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Öğe Sublingual vs. intranasal dexmedetomidine sedation for flexible fiberoptic bronchoscopy procedure: a retrospective comparative study(Verduci Publisher, 2023) Yanik, F.; Sagiroglu, G.; Karamustafaoglu, Y. A.OBJECTIVE: Flexible fiberoptic bronchoscopy (FOB) is an often-employed invasive method in diagnosing, staging, and treating lung diseases. Conventional sedative agents facilitate this process. Dexmedetomidine (DM) has low side effects and is easy to administer for trans-mucosal absorption. This study aimed to investigate trans-mucosal DM used with local anesthesia during the FOB procedure. PATIENTS AND METHODS: Fifty-nine cases were retrospectively analyzed who had undergone diagnostic flexible fiberoptic bronchoscopy (FOB) in our clinic between September 2016 and September 2019. The two methods (Group 1: Sublingual, and Group 2: Intranasal) employed during the FOB procedure for the local anesthesia were compared. RESULTS: Fifty-nine patients were included in the study, wherein forty-six were males (77.9%), and thirteen (22.1%) females had a mean age of 58.02 +/- 8.7 years (range: 39-72 years). Thirty-three patients were in Group 1 (Sublingual) and 26 in Group 2 (Intranasal). No significant differences were there between groups regarding age, gender, body mass index, or ASA physical status. Modified Aldrete Score >9 was significant to reach with time as a correlation between operator and patient satisfaction. Sedation scores for groups at 1st, 9th, 12th, and 15th min were similar. Excessive coughing was observed in two (7.7%) patients of Group 2 but in none of Group 1 (p=0.105). Patients in both groups had no complaints of swallowing, excessive body movement, or lower oxygen saturation during examination (p>0.05). There were no complications (hypotension, bradycardia, respiratory depression, allergy, permanent amnesia, nausea, and vomiting) observed in patients. CONCLUSIONS: Our study results revealed that easily administered trans-mucosal dexmedetomidine sedation is safely applied during flexible fiberoptic bronchoscopy for adequate sedation, high satisfaction, and low complication rates with no significant difference in sublingual or intranasal administration.Öğe Surgical outcomes and clinical courses of solitary fibrous tumors of pleura(Wolters Kluwer Medknow Publications, 2019) Yanik, F.; Karamustafaoglu, Y. A.; Yoruk, Y.Aim: This study's aim is to define the clinicopathological and surgical outcomes, clinical courses, and results of long-term follow-up of cases that underwent surgical treatment for solitary fibrous tumors of the pleura (SFTp). Subjects and Methods: Clinical and long-term follow-up records of 16 consecutive patients who had surgery for SFTp between 2006 and 2016 were reviewed in the retrospective chart review. There were nine males (56%) and seven (44%) females with an average age of 60.5 +/- 17.1 (range 30-87 years). Etiological factors, diagnostic procedures, clinical and surgical outcomes, 5-year overall survival (OS), and disease-free survival (DFS) in these patients were researched. Results: There was no remarkable common etiological factor. Nine of the cases were asymptomatic. Other symptoms were chest pain, dyspnea, cough and hypertrophic osteoarthropathy, respectively. Thoracotomy for the removal of pleural mass was carried out in 15 (94%) cases. Additional resection procedures included the chest wall resection in two cases and lobectomy in two. Video-assisted thoracoscopic surgery (VATS) resection was performed in one (6%) case. Complete surgical excision was performed in 74% of cases. Nineteen percent of cases were malignant SFTp (mSFTp). One of the mSFTp cases died in the 19(th) month after the diagnosis. The mean follow-up time was 50.6 +/- 34.2 months (2--114 months). Mean survival of mSFTp patients was 40.6 +/- 19.08 months (19--55 months) and that for benign SFTp (bSFTp) was 52.9 +/- 37.05 months (2--114 months). Five-year OS--DFS were 93.5% and 74%, respectively. Conclusion: SFTp is an uncommon benign neoplasm but it can have malignant features. Even in the case of recurrence, the main treatment is total surgical excision. Oncologic treatments can be tried in unresectable and metastatic cases. VATS can be used in surgical total excision for small diameter and appropriate tumors. Understanding the nature of these tumors, immunohistochemical, and genetic studies may be a guide in future.