Browsing by Author "Aydemir, Yusuf"

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Factors Affecting Survival in Non-Small Cell Lung Cancer Invading the Chest Wall
(Scientific Publishers india, 2017) Sehitogullari, Abidin; Aydemir, Yusuf; Sayir, Fuat
Aim: The current study aimed to evaluate the factors affecting survival in non-small cell lung cancer invading the chest wall. Method: A total of 45 cases operated on for Non-Small Cell Lung Cancer invading the chest wall (NSCLC) were followed-up for five years. The effects of factors such as depth of tumor invasion of the chest wall (parietal pleura, extra pleural fatty tissue, intercostal muscles, and rib involvement), perinodal involvement, "N" involvement, surgical margin of the resection, and adjuvant chemotherapy on prognosis and survival were evaluated. Results and discussion: The number of males and females among the cases was 38 (84%) and seven (16%), respectively, with a mean age of 55 +/- 8 years (42-74). Chest wall resection and extra-pleural resection was performed in 36 (80%) and nine (20%) cases, respectively. In the multivariate analysis, factors positively affecting survival were depth of invasion, tumor dimension less than 5 cm, N0 lymph node status, complete resection, and complete adjuvant chemotherapy. Full-thickness resection of the chest wall was an important prognostic factor for long-term survival in all patients with NSCLC invading the chest wall. Conclusion: The stage of the tumor and histopathological factors such as lymphatic involvement, extrapleural invasion, and rib invasion have been shown to gain importance in improvement of survival, in addition to advancements in surgical techniques. Although there is no consensus on the surgical approach in presence of chest wall invasion, we suggest that "en bloc" resection should be preferred to extra-pleural resection.
Managing Postpneumonic Empyema Thoracis in Children: Comparison of Different Treatment Options
(Kowsar Corp, 2019) Sehitogullari, Abidin; Sayir, Fuat; Aydemir, Yusuf; Anbar, Ruchan; Sayhan, Havva
Objectives: To compare various treatment methods of postpneumonic empyema (PPE) in children. Methods: Six hundred eighty one (302 females and 379 males) pediatric PPE patients were studied at two different centers between 2000 and 2016. The average age was 4.8 years that ranged from 30 days to 15 years. The patients were considered in six groups. The initial treatments, thoracentesis (group A), chest tube drainage (group B), fibrinolytic therapy (group C), decortication following chest tube drainage (group D), video-assisted thoracoscopic surgery (VATS) (group E) and primary operation without chest tube drainage (group F), were applied to the patients. Results: Success rates were 100%, 47.3%, 82.7%, 100%, 100%, and 100% for thoracentesis, chest tube drainage, fibrinolytic treatment, chest tube drainage, decortication following chest tube drainage, VATS and primer operation, respectively. The overall response rate of fibrinolytic therapy was 82.7% (n = 67). Fourteen of 81 (17.2%) patients who went through fibrinolytic instillation did not respond to treatment; these recovered after the application of thoracotomy and VATS. In addition to decortication pulmonary resections were performed in 15 patients. Overall mortality rate was 1.32%. There was no operative mortality. Postoperative morbidity included wound infection in 22, delayed expansion in 17, and atelectasis in 40 patients. Conclusions: Chest tube drainage can be said to be an efficient and safe primary treatment for PPE in children. In cases when chest tube drainage fails to satisfy, decortication with thoracotomy can be applied well with low mortality and morbidity rates.