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Öğe 13-Year Experience with Penetrating Trauma Patients(Aves Yayincilik, Ibrahim Kara, 2009) Karamustafaoglu, Yekta Altemur; Yavasman, Ilkay; Kuzucuoglu, Mustafa; Mammedov, Ruestem; Yener, YorukObjectives: Thoracic injuries occur in approximately 25-30% of all trauma cases. Among these, 70% is blunt trauma and 30% is penetrating trauma. We presented our clinical experience with penetrating thoracic trauma patients in the last 13 years. Patients and Methods: We retrospectively assessed 200 cases of penetrating thoracic trauma (184 males (%92), 16 females (%8); mean age 27.4 years; range 11 to 80 years) urgently hospitalized at our clinic between 1995-2008. Results: In 153 (76.5%) cases sharp penetrating trauma and in 47 (23.5%) patients gunshot wounds were seen. Intrapleural pathology was found in 174 (87%) cases and extrathoracic organ injury was found in nine cases. Surgical treatment included chest tube thoracostomy in 173 (86.5%) cases and other conservative treatment methods were applied in 27 (13.5%) cases. Thoracotomy was required in 39 (19.5%) of the cases. The morbidity rate was 7.5% and mortality rate was 0.5%. Conclusion: In penetrating thoracic trauma cases, except emergency thoracotomy patients, conservative treatment methods are applied in most of the patients. Trauma with intrathoracic organ injury increases the mortality and morbidity, and requires fast and well-organized multidisciplinary approach.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 Comparison of the Effects of the Sixth and Seventh TNM Staging on Survival in Operable Non-Small Cell Lung Cancer(Aves Press Ltd, 2018) Kuzucuoglu, Mustafa; Karamustafaoglu, Yekta Altemur; Yoruk, YenerBACKGROUND/AIMS In our study, cases who have been operated due to the diagnosis of non-small cell lung cancer (NSCLC) were staged by the 7th edition of the tumor, node, and metastasis (TNM) staging system and analyzed with respect to the survival association between previous and novel TNM systems. MATERIAL and METHODS The study included 136 patients operated with a diagnosis of NSCLC between January 1, 2000 and January 1, 2010 at our clinic. Patients comprised 9 (6.62%) females and 127 (93.38%) males. The age range and mean age of the cases were 30-76 years and 59.4 years, respectively. RESULTS Histopathological examination detected squamous cell carcinoma, adenocarcinoma, adenosquamous cell carcinoma, bronchioalveolar carcinoma, and large cell carcinoma in 88 (64.8%), 41 (30.2%), 4 (2.9%), 1 (0.7%), and 2 (1.4%) cases, respectively. No statistically significant association was found between mortality and tumor type (p=0.184). According to the 7th edition of the TNM staging system, of the cases, 18 (13.2%), 40 (29.4%), 22 (16.2%), 33 (24.3%), and 23 (16.9%) were stage IA, stage IB, stage IIA, stage IIB, and stage IIIA, respectively. There was a statistically significant association between mortality and tumor stage in our study (p=0.028). In addition, applying the 6th edition of the TNM staging revealed a statistically significant association between mortality and tumor stage (p=0.017). CONCLUSION Tumor stage was found to be the most important factor affecting survival in our study group. No statistically significant difference was determined between the subgroups when the previous and novel staging systems were compared.Öğe Effect of mitomycin-C applied through different approaches following tracheal surgery on development of granulation tissue and level of nephrotoxicity in rats(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2019) Kuzucuoglu, Mustafa; Topuz, Ruhan Deniz; Altun, ErenBackground: This study aims to evaluate the effect of mitomycin-C applied through different drug administration approaches on the development of granulation tissue in the field of surgery and renal functions in rats which underwent tracheal surgery. Methods: Fifty male adult Sprague Dawley rats (weighing mean 200 g to 300 g) were divided into five groups. An incision was performed between the fifth and sixth cartilage ring of the trachea in all groups under anesthesia and the incision was primarily repaired with a 6/0 monofilament absorbable suture. A single dose of mitomycin-C 0.5 mg was applied in the experimental animals appropriate with their assigned groups as topical, intraperitoneal injection, injection to the wound edges, and through inhalation. No mitomycin-C was administered in one group which was accepted as the control group. Rats were sacrificed four weeks after surgery and their tracheas were excised subsequently. Tracheal tissue samples were histopathologically evaluated in terms of epithelization, fibrosis, amount of fibroblasts, angiogenesis, and inflammatory response. Diameter and wall thickness of the tracheas were measured. Blood urea and creatinine levels were evaluated for nephrotoxicity, and the rats were immunohistochemically examined for glomerular pathology. Results: Epithelization was statistically significantly decelerated (p<0.01), diameter of the trachea was statistically significantly larger (p<0.05), and wall thickness of the trachea was significantly thicker in the group with topical mitomycin-C application compared to the control group (p<0.01). Conclusion: Topically applied mitomycin-C following tracheal surgery slows down epithelization and, thus, decreases the development of granulation tissue and maintains a wider diameter of the trachea.Öğe A Rare Non-Small Cell Lung Tumor; Lymphoepithelioma Like Carcinoma(Derman Medical Publ, 2013) Kuzucuoglu, Mustafa; Karamustafaoglu, Yekta Altemur; Yanik, Fazli; Yoruk, YenerLymphoepithelioma-like carcinoma, which belongs to a subgroup of non-small cell lung cancer and morphologically resembles to lymphoepithelioma located in the nasopharynx, is a rare tumor of the lung. It was first described by Begin and others in 1987. We evaluated two patients who underwent surgery in our clinic after reviewing medical literature.Öğe A rarely seen mucoepidermoid carcinoma of the left main bronchus(Medknow Publications & Media Pvt Ltd, 2014) Kuzucuoglu, Mustafa; Karamustafaoglu, Yekta Altemur; Cicin, Irfan; Yoruk, YenerMucoepidermoid carcinomas (MEC) are rare malignant tumors that originate in the submucosal bronchial glands, and complete resection usually correlates with favorable prognosis. A 54-year-old male patient was diagnosed with high-grade MEC in the left main bronchus via bronchoscopy. After the patient was diagnosed with metastatic lung cancer, chemotherapy was started. Two years after the diagnosis, the patient is still alive.Öğe Relationship between the Size and Location of the Mass and Hilar and Mediastinal Lymph Node Metastasis in Early and Locally Advanced Non-small Cell Lung Cancer(Coll Physicians & Surgeons Pakistan, 2020) Kuzucuoglu, Mustafa; Gokyer, Ali; Kula, Osman; Yekdes, Ali Cem; Sunal, Baran Serdar; Karamustafaoglu, Yekta Altemur; Yoruk, YenerObjective: To determine whether there is a relationship between the size and location of the mass and lymph node metastasis in non-small cell lung cancer. Study Design: Observational study. Place and Duration of Study: Department of Medical Oncology of Trakya University, from November 2013 to November 2018. Methodology: Records of 112 patients, who were followed up for non-small cell lung cancer, were retrospectively reviewed. Patients with distant organ metastasis (M1) and distant lymph node metastasis (N3), a previous history of malignancy, synchronous or metachronous tumors, and those for whom required data could not be obtained were excluded. Lymph nodes were evaluated according to pathology reports in patients undergoing invasive procedures. In patients without invasive procedures, lymph node larger than 1 cm in thorax CT, SUV above 2.5 in PET, and acceptance of metastasis at the Oncology Council was considered decisive. Diameter of the tumor, the shortest distance between the tumor and the mediastinum, the shortest distance between the tumor and the hilum, and the diameters of the largest mediastinal or hilar lymph nodes were measured from the thoracic computed tomography (CT) taken at the time of the diagnosis. The relationship between these values and lymph node metastasis was statistically evaluated. Results: Upon consideration of thoracic CT measurements, lymph node metastasis was found to have a statistically significant relationship with tumors with a large diameter (>55 mm) (p<0.001), tumors close to the mediastinum (<7 mm) (p=0.003), and tumors close to the hilum (<60 mm) (p=0.045). The evaluation of the distinctiveness of markers in diagnosis through ROC analysis showed AUC of 0.70 (p<0.001) for the largest tumor diameter, and the risk of lymph node metastasis was higher for lesions above 55 mm. Conclusion: In thorax CT, Large tumor size, tumor close to mediastinum, tumor close to hilum, large lymph node, and high SUV value of lymph node in PET-CT are associated with increased chances of metastasis.Öğe Results of Mini Axillary Thoracotomy for Primary Spontaneous Pneumothorax(Derman Medical Publ, 2011) Yanik, Fazli; Karamustafaoglu, Yekta Altemur; Kuzucuoglu, Mustafa; Mammedov, Rustem; Yoruk, YenerAim Pneumothorax knows a common clinical problem. Mini axillary thoracotomy major indication is pneumothorax surgery, allowing easily apical resection and pleurectomy with excellent longterm results. Herein, we describe our experience with the axillary thoracotomy for the treatment of pneumothorax. Material and Methods A total of 56 cases underwent mini axillary thoracotomy with the diagnosis of primary spontaneous pneumothorax in our department between 19962008. Fifty four of the cases were males (96.5%) and two (3.5%) were females with a mean age of 28.2 (17- 43). Twenty- nine cases (51.7%) had right pneumothorax and 27 (48.3%) left pneumothorax. Results We performed apical wedge resection and apical pleurectomy in 33 cases (59%), bullae ligation and apical pleurectomy in 23 cases (41%). Four patients developped morbidity. There was no mortality. Median hospital stay was 4.5 day (3- 8). During 13 years follow up recurrens was not detected. Conclusions A mini axillary thoracotomy was short hospital stay, cosmetically acceptable was not recurrence. A mini axillary thoracotomy is a good choice when a spontaneous pneumothorax requires surgery due to excellent results for the patient.Öğe Topographic evaluation of sternal foramen patients with thoracic computed tomography(Springer France, 2020) Kuzucuoglu, Mustafa; Albayrak, IlkayPurpose In our study, we aimed to determine the topographic analysis of sternal foramen cases incidentally detected in patients underwent thoracic computed tomography. Materials and methods Patients aged 18 and over who were admitted to the thoracic surgery outpatient clinic for various reasons and underwent thoracic computed tomography (CT) between January 1, 2018 and January 1, 2019 were evaluated retrospectively. Thoracic CT scans of all patients with sternal foramen were evaluated by applying 3D bone configuration to evaluate foramina in the sternum and ribs. The data obtained were analyzed statistically by SPSS (Statistical Package for Social Sciences Version 21.0). Results Nine hundred and twelve patients were evaluated and sternal foramen prevalence was found to be 8.44% in our study. Of the 68 patients included in the study, 48 were male and 20 were female. The sternal foramen was localized in the corpus in 66.2% of the patients, whereas it was localized in xiphoid in 33.8%. Nine patients had scoliosis deformity and three patients had foramen in the rib. Conclusion Sternal foramen is a more common defect than thought, and should be kept in mind in clinical practice to prevent complications.Öğe Transabdominal subcostal approach in surgical management of Morgagni hernia(Elsevier Science Bv, 2011) Karamustafaoglu, Yekta Altemur; Kuzucuoglu, Mustafa; Tarladacalisir, Taner; Yoruk, YenerObjective: Morgagni hernia is an uncommon type of diaphragmatic hernias whose pathophysiology is not clear. We aimed to retrospectively evaluate morbidity, mortality, and treatment outcomes in 13 cases of Morgagni hernia treated with the subcostal approach. Material and methods: Between 1993 and 2009, 13 patients with Morgagni hernia were operated in our department. Of the 13 patients with a median age of 65 years (range: 13-78), 12 were female. Chest roentgenograms, thorax computed tomography (CT), and barium enema roentgenographic studies were used as diagnostic utilities. The contents of the hernia, as diagnosed with CT and confirmed at surgery, were omentum and colon in all patients. Results: All the patients were operated electively except one patient on ventilation treatment. Transabdominal repair with the subcostal approach was performed in all patients. There was no operative morbidity and mortality. The median hospital stay was 8 days (range: 614 days). There was no recurrence during the follow-up of 48.8 months (1-132 months). Conclusion: We recommend the transabdominal subcostal approach in patients with Morgagni hernia for surgical exposure, easy repair of the hernia sac, and low morbidity. (C) 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B. V. All rights reserved.Öğe Video-thoracoscopic sympathectomy by use of a transaxillary single-port approach(Ekin Tibbi Yayincilik Ltd Sti-Ekin Medical Publ, 2011) Kuzucuoglu, Mustafa; Karamustafaoglu, Yekta Altemur; Tarladacalisir, Taner; Mammedov, Rustem; Yoruk, YenerBackground: In this prospective study, we evaluated the outcome and the value of sympathectomy by the use of a transaxillary single-port thoracic approach in a consecutive series of patients with palmar and/or axillary hyperhidrosis. Methods: Between June 2007 and June 2009, a total of 28 patients (14 males, 14 females; mean age 23.4 years; range 13 to 36 years) admitted to our clinic with palmar and/or axillary hyperhidrosis underwent uniport video-assisted thoracoscopic sympathetic chain electrocauterization of the T2 and T4 ganglia at our clinic. There were both palmar and axillary hyperhidrozis in 14 cases (50%) and only palmar hyperhidrosis in 14 cases (50%). Results: Surgical complications were minimal and only one patient developed effusion. There were no deaths. Improvement in axillary and palmar hyperhidrosis was observed in all patients. Conclusion: Single-port thoracoscopic electrocauterization of the sympathetic nerves from T2 to T4 provides excellent cosmetic and functional outcomes, with best results in patients with hyperhidrosis.
