Current Thoracic Surgery

Published by Current Thoracic Surgery
Print ISSN: 2548-0316
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Radiological examinations of case 1, (a) peripheral consolidations and ground-glass opacities in bilateral lungs, more pronounced on the right, (b) pneumothorax in the right hemithorax, (c) expansion defect after tube thoracostomy.
The combined use of traditional drainage bottles to prevent virus spread. The first bottle is connected to a second bottle with a hose. One bottle contains 70% ethyl alcohol and the other bottle contains 10% concentration NaOCl. A viral/bacterial filter has also been added to the air cannula of the last bottle.
Radiological examinations of case 2, (a) Peripheral consolidations and ground-glass opacities in bilateral lungs, (b) pneumothorax in the right hemithorax, (c) early chest x-ray after tube thoracostomy.
Although the information increases about the lung damage and radiological findings of SARS-CoV-2 disease day by day, the development of pneumothorax has been reported as a very rare finding, and our information is limited with a few case reports. Here we present a 54-year-old male and a 71-year-old female patient, who were diagnosed spontaneous pneumothorax while they were treating for SARS- CoV-2 pneumonia. A tube thoracostomy performed to each patient for the treatment of pneumothorax. While one case treated with tube thoracostomy successfully prolonged air leak, developed in other patient. Spontaneous pneumothorax should be kept in mind as a differential diagnosis when a sudden hypoxia finding developed in respiratory parameters of patients with SARS-CoV-2. Additional measures also should be taken for these patients during treatment with tube thoracostomy.
 
The anastomosis was reinforced with PGA that was rolled 1 cm width at four points in groups 3 and 4.
Scaling the tensile strength by an electronic spring scale.
Comparison of groups in air leak pressure by sphygmomanometer.
Results of tensile strength experiment.
Scaling the air leakage by a specific manometer.
ABSTRACTBackground: This study aims to investigate the effect of polyglycolic acid (PGA) mesh application in tracheal anastomosis on the air-leakage and tension resistance.Materials and Methods: Tracheae were collected from freshly slaughtered healthy sheep weighing 25-30 kg (2-3 years old) that were acquired from the local slaughterhouse. Twenty-eight tracheae were transported to the laboratory within an hour of slaughter and then dissected to remove the esophagus before obtaining 20-cm long tracheae. All tracheae were transected at the midpoint. In Groups 1 and 2, the transected tracheae were anastomosed by using interrupted 3-0 Vicryl sutures. In Groups 3 and 4, after anastomosing the transected tracheae with interrupted 3-0 Vicryl, the sites of anastomosis were reinforced by using Polyglycolic acid mesh. Groups 1 and 3 were tested for tensile strength, while Groups 2 and 4 were tested for pressure resistance.Results: The median pressure was 49.00 ± 7.47 mmHg in the group anastomosed with only Vicryl, whereas it was measured as 70 ± 13.49 mmHg in the group on which the anastomoses were reinforced with PGA mesh. The median force needed to break anastomoses were 166.40 ± 24.28 Newton in the Vicryl-only group and 136.80 ± 34.93 newton in the PGA- reinforced group. The difference between the pressure resistance values of the Vicryl-only group and the PGA reinforced group was significant (p = 0.006). However, the difference with regard to the tensile strength was insignificant (p = 0.201).Conclusion: We found that the reinforcement of the anastomosis site with polyglycolic acid mesh significantly increases the pressure resistance but does not significantly affect tensile strength.Key Words: trachea, anastomoses, polyglycolic acid (4) (PDF) The effect of polyglycolic acid mesh application in tracheal anastomoses on pressure and tensile strength: an ex vivo experimental study. Available from: https://www.researchgate.net/publication/332773479_The_effect_of_polyglycolic_acid_mesh_application_in_tracheal_anastomoses_on_pressure_and_tensile_strength_an_ex_vivo_experimental_study [accessed Nov 16 2021].
 
(a) Depth of the pectus deformity at the most collapsed area in the sternum, (b) depth of chest cavity, (c) lateral diameter of the chest, (d) distance between two arcus costarum.
(a) Chest circumference, (b) distance between two shoulders. (c) shoulder circumference.
Background: Pectus excavatum (PE) is the most commonly seen chest wall deformity of childhood age. One of the most widely accepted methods in preoperative patient evaluation is the pectus index. In this study, it is aimed to measure the depth perception which is not aesthetic; aimed to establish an objective criteria which is simple, cheap, effective, and can be measured with physical examination or anthropometry instead of radiological examination dependent measurements. Materials and Methods: 18 patients who were admitted to our clinic between May 2015 and August 2016 with complaints of PE deformity and who were planned for surgical repair were included in the study. Sternal deformity’s depth, anthropometric measurements, pectus indexes, echocardiography, and pulmonary function test results and patient symptoms were classified. Results: 18 patients were included in the study. The mean patient age was 14.27 years. One patient had mild mitral insufficiency and a flappy mitral front leaflet. One patient had mitral valve prolapse. No restrictive or obstructive results were observed in the pulmonary function test. There was no significant differences between the pectus index and sternal depth. Conclusions: According to this study, there is a surgical indication in patients whose sternal depth is 1.2 cm and higher, regardless of the pectus index.
 
Metastasis of tracheobronchial tree is an infrequent and life-threatening condition. Endobronchial metastasis is rare while endotracheal metastasis is extremely rare entity. Renal cell carcinoma (RCC) constitutes approximately 3% of all adult malignancies and metastasizes 30% cases to organs during the course of the disease. Lung is the most common target organ of RCC metastasis and usually bilateral parenchymal metastases are seen as well as tracheobronchial system. Hemoptysis may be the first manifestation and bronchoscopy is useful for both diagnosis and therapy. Argon plasma coagulation (APC) is a choice of current therapeutic techniques to achieve hemostasis from bleeding endobronchial lesions. Here we report a case of 72-year-old man was suffering hemoptysis due to endotracheal metastasis of RCC diagnosed via rigid bronchoscopy and palliated with APC successfully.
 
ABSTRACT Background: Pulmonary artery reconstruction can be preferred as an alternative to pneumonectomy, to spare the functional lung parenchyma in lung cancer. This study aimed to evaluate the morbidity, mortality and survival rates of the patients who had undergone pulmonary artery reconstruction due to central non-small cell lung cancer (NSCLC) and also to compare their data with those of the patients who had undergone pneumonectomy. Materials and Methods: In this study, 88 patients who underwent pneumonectomy (group PN) and 20 patients who underwent standard or sleeve lobectomy (double sleeve) with pulmonary artery reconstruction (group PAR) for NSCLC with stages I-IIIA between January 2005 and December 2010 were evaluated retrospectively. The morbidity and mortality rates, durations of the hospital and intensive care unit stay, 5-year and mean survival rates of the homogenous patient groups were analyzed comparatively. Results: The postoperative morbidity rate was 30% in the PAR group and 53% in the PN group (p = 0.77). The bronchial complication rate was 0% in the PAR group and 15% in the PN group (p = 0.04). The 30-day mortality rate was 5% in the PAR group and 5.6% in the PN group (p = 1). The median follow-up period for all patients was 31.5 months (range: 0-84 months) and total 5-year survival was 56.2%. In early-stage tumors (stage I + stage II), total 5-year survival rate was 64% in the PAR group and 60% in the PN group (p = 0.7). In late-stage tumors (stage III), total 5-year survival rate was 52% in the PAR group and 30% in the PN group (p = 0.04). No local recurrence was observed in either group during the follow-up period. Conclusions: In central lung tumors, to avoid pneumonectomy, major anatomical lung resection with pulmonary artery reconstructions can safely be performed with acceptable morbidity and mortality rates. Oncological outcomes of pulmonary angioplasty procedures regarding survival and local recurrence are not worse than those of pneumonectomy. Even in advanced stage lung tumors, these procedures can be an alternative to more radical operations such as pneumonectomy.
 
Thymolipoma is a rare, slow-growing, benign anterior mediastinal tumor consisting of mature adipose tissue and thymic tissue. Herein we describe the case of a completely excised giant thymolipoma with uniportal video-assisted thoracoscopic surgery, which was detected incidentally on chest X-ray, with the review of the literature. A 30-year-old male patient was hospitalized to the department of general surgery with the diagnosis of appendicitis. Preoperative chest x-ray revealed mediastinal enlargement extending to the diaphragm at right paracardiac area where cardiac contours were erased and cardiomegaly-like appearance was observed. In the contrast-enhanced computed tomography of the chest, a massive mass of soft tissue was detected in fat density. The mediastinal lesion was completely excised with uniportal VATS. Histopathologically, the tumor was reported to be thymolipoma. Thymolipoma it should be totally removed with VATS surgery for both diagnosis and treatment. Key Words: thymolipoma, uniportal VATS, mediastinal mass, giant
 
Top-cited authors
Levent Cansever
  • Sağlık Bilimleri Üniversitesi Yedikule Hospital for Chest Disease and Thoracic Surgery
Cemal Aker
  • Yedikule Hospital for Chest Disease and Thoracic Surgery
Muzaffer Metin
  • Yedikule Hospital for Chest Disease and Thoracic Surgery
Mehmet Ali Bedirhan
  • Yedikule Hospital for Chest Disease and Thoracic Surgery
Burcu Ancın