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Öğe 3-Year Follow-Up After Uniportal Thoracoscopic Sympathicotomy for Hyperhidrosis: Undesirable Side Effects(Mary Ann Liebert, Inc, 2014) Karamustafaoglu, Yekta Altemur; Kuzucuoglu, Mustafa; Yanik, Fazli; Sagiroglu, Gonul; Yoruk, YenerObjective: Endoscopic thoracic sympathectomy or sympathicotomy, for the treatment of palmar, axillary, and plantar hyperhidrosis, is generally performed at one or two levels, between T2 and T5. Compensatory sweating (CS) is a severe and undesirable side effect of this procedure. Here, we describe the success of treatment and degree of postoperative CS in sympathicotomy patients. Subjects and Methods: This study included 80 patients treated by uniportal (5-mm) thoracoscopic sympathicotomy (electrocautery) for primary hyperhidrosis over a 6-year period (2007-2013). Sympathicotomy was performed bilaterally at T2 for blushing (n=2), T2-T3 for palmar-only hyperhidrosis (n=34), T2-T4 for palmar and axillary hyperhidrosis (n=39), and T3-T4 for axillary-only hyperhidrosis (n=5). Outcome was assessed 2 weeks postsurgery at the clinic and annually thereafter by telephone questionnaire. Mean follow-up time was 35.2 +/- 23.3 months. Questionnaires assessed patients' degree of sweating, postoperative CS, overall satisfaction, and complications. Results: Seventy-one patients (88.7%) were very satisfied, whereas only 9 (11.3%) were dissatisfied with the procedure. Complication incidence was 7.5%, and CS occurred in 77.5% of patients. Therapeutic success rate was 97.5%; complete relief of hyperhidrosis was achieved in 72 (90%) patients, whereas 8 (10%) experienced recurrence. Conclusions: CS is a frequent side effect of thoracoscopic sympathicotomy. We recommend all patients undergoing this procedure should be warned of the potential risk of developing severe CS.Öğe An analysis of overall survival in patients who have undergone lung metastasectomy operations for lung metastases of colorectal cancers and malignancies other than colorectal cancer(Kuwait Medical Assoc, 2019) Yanik, Fazli; Karamustafaoglu, Yekta Altemur; Yoruk, YenerObjective: To compare the survival and factors affecting survival between patient groups with primary colorectal cancers and malignancies other than colorectal cancer, who underwent curative pulmonary metastasectomy Design: Retrospective study Setting: Trakya University School of Medicine, Edirne, Turkey Subjects: Forty-four cases who underwent curative metastasectomy in our clinic between January 2006 and August 2015 Interventions: Primary colorectal cancers (Group 1 = 14 cases), malignancies other than colorectal cancer (Group 2 = 30 cases) Main outcome measure(s): Age, gender, type of primary malignity, disease-free survival, adjuvant therapy, number of radiological nodules, number and type of operations, number and site of nodules resected, presence of relapse, and mean survival Results: Two cases (4.7%) underwent lobectomy, and a total of 123 nodules were excised in 38 cases (86.3%) using thoracotomy and in four cases (9%) using video thoracoscopic surgery. The median survival value was 33 +/- 5.4 months (range:22.2 - 43.7 months) in Group 1, and 28 +/- 6.8 months (range:14.5 - 41.4 months) in Group 2; the cumulative value was 33 +/- 3.7 months (range:25.6 - 40.3 months). Survival did not differ significantly between the groups (p=0.738). Age (p=0.81), gender (p=0.35), disease-free survival (p=0.24), number of metastatic nodules (p=0.60), presence of synchronous-metachronous tumor (p=0.94), adjuvant chemotherapy (p=0.96), adjuvant radiotherapy (p=0.86), and relapse of disease (p=0.07) were not significantly correlated with survival. Conclusion: Survival and factors that affected survival did not differ significantly between the two groups that underwent metastasectomy. It was indicated that the primary tumor is not an effective factor in the selection of patients who would undergo metastasectomy.Öğe Barotrauma during apnea testing for brain death. Barotrauma and apnea testing(Reial Acad Medicina Illes Balears, 2022) Inal, Mehmet Turan; Memis, Dilek; Ceritoglu, Ece Burcak; Karakas, Hilal; Simsek, Osman; Yanik, FazliThe apnea test is used for the diagnosis of brain death. Various complications have been reported to have developed during the apnea test. A 44-year-old woman was hospitalized in the intensive care unit due to unconsciousness due to a posterior inferior carotid artery aneurysm. On the forty-ninth day of her hospitalization in the intensive care unit, the patient had no motor response and all brain stem reflexes were negative. Brain death was considered in the patient, but subcutaneous emphysema and bilateral pneumothorax developed within minutes during the apnea test. The patient underwent bilateral tube thoracostomy. The patient could not be diagnosed with brain death and died on the fiftieth day of her hospitalization. This report emphasizes that multiple complications can be observed during the apnea test and underlying mechanisms and therapeutic approaches are discussed.Öğe Can Awake Thoracoscopy Procedure be Performed with the Help of Thoracic Paravertebral Anesthesia?(IBN SINA TRUST, 2018) Yanik, Fazli; Karamustafaoglu, Yekta Altemur; Copuruoglu, Elif; Sagiroglu, GonulAim: The aim of this study was to present our experience with 11 patients who were spontaneously breathing with Awake Video Thoracoscopy (AVATS) procedure with the help of TPB because of rareness in the literature. Materials and Methods: Between December 2015 and December 2017, a total of 125 VATS cases were performed; 11 cases underwent VATS operation with the help of TPB; age, gender, operation performed, duration of operation, time of onset of mobilization-oral intake, duration of hospital stay, Visual Analogue Scale (VAS) scores were evaluated retrospectively. Results: All cases were treated with uniportal AVATS procedure with the help of TPB. The mean age was 40,3 +/- 17,4 years (range 18-64 years), nine (82%) of the pateints were male and two (18%) were female. Operation procedures included wedge resection in eight (73 %) patients (six of them for pneumothorax, two of them for diagnosis), in three (27%) patients pleural biopsy (one of them used talc pleurodesis). There were no perioperative events. The mean operation time was 27,7 +/- 6,4 minutes (range, 20-40 min) and the mean anesthesia time was 25 +/- 3,8 minutes (range 20-30 min). The mean time of mobilizitation, oral intake opening time and length of hospital stay was 1,1 +/- 0,4 hours (1-2 hours), 3,5 +/- 0,5 hours (3-4 hours), 2,6 +/- 0,5 days (2-3 days), respectively. Conclusion: Awake Video Asssited Thoracoscopic Surgery with the help of TPB has less side effects and less complication risks than other awake procedures with the help of other regional anesthesia techniques. We conclude that; although AVATS with the help of TPB has some minor complications, it has advantages such as early discharge, early mobilization and early oral intake, low pain levels in well-selected patient groups.Öğe Cervical Cystic Lymphangioma, Rarely Detected in Adults with Rapid Progression, 2 Case Reports(Ibn Sina Trust, 2023) Yanik, Fazli; Karamustafaoglu, Yekta Altemur; Yoruk, YenerCystic Lymphangioma(CL) is rarely detected in adulthood. We presented two cases with neck swelling at an advanced age. Both of cysts were located in the cervico-mediastinally and showed rapid progression. The cysts were excised successfully and there was no recurrence in the follow-up period. Although there are many alternatives in treatment, CL, which is rare in adults, can be treated with surgical excision successfully in appropriate cases to definitively prevent recurrence and complications.Öğe Comparison of awake and intubated video-assisted thoracoscopic surgery in the diagnosis of pleural diseases: A prospective multicenter randomized trial(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2019) Kocaturk, Celalettin; Kutluk, Ali Cevat; Usluer, Ozan; Onat, Serdar; Cinar, Huseyin Ulas; Yanik, Fazli; Cesur, EzgiBackground: This study aims to compare the safety and diagnostic accuracy of awake and intubated video-assisted thoracoscopic surgery in the diagnosis of pleural diseases. Methods: This prospective randomized study was conducted between October 2016 and April 2018 and included 293 patients (201 males, 92 females; mean age 53.59 years; range, 18 to 90 years) from five medical centers experienced in video-assisted thoracoscopic surgery. The patients were randomized into two groups as awake video-assisted thoracoscopic surgery with sedoanalgesia (non-intubated) and video-assisted thoracoscopic surgery with general anesthesia (intubated). Patients with undiagnosed pleural effusions and pleural pathologies such as nodules and masses were included. Conditions such as pain, agitation, and hypoxia were indications for intubation. The groups were compared in terms of demographic data, postoperative pain, operative time, complications, diagnostic accuracy of the procedures, and cost. All patients completed a follow-up period of at least 12 months for samples that were non-specific, suspicious for malignancy or inadequate. Results: Awake video-assisted thoracoscopic surgery was performed in 145 and intubated video-assisted thoracoscopic surgery was performed in 148 patients. Pleural disease was unilateral in 83% (243/293) and bilateral in 17% (50/293) of the patients. There was no difference between the groups in terms of presence of comorbidity (p=0.149). One patient in the awake video-assisted thoracoscopic surgery group (0.6%) was converted to general anesthesia due to refractory pain and agitation. As postoperative complications, fluid drainage and pneumonia were observed in one patient in the awake video-assisted thoracoscopic surgery group (0.6%) and fluid drainage was detected in one patient in the video-assisted thoracoscopic surgery group (0.6%). There were no differences in pain intensity measured with visual analog scale at postoperative 4, 8, 12, or 24 hours (p>0.05). Distribution and rates of postoperative pathological diagnoses were also similar (p=0.171). Both operative cost and total hospital cost were lower in the awake video-assisted thoracoscopic surgery group (p<0. 001, p=0.001). Conclusion: Our study showed that awake video-assisted thoracoscopic surgery is safe, has similar reliability and diagnostic accuracy compared to video-assisted thoracoscopic surgery performed under general anesthesia, and is less costly. Awake video-assisted thoracoscopic surgery can be the first method of choice in all patients, not only in those with comorbidities.Öğe The Comparison of Two Different Techniques of Remifentanil Administration During Implantable Vascular Access Device Procedures(Elsevier Science Inc, 2021) Sagiroglu, Gonul; Baysal, Ayse; Yanik, FazliPurpose: The aim was to compare analgesic efficacy and adverse effects of two different techniques of intravenous remifentanil administration in patients undergoing vascular; access device procedures with monitored anesthesia care. Design: A randomized, single-blinded controlled study. Methods: The patients (N = 92) were 30-80 years old and of American Society of Anesthesiologists Physical Status I-III. The first group was the continuous infusion group (group CI). Intravenous continuous remifentanil was infused after starting at a dosage of 0.1 mcg/kg/min, and the dose was raised incre-mentally up to 1 mcg/kg/min if required. The second group was intravenous bolus patient-controlled sedation analgesia (PCSA) with remifentanil infusion at a dose of 0.05 mcg/kg per minute and bolus of 0.1 mcg/kg with lock-out time of 3 minutes. In both groups, a bolus dose of 0.1 mcg/kg remifentanil was administered. The data evaluated include level of pain and sedation, total amount of remifentanil con-sumption, bolus doses of remifentanil, patient and surgeon satisfaction, hemodynamic data, and adverse events. Findings: In comparison between techniques, pain and sedation scores during procedure, duration of procedure, patient and surgeon satisfaction, additional rescue medication, and bolus doses were not statistically different (P > .05). The total amount of remifentanil administered was significantly lower in the infusion group than that in the bolus group (P = .031). Conclusions: For central venous access device procedures under monitored anesthesia care, remifentanil use in both infusion and bolus techniques could provide sufficient sedation and analgesia without serious adverse effects. Total remifentanil consumption amount in infusion group is lower than that in the bolus group. (c) 2021 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.Öğe Current overview of awake, non-intubated, video-assisted thoracic surgery(Termedia Publishing House Ltd, 2023) Yanik, FazliAwake video-assisted thoracoscopic surgery (A-VATS) enables the surgeon to penetrate the tissue via a small incision and with less contact between the lung and atmospheric pressure; postoperative respiratory functions are also less affected than in open surgery. A-VATS is a safer technique than traditional VATS and non-intubated video-assisted thoracoscopic surgery (NI-VATS) because it does not require muscle relaxants and sedoanalgesics. In particular, diagnostic VATS for pleural effusions can be easily performed over a single port using only local anaesthetic. Anaesthesia-related risks increase even more for elderly patients and those with severe comorbidities. Although there are long and risky operations in thoracic surgery, general anaesthesia is not required for some thoracic surgery procedures. However, A-VATS is limited to minor procedures. Due to regional anaesthesia and sedation, NI-VATS is a safe and effective method for many indications. The results show that this method can be applied with low mortality and morbidity.Öğe The Effect of Balloon-Blowing Exercise on Postoperative Pulmonary Functions in Patients Undergoing Total Hip Arthroplasty(Lippincott Williams & Wilkins, 2021) Kizilcik Ozkan, Zeynep; Yanik, Fazli; Unver, Seher; Yildiz Findik, UmmuGeneral anesthesia, prolonged immobilization, and pain may adversely affect pulmonary function in patients undergoing prosthetic surgery. The aim of this study was to evaluate the effect of balloon-blowing exercises on pulmonary functions in patients undergoing total hip arthroplasty. The patients in the experimental group performed three sets of balloon-blowing exercises in the morning, at noon, and in the evening on the first to third days postoperatively. The increase in forced vital capacity (FVC) values between the control and experimental groups in the postoperative period was statistically significant (p < .001), in favor of the experimental group. The increase in forced expiratory volume during the first second (FEV1)/FVC ratio was found to be significantly higher in the experimental group than in the control group (p < .001). Patients who performed balloon-blowing exercises increased their FVC and FEV1/FVC ratio.Öğe Esophageal self-expandable metal stent placement for the palliation of dysphagia due to lung cancer(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2019) Yanik, Fazli; Karamustafaoglu, Yekta Altemur; Yoruk, YenerBackground: This study aims to report our experience with esophageal self-expendable metal stents for the palliation of malignant dysphagia and tracheoesophageal fistulas caused by lung cancer. Methods: Esophageal self-expandable metal stents were deployed in 56 patients (55 males, 1 female; mean age 63.5 years; range, 42 to 79 years) with malignant dysphagia due to lung cancer between August 2002 and May 2018. Of the patients, 34 had received previous chemoradiotherapy, eight only chemotherapy, and three only radiotherapy, while four had pneumonectomy. Tracheoesophageal fistula was coexisting in 12 patients (21%). Stents were inserted under fluoroscopic control over guide-wire in 28 patients and under flexible endoscopic control in the remaining 28 patients. One stent was used in all patients, except two patients with tracheoesophageal fistula, one patient who had an external compression causing downward migration of stent, and two patients who had tumor progression. Results: Dysphagia improved in all patients after stent insertion. Tracheoesophageal fistula was sealed off in all patients. All patients remained asymptomatic without dysphagia symptoms during the follow-up period except for two patients who underwent gastrostomy. All patients with tracheoesophageal fistula died. Their mean duration of survival was 2.8 months. Of the patients with tracheoesophageal fistula, one died of mediastinitis, one died of esophageal perforation, while the others died of cancer-related reasons. Of the dysphagia patients without tracheoesophageal fistula, all died except for two patients. Mean duration of survival in this group was 4.3 months. Conclusion: Dysphagia in lung cancer may have many underlying reasons. Self-expandable metal stents may provide satisfactory relief of dysphagia symptoms with minimal morbidity after a single procedure in patients with limited lifespan.Öğe Evaluation of Chrisofix® Chest Orthosis Application in Patients with Traumatic Rib Fractures(Ibn Sina Trust, 2024) Isikli, Ayse Gokce; Yanik, Fazli; Karamustafaoglu, Yekta Altemur; Yoruk, YenerBackground: The Chrisofix (R) Chest Orthosis is an effective and easy to use device for the treatment of rib fractures. It is used as a supportive treatment to reduce the pain levels and complication risks of the patients. Methods: Patients hospitalized with the diagnosis of rib fractures in the Thoracic Surgery Service of a university hospital were retrospectively scanned in an online computer program between October 2018 and October 2021. The study sample consisted of patients with the treatment (30) and control (30) groups. Results: Visual Analog Scale and incidence of atelectasis of the patients in the experimental group (The Chrisofix (R) Chest Orthosis) is statistically significantly lower than the control group (P < 0.05). In both the experimental and control groups, no statistically significant difference was found between the variables of patient's demographic and clinical characteristics (p > 0.05). Conclusions: In the study, with the use of The Chrisofix (R) Chest Orthosis, a significant decrease was observed in the Visual Analog Scale and the incidence of atelectasis.Öğe Experience in totally implantable venous port catheter: Analysis of 3,000 patients in 12 years(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2018) Yanik, Fazli; Karamustafaoglu, Yekta Altemur; Karatas, Adem; Yoruk, YenerBackground: This study aims to present our experience with patients who were performed totally implantable venous port catheter. Methods: Demographics-clinical features, surgical results and complications of 3,000 patients (1,824 males, 1,176 females; mean age 61.04 +/- 11.5 years; range, 18 to 88 years) who were performed totally implantable venous port catheter between March 2005 and March 2017 were evaluated retrospectively. Totally implantable venous port catheter indications, complications, catheter duration of stay, reasons for catheter removal and statistical analysis information were reported in detail by reviewing patient records. Results: Of the cases, the Seldinger method was used in 98%, 1% (n=36) had the catheter inserted with superficial Doppler ultrasonography, while the veins were not found in 1% (n=29) and these patients were excluded from the study. Totally implantable venous port catheter was inserted via right internal jugular vein in 2,095 patients (70%), via right subclavian vein in 470 patients (16%), via left internal jugular vein in 290 patients (10%), and via left subclavian vein in 106 patients (3%). Mean duration of stay for totally implantable venous port catheter was 46.7 months (range, 1 to 78 months). Complications were detected in a total of 288 patients (9.6%), 153 (5.1%) being early and 135 (4.5%) being late. The most common oncologic indication was colorectal cancer. The rate of port removal was 298/3,000 (9.9%) and the main reasons were infection, thrombosis, pain, and end of treatment. Totally implantable venous port catheter was required to be inserted twice in 33 patients (1%) and thrice in 14 patients (0.5%). Totally implantable venous port catheter had malposition in eight patients and all were revised successfully with over the guide method. Conclusion: Totally implantable venous port catheter may increase the quality of life in cancer patients. Despite possible complications, totally implantable venous port catheter is safe and comfortable for long-term intravenous treatment. Possible complications may be prevented or managed when totally implantable venous port catheter is performed by surgeons with adequate experience.Öğe Factors affecting response rates after thymectomy for myasthenia gravis(Derman Medical Publ, 2018) Yanik, Fazli; Karamustafaoglu, Yekta A.; Yoruk, YenerAim: In our study, we report the clinical response obtained after transsternal extended thymectomy (TSET), the factors affecting the response, and the most appropriate timing of the operation. Material and Method: A total of 35 cases underwent TSET with the diagnosis of myasthenia gravis in our department from December 1996-June 2015. Twenty of the cases were females (57%) and fifteen (43%) were males with a mean age of 42 +/- 15 (14-68). The case registry has been analyzed retrospectively. Results: Postoperative histopathological examination revealed non-thymoma thymic pathologies in 19 (54%), thymoma in 16 (46%). Myasthenia gravis symptoms were staged according to the Osserman classification: 8 (22,9%) were stage I, 13 (37,1%) were stage IIa, 11 (31,4%) were stage IIb, and 3 (8,6%) were stage III, with no patients at stage IV. The duration of symptoms of <24 month before the operation was statistically significant for groups with and without thymoma (p<0,001). However, parameters of age, gender, preoperative Osserman stage, and pathological diagnosis were not statistically significant between groups. Discussion: Transsternal extended thymectomy allows for extended removal of all the mediastinal tissue in the anterior mediastinum with a low complication rate. Symptom duration before operation is the most important factor in response to treatment; therefore, patients must be operated on as soon as possible. Thymectomy also seems to be helpful for early stage MG.Öğe Giant Pulmonary Herniation: A Late and Rare Complication of Minimally Invasive Lung Biopsy for Interstitial Lung Disease(Marmara Univ, Inst Health Sciences, 2023) Edis, Ebru cakir; Yanik, Fazli; Karabulut, Derya; Hereklioglu, SavasPulmonary herniation is the protrusion of the lung parenchyma beyond the normal limits of the thoracic cavity. It is a rare entity. In general, the defect in the chest wall is accompanied by increased intrathoracic pressures in the formation mechanism. Usually the cause is blunt-penetrating thoracic trauma, violent cough or previous thoracic surgery with insufficient closure of the chest wall. We report a case with giant pulmonary herniation that developed four years after biopsy in a patient diagnosed with usual interstitial pneumonia by VATS. Although this is a very rare condition in the literature, one of the late and rare complications of diagnostic pulmonary resections with awake VATS may be caused giant pulmonary herniationÖğe An interesting mediastinal cyst case: Benign cystic mesothelioma(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2018) Yanik, Fazli; Karamustafaoglu, Yekta Altemur; Ozpuyan, Fulya; Yoruk, YenerAnterior mediastinal, well-defined, ametabolic cystic lesion was detected incidentally in a 69-year-old male patient. Uniportal video-thoracoscopic surgery was performed to the lesion for diagnosis and treatment purposes. Histopathological findings were in accordance with benign cystic mesothelioma. Benign cystic mesothelioma has been defined in the abdomen, particularly among females of reproductive age. Benign cystic mesothelioma originating from mediastinal pleura is very rare entity and was not defined in the literature. To our knowledge, we present this rare and interesting mediastinal cystic lesion for the first time in the literature.Öğe Intrathoracic Desmoplastic Fibroblastoma: A Rare Localization(Derman Medical Publ, 2013) Karamustafaoglu, Yekta Altemur; Yanik, Fazli; Yoruk, YenerDesmoplastic Fibroblastoma (Collagenous Fibroma) is an extremely rare which is a recently described tumor that may arise in the subcutaneous tissue or skeletal muscle. Herewith was reported a case of a Desmoplastic Fibroblastoma with an intrathoracic localization. A 56-year-old man referred with a painless right intrathoracic tumor. Physical examination was normal and electrocardiography, abdominal ultrasonography and routine blood tests were unremarkable. The chest X ray showed consolidation with lobulated contour in right lower zone. Thorax computerized tomography (CT) revealed 10x15 cm mass filling right lower hemithorax. The patient underwent right posterolateral thoracotomy and the tumor was totally removed and histopathologic diagnosis revealed a rare desmoplastic fibroblastoma. Postoperative course was uneventful.Öğe Leser-Trelat sign of patient with recurrent pleural effusion(Kare Publ, 2015) Yanik, Fazli; Karamustafaoglu, Yekta Altemur; Karatas, AdemLeser-Trelat sign includes the combined sudden onset of seborrheic keratosis and internal malignancy, most commonly adenocarcinoma of the stomach. A case of Leser-Trelat sign in a 75-year-old healthy woman is presented. To search for an underlying malignancy, the invasive and noninvasive investigations were performed and found to reveal any evidence of malignancy. To date, almost all cases of Leser-Trelat sign have been reported in association with an underlying malignancy. There have been a few report associated with healthy individuals in literature.Öğe Management of a difficult infectional disease: Descending necrotizing mediastinitis(J Infection Developing Countries, 2018) Yanik, Fazli; Karamustafaoglu, Yekta Altemur; Yoruk, YenerIntroduction: Descending Necrotizing Mediastinitis (DNM) is the fatal form of mediastinitis and mostly develops as a complication of peritonsillar abscesses or dental-odontogenic infections. The aim of this study is to evaluate clinical and surgical feature of the patients with DNM who were managed in our clinic. Methodology: We retrospectively evaluated 13 consecutive patients with the diagnosis of DNM between February 2005 and February 2018. All of them had the typical physical appearance, history and radiological findings. Results: Ten (77%) patients were male, 3 (23%) patients were female with a median age of 48.2 (18-76 years). All patients underwent Cervico-Mediastinal Drainage (CMD) with debridement of the necrotic and infected tissues. Other supplimantary surgical procedures were tube thoracostomy (n = 8), VATS mediastinal drainage (n = 4), tracheostomy (n = 2) and thoracatomy (n = 1). The median time to diagnosis of DNM, tube drainage (inserted after CMD) removal time, tube thoracostomy removal time, lenght of hospital stay were 1.8 (range 1-4) days, 13.6 (range 10-20), 12.6 days (range 10-27) and 21.5 days (range 15-30), respectively. Appropriate and potent antibiotics were used according to the fever-CRP response with the consultation on infectious disease specialist. Two patients were lost due to fulminant sepsis (n = 1) and massive cervical haemorrhage (n = 1). Overall mortality rate was 15%. Complications were recorded in 6 patients (46%). Conclusions: The critical point in the management of DNM is the correct diagnosis, rapid surgical intervention with antibiotherapy and close follow-up for possible complications. We concluded that the combination of minimally invasive management as VATS-tube thoracostomy with CMD is the most appropriate surgical interventions.Öğe Outcomes of Non-intubated Versus Intubated Thoracoscopic Surgery for Primary Spontaneous Pneumothorax(Lippincott Williams & Wilkins, 2023) Yanik, Fazli; Karamustafaoglu, Yekta Altemur; Yoruk, YenerBackground: This study aimed to compare the outcomes of non-intubated video-assisted thoracic surgery (N-VATS) and intubated video-assisted thoracic surgery (I-VATS) for primary spontaneous pneumothorax (PSP).Materials and methods: We retrospectively analyzed 120 consecutive patients who underwent VATS for PSP. The patients were divided into N-VATS and I-VATS groups. Demographics, clinical characteristics, postoperative results, pain scores, follow-up results, and management were evaluated and compared between the groups. Local anesthesia and deep sedation (ketamine 2 mg/kg IV and propofol 2 mg/kg IV slow infusion) were administered under spontaneous ventilation in the N-VATS group.Results: The groups did not differ significantly in terms of age, sex, American Society of Anesthesiology score, pneumothorax side, or smoking history ( P >0.05). The mean operation time, anesthesia time, oral intake opening time, and mobilization time were significantly shorter in the N-VATS group (26.04 +/- 4.61 vs. 48.26 +/- 7.82 min, 42.14 +/- 6.40 vs. 98.16 +/- 12.4 min, 2.1 +/- 0.4 vs. 8.4 +/- 1.2 h, and 4.2 +/- 0.9 vs. 2.6 +/- 1.4 between N-VATS and I-VATS, respectively; P <0.05). The surgical outcomes did not differ in terms of minor complications (12%-13%) and recurrence rates (5.1%-6.4%) during a mean follow-up period of 88.4 +/- 10.2 mo. No cases of conversion to open surgery or mortality were observed. General anesthesia and intubation were not required for any patient in the N-VATS group.Conclusions: Our results revealed no differences in minor complications or recurrence rates between groups. However, the N-VATS group had significantly shorter operation, anesthesia, oral intake opening, and mobilization times. The most important advantage of N-VATS for PSP is its fast recovery while avoiding the risks of general anesthesia and intubation. Further prospective studies with larger sample sizes are warranted.Öğe Palliative treatment of recurrent tracheal pleomorphic adenoma 10 years after segmental resection using the endobronchial shaver(Wiley, 2020) Karamustafaoglu, Yekta Altemur; Yanik, Fazli; Yoruk, YenerObjectives Thoracic surgeons often encounter patients with obstruction of the central airways requiring bronchoscopy to provide an open airway. The endobronchial shaver (Richard Wolf GmbH,Germany) is one of the new devices available for treatment of central airway obstruction. We report a tracheal tumor managed with this device. Methods We report the successful use of endobronchial shaver via rigid bronchoscopy to resecte a complex stenosis 77-year-old male patient. Patient admitted to our clinic for progressive dyspnea and stridor. The patient's medical history was cervical collar incision with resection and anastomosis 10 years ago. A mass causing a obstruction of 70% of the tracheal lumen was detected with fiberoptic bronchoscopy. So, we decided to use endobronchial shaver for immediate effect. Results Trachea was successfully recanalized with Endobronchial shaver (Richard Wolf GmbH, Germany). The patient was successfully extubated, and his dyspnea was resolved. Histopathologic examination of debris was revealed a tracheal pleomorphic adenoma. Postoperative course was uneventful and there was no evidence of recurrent or stenosis in 5 months of follow-up. Conclusion The Endobronchial shaver is an excellent instrument to manage intrluminal complex stenoses including tumor and granulation tissue with advantages including efficient removal of mass without a need for separate suctioning, coagulation,and limitation in oxygenation.
