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Öğe Abdominothoracic Fistulas due to Complicated Echinococcosis(Georg Thieme Verlag Kg, 2012) Karamustafaoglu, Y. A.; Tarladacalisir, T.; Yoruk, Y.Purpose Abdominothoracic fistulas are severe complications of hydatid disease. We report here on the results of surgical treatment of hydatid abdominopleural fistulas in 6 patients. Material and Methods Between 2004 and 2010, 6 patients with abdominothoracic fistulas (ATF) were treated. The patients were 3 men and 3 women (age range: 4762 years; median age: 57.1 years). The main symptoms were dyspnea, chest pain, cough, purulent sputum, high fever in 4 patients and additionally bilioptysis in 2. Fistulas were left abdominopulmonary in 1, hepatopulmonary in 2 and hepatopleural in 3 patients. Results Five patients were operated for ATF and 1 patient was treated with tube thoracostomy. In 4 patients, liver dome hydatid cyst abscesses were exposed through a right thoracophrenotomy, a first left thoracophrenotomy was performed in 1 patient followed by a second left lower lobectomy due to a destroyed lobe. Tube thoracostomy and percutaneous transhepatic drainage was applied successfully in Patient #5. All patients were discharged from hospital in good health. Our strategy consisted of adequate evacuation of the intrahepatic cyst with dissection and closure of the fistula via thoracophrenotomy. Discussion ATF due to hydatid cyst is uncommon. In rare cases ATF may be present at the abdominal, thoracic or diaphragmatic level. Thoracophrenotomy is the best surgical treatment for all three levels.Öğe ESOPHAGEAL SELF EXPANDABLE METAL STENTS FOR THE PALLIATION OF DYSPHAGIA DUE TO LUNG CANCER(Elsevier Ireland Ltd, 2009) Yoruk, Y.; Karamustafaoglu, A. Y.[Abstract Not Available]Öğe Esophageal stent placement for the palliation of dysphagia in lung cancer(Georg Thieme Verlag Kg, 2007) Yoruk, Y.Background: The aim of this study was to evaluate the experience with expandable metal stents for the palliation of malignant dysphagia caused by lung cancer. Methods: Between August 2002 and April 2006, we deployed esophageal metal stents in 14 patients with esophageal involvement from lung cancer. The mean age of the patients was 61.4 years, and 12 were male patients. Expandable metal stents were inserted under fluoroscopic control over a guide-wire with the patient under conscious sedation. Results: Four patients had concomitant tracheoesophageal fistula. Eleven patients had received previous chemotherapy or radiotherapy and two had had a pneumonectomy. Immediate improvement after esophageal stent replacement was seen in all patients. The fistula was sealed off in all. All the patients remained asymptomatic during follow-up. All patients died, with mean survival of 10 weeks for patients with fistula and 8.3 months in the patients without fistula. Conclusion: The poor quality of life associated with malignant dysphagia and tracheoesophageal fistula in lung cancer patients can be significantly improved by a non-surgical intervention such as the deployment of expandable metal stents.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 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 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.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.