, 129 females; mean age: 61.9 +/- 8.6 years; range, 17 to 84 years) who underwent lobectomy or bilobectomy due to primary non-small cell lung cancer were retrospectively analyzed. The patients were divided into two groups as operated on through video-assisted thoracic surgery and through open thoracotomy. The 30-and 90-day mortality rates and survival rates were compared. Results: Of the patients, 202 (28.6%) underwent video-assisted thoracic surgery and 504 (71.4%) underwent open thoracotomy. Lobectomy was performed in 632 patients (89.5%) and bilobectomy was performed in 74 patients (10.5%). Patients who were chosen for video-assisted thoracic surgery were statistically significantly older, did not require any procedure other than lobectomy, did not receive neoadjuvant therapy, had a small tumor, and did not have lymph node metastases. The 30-and 90-day mortality rates in the video-assisted thoracic surgery and open thoracotomy groups were 1.8% vs. 2% and 2.6% vs. 2.5%, respectively. The five-year survival rates of video-assisted thoracic surgery and open thoracotomy groups were 74.1% and 65.2%, respectively (p>0.05). The 30-and 90-day mortality and five-year survival rates were 2.1%, 2.6%, and 73.5% in the video-assisted thoracic surgery group and 2.1%, 2.1%, and 68.5% in the open thoracotomy group, respectively, indicating no statistically significant difference between the two groups. Conclusion: Throughout the study period, video-assisted thoracic surgery was more preferred in patients with advanced age, in those who had a small tumor, who did not receive neoadjuvant therapy, did not have lymph node metastasis, and did not require any procedure other than lobectomy. In the video-assisted thoracic surgery and open thoracotomy groups, 30-and 90-day mortality and five-year survival rates were similar. Based on these findings, both procedures seem to be acceptable in this patient population.