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Öğe One-stage surgical management for lung and liver hydatid diseases Management of liver and lung cysts(Springer Wien, 2011) Karamustafaoglu, Y. A.; Reyhan, G.; Kuzucuoglu, M.; Yoruk, Y.Background: Hydatid disease remains a serious health problem in Mediterranean areas. We reviewed the efficacy of a single-stage operation in coexisting cysts of lung and liver in patients. Methods: Forty-one patients operated for the cysts located on the dome of the liver and right lung with one-stage surgical approach on between 1990 and 2010. There were 19 males (46%) and 22 females (54%) patients. The age range was 10-82 years, with a median age of 34 years. Results: All patients had simultaneous operations for both organs via right thoracotomy and phrenotomy except one patient. Surgical techniques used in the lung were cystotomy and capitonnage, with wedge resection of the destroyed lung parenchyma in three (7.3%) and additional decortication in three (7.3%). Cystotomy was applied with membrane removal in the liver cysts. Postoperative complications were prolonged biliary drainage, empyema, prolonged air leak, pleural effusion in one case (2.4%) each, respectively. All patients managed successfully and discharged. No hospital mortality occurred. Conclusions: We propose that concomitant right pulmonary and liver dome hydatid cysts can be treated effectively and safely in a one-stage operation through a right posterolateral thoracotomy and phrenotomy.Öğe Transaxillary Approach for Thoracic Outlet Syndrome: Results of Surgery(Georg Thieme Verlag Kg, 2011) Karamustafaoglu, Y. A.; Yoruk, Y.; Tarladacalisir, T.; Kuzucuoglu, M.Background: Thoracic outlet syndrome (TOS) is one of the most complicated diseases in thoracic surgery with regard to both diagnosis and treatment. Surgical removal of the first rib and cervical rib, if present, has been suggested as the treatment of choice in patients who do not benefit from physiotherapy. In this retrospective study, our surgical experience with TOS and the management of surgical complications are presented. Methods: A total of 109 cases with the diagnosis of TOS were operated on between January 1995 and April 2010. Ninety-five of the cases were females (87.2%) and 14 (12.8%) were males with a mean age of 35.7 (16-58). Results: A total of 131 operations were performed, of which 21 were bilateral and one was a recurrent operation. The diagnosis was neurogenic TOS in 107 (98.2%) and vascular TOS in two (1.8%) patients. All neurogenic TOS operations were performed via the transaxillary route. A posterior thoracoplasty approach was used for recurrent TOS in one case. A total of 23 (21.1%) cases had a cervical rib. Fibromuscular bands were observed in 68 (62.3%) cases. The rates for favorable and poor surgical outcome were 125 (95.4%) and 6 (4.6%), respectively. The most common complication was apical pneumothorax in 32 (24.6%) cases, followed by wound infection in four (3%), lymphatic leak, axillary hematoma and mild brachial plexus traction palsy in one (0.8%) case. Mortality was not observed. Conclusions: In our experience the exposure provided by the transaxillary approach is safe and superior to that offered by other approaches as it allows a wide range of surgical applications such as first rib resection, cervical rib resection and resection of fibrotic bands.