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Öğe Dermatofibrosarcoma protuberans(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2009) Karamustafaoglu, Y. Altemur; Reyhan, Goekay; Top, Huesamettin; Kement, Buelent; Yoruk, Yener; Balkanli, KunterDermatofibrosarcoma protuberans (DFSP) is a rare, locally aggressive tumor arising from the skin. We reported two cases who presented with a huge mass arising from the left upper anterior part of chest wall. We performed a wide local excision for two patients. Skin defect was closed with free split skin greft. Histopathological studies revealed the lesion to be dermatofibrosarcoma protuberans. Follow-up was three months for the first patient and 48 months for the second patient. There was no recurrence and metastasis in both patients.Öğe Factors affecting mortality in traumatic diaphragmatic ruptures(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2014) Tarladacalisir, Taner; Karamustafaoglu, Y. Altemur; Yoruk, YenerBackground: This study aims to investigate possible factors affecting mortality in patients with traumatic diaphragmatic ruptures. Methods: Between May 1997 and May 2009 a total of 30 patients (27 males, 3 females; mean age 42.6 years; range 16 to 88 years) were operated in our clinic with a diagnosis of traumatic diaphragmatic rupture. The patients were evaluated retrospectively in terms of possible factors affecting mortality. Emergency surgery was performed 22 patients within the first seven days. Other two patients were operated in the latent phase and six patients were operated in the obstructive phase. Results: Thoracotomy was performed in nine patients, laparotomy in nine patients and thoracotomy + laparotomy in 12 patients. Eight patients were diagnosed by explorative laparotomy. The mean duration of hospitalization was 12 days (range, 1-50 days). Morbidity was observed in eight patients (27%), while mortality was seen in seven patients (23%). Five patients had no associated pathology, while various associated pathologies were observed in 25 patients. Additional surgical interventions were required for associated pathologies in 16 of these patients.(53%). Older age (p=0.020) and need for longer length of stay in the intensive care unit (p=0.020) were found to be negative prognostic factors affecting mortality. Conclusion: Associated organ injuries are the main prognostic factors which affect morbidity and mortality. Early weaning from mechanical ventilation, aggressive treatment and close follow-up of patients with elderly and those with organ injuries associated with traumatic diaphragmatic ruptures may reduce morbidity and mortality.Öğe Post Intubation Early and Late Tracheal Pathologies(Bilimsel Tip Publishing House, 2011) Karamustafaoglu, Y. Altemur; Reyhan, Gokay; Kocal, Sedat; Yoruk, YenerObjective: Herein, we present our experience in treating the tracheal ruptures and stenoses after endotracheal intubation. Material and Method: Nine patients with tracheal stenosis and rupture after prolonged intubation between December 2004-November 2009 were retrospectively evaluated. Four of these cases were tracheal ruptures and five were tracheal stenoses. Three of the cases with tracheal ruptures were male and one was female, with a mean age of 37 (25-46). Three of the cases with tracheal stenoses were male and two were female, with a mean age of 32 (15-43). The etiology of all cases with tracheal rupture was forced intubation for general anesthesia and prolonged mechanical ventilation in all tracheal stenosis cases. Results: All cases with tracheal rupture were treated conservatively. There was no morbidity or mortality. Resection and anastomosis were performed in three tracheal stenoses cases, tracheostomy was applied in one case for long tracheal stenoses and broncoscopic dilatation and stent in one case quadroplegic case. Tracheoesophageal fistula developed in one case which was treated surgically. Conclusion: Tracheal rupture and stenosis can occur in any patient after intubation of any duration. Therefore, special notice is required to diagnose these cases as soon as possible. Proper treatment should be planned in the light of clinical observation.Öğe Risk factors for early mortality and morbidity after pneumonectomy(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2014) Sagiroglu, Gonul; Copuroglu, Elif; Meydan, Burhan; Tasci, Erdal; Karamustafaoglu, Y. Altemur; Baysal, Ayse; Yoruk, YenerBackground: This study aims to investigate possible risk factors which affect the mortality and morbidity of pneumonectomy patients due to the non-small cell lung cancer (NSCLC). Methods: Demographic, clinical and pathological features of 100 patients (96 males, 4 females; mean age 58.4 +/- 8.9 years; range 38 to 82 years) who underwent pneumonectomy between April 2008 and October 2009 were retrospectively analyzed. Results: The morbidity and mortality rates were found to be 56% and 14%, respectively. The complications included cardiopulmonary in 46%, bleeding in 7%, and wound infection in 3% patients. There was no significant effect of age, sex, smoking habit, diabetes, hypertension, and coronary artery disease on 30-day morbidity and mortality. Neoadjuvant therapy (p=0.049), right pneumonectomy (p=0.01), and intraoperative blood transfusion (p=0.049) were associated with significantly increased morbidity. The duration of intensive care unit and hospital stays was significantly longer in patients with respiratory failure and bronchopleural fistula. Conclusion: Pneumonectomy is a high-risk procedure in patients with neoadjuvant therapy, right pneumonectomy, and intraoperative blood transfusion. However, we believe that it is possible to reduce the risk factors with careful preoperative evaluation, rigorous anesthetic assessment and surgical interventions.Öğe Self-expandable esophageal stents placement for the palliation of dysphagia as a result of lung cancer(Wiley-Blackwell Publishing, Inc, 2010) Karamustafaoglu, Y. Altemur; Yoruk, Y.P>We report our experience with self-expandable metallic stents for the palliation of malignant dysphagia and tracheoesophageal fistulae caused by lung cancer. Esophageal self-expandable metallic stents were deployed in 28 patients with malignant dysphagia as a result of lung cancer between August 2002 and January 2009. Mean age was 62.1 (42-77) with 26 male patients. Twenty-three patients received previous chemo-radiotheraphy and two had pneumonectomy. Tracheoesophageal fistulae were coexisting in eight patients. Stents were inserted under fluoroscopic control over guide-wire with the patient under conscious sedation. One stent was used in all patients except one fistula patient with two stents. Immediate improvement after stent insertion was seen in all patients. Fistulae were sealed off in all. No complication was seen except transitional pain in 12 patients (42%). During the follow-up, all patients remained asymptomatic with no clinical appearance of dysphagia symptoms except one patient whom gastrostomy was applied. All patients with fistulae died with a mean survival of 15.4 weeks. Dysphagia patients without a fistulae died with mean survival of 6 months except one patient with 1 month follow-up. Self-expandable esophageal metallic stent insertion can manage malignant dysphagia in lung cancer patients with significant survival period via nonsurgical approach.Öğe Traumatic rupture of giant pulmonary hydatid cyst in a child(Medcom Ltd, 2010) Karamustafaoglu, Y. Altemur; Gungor, A.Introduction: Trauma as a cause of hydatid cyst rupture leads to various clinical conditions, especially in children. Current literatures regarding the clinical presentation and management of such patients are rare. Case report: A 14-year-old child was admitted with chest pain and dyspnoea due to blunt thoracic trauma after falling off a bicycle. Chest computed tomography showed right hydropneumothorax and cystic cavity. After chest tube insertion, massive air leak was observed from the tube. Cystotomy and capitonnage were performed on the right lower lobe via a posterolateral thoracotomy. He was discharged from the hospital in good condition. Conclusion: Ruptured hydatid cysts into the pleura are difficult to diagnose radiologically. It can be misdiagnosed radiologically as empyema or hydrothorax. In undetermined cases, all the findings may be suggestive but not diagnostic. Operation must be performed early for exploration when the condition is suspected. High complication rate has been found in children who were operated late. (Hong Kong j.emerg.med. 2010;17:381-383)