Browsing by Author "Mergan, Duygu"

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Are Serum Mac 2-Binding Protein Levels Elevated in Esophageal Cancer? a Control Study of Esophageal Squamous Cell Carcinoma Patients
(Hindawi Ltd, 2018) Cobanoglu, Ufuk; Mergan, Duygu; Dulger, Ahmet Cumhur; Celik, Sebahattin; Kemik, Ozgur; Sayir, Fuat
Objective. Elevated serum Mac 2-binding protein (M2BP) levels have been observed in some cancers. As far as we know, its importance has not been investigated in esophageal squamous cell carcinoma (ESCC). The investigated problem of this study was to evaluate whether there was a difference between ESCC patients and the control group in terms of M2BP. Also, we evaluated the diagnostic performance of serum M2BP alone or in combination with the CEA for patients with ESCC. Material and Methods. Blood serum samples were collected from 50 healthy donors and 150 patients with ESCC. M2BP levels of all 200 samples were quantified by ELISA (enzyme-linked immunosorbent assay). Patients who had been diagnosed with ESCC and did not have any other malignancies were enrolled to study. Results. The two groups did not significantly differ in terms of age (p > 0 05). In the control group, the mean serum M2BP level was 14.97 coproduct 3.46 ng/mL. The mean serum M2BP level of the ESCC patients was 176.65 +/- 22.14 ng/mL. The serum M2BP level was significantly higher in patients with ESCC than in the control group (p < 0 001). Gender was also comparable in both groups (p = 0 695). Conclusions. Our analysis demonstrated that this marker may be associated with the mechanism of the disease. Despite that serum M2BP is not a specific marker for ESCC, it can be used as an adjuvant biomarker for the diagnosis of ESCC.
Chest Traumas Due To Bicycle Accident in Childhood
(derman Medical Publ, 2011) Cobanoglu, Ufuk; Melek, Mehmet; Sayir, Fuat; Mergan, Duygu
Aim Childhood injuries are the leading cause of death in children and result in significant healthcare utilization. Trauma is the second most common cause of mortality in children aged 1-4 years and leading cause of death in children older than 4 years. Thoracic injury is the second most leading cause of death in traumatized children. Multisystemic injury is found in more than 50% of children with thoracic injuries most of which are secondary to blunt traumas. We planned this study to evaluate thorax trauma cases secondary to bicycle driving in childhood and to draw attention to the importance of the regulation of traffic rules, the education of bicycle drivers. Material and Methods A retrospective evaluation was performed in 17 pediatric patients admitted to the Department of Thoracic Surgery during 2006-2010 with a diagnosis of chest trauma due to bicycle driving. For every patient, a pediatric trauma score (PTS) was calculated. Descriptive statistics were performed for PTS. Results Eleven (64.70%) cases were injured due to the tricycle accidents and six cases 6 (35.29%) were injured due to the two-wheeled bicycle accidents. The most frequent thoracic pathologies included pulmonary contusion (41.2%) and chest wall contusion (29.41%). Extrathoracic injuries were seen in 35.29%, the extremities (17.64%) and abdomino pelvic (11.76%) being the most commonly involved. Treatment consisted of symptomatic treatment in 12 patients (70.58%), tube thoracostomy in 2 patients (11.76%), and thoracotomy in 1 patient (5.9%). The morbidity was seen in 3 patients (17.64%). The mortality rate was 5.9% (n:1). The mean PTS of the cases who had additional system injuries were significantly worse than the cases who had isolated chest traumas. Conclusions The pediatric thorax has a greater cartilage content and incomplete ossification of the ribs. Due to the pliability of the pediatric rib cage and mediastinal mobility, significant intrathoracic injury may exist in the absence of external signs of trauma. Pulmonary contusion and pneumothorax are frequently present without rib fractures. Pulmonary contusion, pneumothorax, and rib fractures are the most common injuries. In order to prevent bicycle accidents; bicycle drivers should have specific education, helmet use must become widespread and special traffic regulations have to be settled. Increasing the education level if family will contribute to the prevention of childhood trauma.
Diagnostic Dilemma in Hydatid Cysts: Tumor-Mimicking Hydatid Cysts
(Aves, 2015) Cobanoglu, Ufuk; Asker, Selvi; Mergan, Duygu; Sayir, Fuat; Bilici, Salim; Melek, Mehmet
OBJECTIVES: Hydatid cysts are sometimes confused with different pathologies, and problems arise in their diagnosis and treatment. In this study, cases that are followed up with a diagnosis of lung malignancy and that are detected to have hydatid cysts were retrospectively examined. MATERIAL AND METHODS: Seven patients with hydatid cysts whose clinical and radiological features were consistent with lung malignancy were retrospectively examined between 2010 and 2014 regarding sex, age, symptoms, diagnostic methods, surgical procedures performed, and postoperative complications. In the diagnosis of the patients, radiological diagnostic methods such as chest radiography, thoracic computed tomography (TCT), and positron emission tomography+computed tomography (PET-CT) as well as invasive diagnostic methods such as bronchoscopy, fine-needle aspiration biopsy, thoracentesis, and video-assisted thoracoscopic surgery were used. RESULTS: The average diameter of the lesions was determined as 4.14 +/- 1.57 cm in TCT. Maximum standardized uptake value (SUV max) was measured as 8.77 +/- 3.41 (5.4-15.1) in the PET-CT analysis. Bronchoscopy, fine-needle aspiration biopsy, and thoracentesis yielded no results. Definitive diagnosis was established by performing thoracotomy and video-assisted thoracoscopic surgery. CONCLUSION: Pulmonary hydatid cysts can appear as malignant diseases such as lung cancer as well as infectious pathologies such as tuberculosis or benign pathologies. Radiologically, it should be kept in mind that pulmonary hydatid cysts can mimic many pulmonary pathologies, particularly malignancies. Necessary examinations towards its differential diagnosis must be performed in the preoperative period.
Diaphragmatic Herniation Diagnosed at a Late Stage: an Evaluation of Eight Cases
(Baycinar Medical Publ-baycinar Tibbi Yayincilik, 2012) Sayir, Fuat; Cobanoglu, Ufuk; Bilici, Salim; Melek, Mehmet; Mergan, Duygu
Background: In this study, we aimed to analyze patients with diaphragmatic hernias who had specific clinical features and interesting clinical, radiologic presentations, and had operated following late diagnosis. Methods: A total of eight diaphragmatic hernia cases, of whom three were adults and five were children (4 males, 4 females; mean age 12.4 +/- 24 years; range 9 months to 28 years), who were diagnosed in the late period and who were operated on in our clinic between January 2006 and August 2010 were evaluated retrospectively. In all patients, primary repair of the diaphragm was performed following laparotomy and thoracotomy. Results: The children were diagnosed following the neonatal period. Three patients were diagnosed in adulthood. Five patients had right-sided congenital Morgagni hernias, one patient had a hiatal hernia, and two patients had left-sided Bochdalek hernia. All patients were discharged between the 5th and 19th postoperative days. The average duration of hospital stay was 9.8 days (range 7 to 23 days). The follow-up time were between six months and two years, and no significant respiratory and gastrointestinal complaints were recorded. No morbidity was detected in three cases with Morgagni hernia. Conclusion: Congenital diaphragmatic hernias are pathologies which are seen in the neonatal period, and the diagnosis of these hernias can be difficult after this period. Mortality and morbidity rates are low in cases who are followed and treated in clinics by dedicated thoracic surgeon.
The Effect of Diaphragmatic Plication on Pulmonary Function Test, Dyspnea Score and Arterial Blood Gases: Analysis 11 Patients With Diaphragmatic Elevation
(derman Medical Publ, 2011) Cobanoglu, Ufuk; Sayir, Fuat; Mergan, Duygu; Toktas, Osman
Aim Diaphragmatic evantration or paralysis in adults is associated with respiratory distress. In this study, we aimed to compare preoperative and postoperative pulmonary function tests, arterial blood gas analyses and dyspnea scores of the cases in whom plication had been performed for diaphragmatic elevation. Material and Methods Between January 2004 and March 2010 eleven adult patients who had undergone diaphragmatic plication due to diaphragmatic paralysis and eventration were analyzed. There were 7 (63.63%) men and 4 (36.37%) women aged 28-65 (mean 38 +/- 2.9). Diaphragmatic plication was performed. Pulmonary function test, dyspnea scores, and arterial blood gases in the preoperative and postoperative period were studied. Results Dyspnea was present in all of the cases and a decrease in both FVC, FEV1, FEV1/FVC values of pulmonary function test and partial pressure of oxygen in the arterial blood were observed. In chest x-ray and thorax computed tomography, it was detected that right or left diaphragm was elevated. Diaphragmatic paralysis was detected by fluoroscopy in 6 patients. Transthoracally, diaphragmatic plication was performed to the cases. There were no postoperative complications or deaths. In postoperative six and twelve months, significant improvements in the symptoms, the values of pulmonary function tests, partial pressure of oxygen in the arterial blood and dyspnea scores of the patients were observed. Conclusions Diaphragmatic plication is a safe and effective procedure for adult patients with dyspnea due to unilateral diaphragmatic elevation. Lung expansion is easily achieved by performing diaphragm plication.
Erythrocyte Catalase and Carbonic Anhydrase Activities in Lung Cancer
(Asian Pacific Organization Cancer Prevention, 2010) Cobanoglu, Ufuk; Demir, Halit; Duran, Memet; Sehitogullari, Abidin; Mergan, Duygu; Demir, Canan
Aim: To study the relationship between the pathogenesis of lung cancer and antioxidant status and acidic media by measuring the activities of erythrocyte catalase (CAT) and carbonic anhydrase (CA). Methods: A total of 26 patients with lung cancer and 15 healthy individuals were included in the study. The CAT and CA activities of erythrocytes were defined. The catalase (CAT) activity of erythrocytes was measured using Aebi's method. Carbonic anhydrase (CA) activity was analyzed by CO2 hydration. Results: It was found that erythrocyte CA and CAT activities were significantly lower in patients with lung cancer compared to controls (p<0.05). Of the 26 patients with lung cancer, seven (26.9%) had metastasis, and the CA and CAT levels in patients with metastasis were significantly decreased (p=0,0001). Conclusions: Development of oxidative stress due to lung cancer may be related to the balance between prooxidant and antioxidant reactions. Catalase may have a preventive effect for malignant lung cancers and the gene of the antioxidant enzymes may be one of the anti-oncogenes, and inactivation of one of these genes in the process of carcinogenesis may lead to tumor development. This may be an explanation for the very low levels of antioxidant CAT in patients with lung cancer compared to healthy individuals. Carbonic anhydrase (CA) in tumor cells may be an indicator of the acid-base balance in lung cancer. Decreased levels of CA in patients with lung cancer may provide a convenient media for tumor development, growth and metastasis by creating an acidic media.
A Foreign Body Aspiration Showing Migration and Penetration: Hordeum Murinum
(derman Medical Publ, 2012) Sayir, Fuat; Cobanoglu, Ufuk; Sertogullanndan, Bunyamin; Mergan, Duygu
Aspiration of foreign bodies is an important cause of mortality and morbidity in the childhood period. Very rarely seen among the tracheobronchial foreign body aspirations is the Hordeum Murinum, which has an atypical clinical presentation. It may cause unavoidable sequelae in the bronchial system requiring surgery, like bronchiectasis and destruction of the lung parenchyma in patients with delayed diagnosis. Hordeum Murinum, which is hard to pull out due to its progressive nature, may cause interesting clinical pictures. In this study, a case of Hordeum Murinum aspiration is reported which has been diagnosed early due to hemoptysis could be pulled out by thoracotomy after negative bronchoscopy.
An Ideal Choice in the Diagnosis of Interstitial Lung Diseases: Video- Assisted Thoracoscopic Surgery
(derman Medical Publ, 2012) Cobanoglu, Ufuk; Sayir, Fuat; Mergan, Duygu
Aim: Interstitial lung diseases are a heterogeneous group of diseases with a known or unknown etiology affecting the interstitium of the lung. In this study, our experience in the lung biopsy performed by video-assisted thoracoscopic surgery and open lung biopsy for interstitial lung diseases is discussed. Material and Method: In this study, we reviewed 31 patients with a clinical diagnosis of interstitial lung disease who underwent open or thoracoscopic lung biopsy between the years of 2004 and 2010. The cases were examined retrospectively for the age, sex, radiological appearance, operative time, chest tube duration, postoperative hospital stay and the complications. Thoracotomy was performed to 19 of the patients (61.30%) while twelve patients (38.70%) underwent video-assisted thoracoscopic surgery. Result: Fourteen of the cases (45.16%) were male while 17 patients were female (58.06%) with a mean age of 40.83 +/- 15.537 (18-69). Nonspecific interstitial fibrosis constituted the most of the certain diagnoses (29.27%). Operative time, chest tube duration and postoperative hospital stay were significantly shorter in video-assisted thoracoscopic surgery group (p values were 0.018, 0.001 and 0.011 respectively). The overall morbidity rate was 12.90% and there was no mortality. Discussion: In spite of recent advances in clinical diagnostic techniques, lung biopsy is the gold standard for the diagnosis of interstitial lung disease. In our opinion, video-assisted thoracoscopic surgery should be the first choice in the diagnosis of interstitial lung diseases, since these patients can be discharged early as a result of shorter chest tube duration and hospital length of stay.
Isolated Hemothorax Following Thoracic Trauma: Analysis of 57 Cases
(derman Medical Publ, 2012) Cobanoglu, Ufuk; Melek, Mehmet; Kara, Volkan; Mergan, Duygu
Aim: The aim of this study was to review cases with isolated hemothorax after thoracic trauma, to assess the diagnostic and treatment methods, and to discuss the determining factors of morbidity and mortality. Material and Method: A total of 57 patients were examined retrospectively. All patients underwent tube thoracostomy and underwater seal as the initial treatment approach. Emergency thoracotomy was performed on cases with continuing drainage from the chest tube, expanding hemothorax on the posteroanterior (PA) chest x-ray, and with hemodynamic instability. Result: Hemothorax occurred as a result of penetrating trauma in 31 (54.38%) and due to blunt trauma in 26 (45.61%) cases. Of the cases, 49 (85.96%) underwent tube thoracostomy drainage. All the 8 cases (14.03%) that underwent emergency thoracotomy had penetrating trauma. Mortality occurred in one patient (1.75%) who had penetrating trauma and who underwent emergency thoracotomy. The morbidity rate in patients with blunt trauma was significantly higher than those with penetrating trauma (p<0.0001). Discussion: Accurate diagnosis and appropriate surgical intervention in cases with traumatic hemothorax is essential for reducing the morbidity and mortality. Chest tube insertion and underwater seal application should be the initial treatment modality and successful in most cases. Emergency thoracotomy is life-saving in indicated patients. The need for thoracotomy is higher in isolated hemothorax due to penetrating chest trauma.
Oesophageal Foreign Bodies Caused by Meat Consumed During the Sacrifice Feast: Our Single-Centre Experience
(Pakistan Medical Assoc, 2018) Cobanoglu, Ufuk; Mergan, Duygu; Kemik, Ozgur; Sayir, Fuat
Objectives: To compare the frequency of oesophageal foreign bodies during the month of Eid-ul-Adha with other months. Methods: This retrospective study was conducted at YuzuncuYil University Hospital, Van, Turkey, during 2012-16, and comprised individuals who were treated for bone and/or meat fragments lodged in the oesophagus. The number of hospital admissions with diagnosis of oesophageal foreign bodies during Eid-ul-Adha episodes were extricated and compares with similar date for the other months.Minitab 13 was used for statistical computations. Results: Among the 289 cases in the study, a pronounced increase in the number of patients was observed during Eid-ul-Adha, with the most frequent symptoms in 263(91%) patients being dysphagia and odynophagia. The number of patients with oesophageal foreign bodies diagnosed during Eid-ul-Adha were significantly higher than the other months (p<0.05). Conclusion: An increase in cases of oesophageal foreign bodies was found during Eid-ul-Adha.
Pen Lid Aspirations of School Aged Children: Educators and Parents Should Pay Attention To an Issue
(derman Medical Publ, 2011) Cobanoglu, Ufuk; Mergan, Duygu
Aim Foreign body aspiration is an important cause of morbidity and mortality in childhood. Determining and removing aspirated foreign bodies from the airways is important in preventing complications. This research aims to investigate the features of tracheobronchial aspiration pen lid cases admitted to Van 100. Yil University Medical Faculty Chest Surgery Clinic, and to find out whether these data are consistent with the literature. Material and Methods Thirteen pediatric patients who were admitted to our clinics between 1995 and 2007 with the diagnosis of pen lid aspiration, were retrospectively reviewed in terms of gender, age, complaints, timing of consultation, physical examination findings, radiologic findings and, localization of the foreign body, types of treatment given, complications and mortality. Results Of the patients 6 (46.2%) were male and 7 (53.8%) were female. The range of age was 7-14 years, and mean age was 9.2 +/- 5.6. The most common complaint was unexpected coughing in symptomatic patients. Other frequent symptoms were respiratory distress and wheezing. It has also been revealed that of all the cases, 6 ( 46.2%) admitted to the hospital in the first 6 hours, 5 (38.4%) in 24 hours, and 2 patients (15.4%) consulted in the hospital after more than 72 hours elapsed. Nine (69.2%) of the foreign bodies were located in the right bronchial tree, 4 (30.8%) were in the left. The foreign bodies were taken out by rigid bronchoscopy in all cases. There were no complications and mortality in this group. Conclusions Pen lids aspiration for school-age childern is a significant danger, they are mainly accidentally among the school-age children. This series has been compiled to underline the fact that these events can be prevented by simple precautions by parents and teachers.
Pleural Complications of Hydatid Cyst: Cases Presenting With Pneumothorax and Empyema
(derman Medical Publ, 2015) Cobanoglu, Ufuk; Bilici, Salim; Asker, Selvi; Sayir, Fuat; Melek, Mehmet; Mergan, Duygu
Aim The present study discussed cases of pulmonary hydatid cysts with pleural complications presenting with pneumothorax and empyema, which were retrospectively reviewed in terms of diagnostic and therapeutic procedures and for which the authors' clinical experience was presented. Material and Method: A total of 23 cases of pulmonary hydatid cysts with pleural complications that were treated at our clinic between 2007 and 2014 were retrospectively reviewed. The pleural complications in these patients included pneumothorax (34.78%), pyothorax (17.39%), pyopneumothorax (26.08%), hydropneumothorax (21.75%), and severe pleural thickening (17.39%). Results: At the initial step, 19 patients (82.61%) underwent tube thoracostomy and drainage, and 4 cases (17.39%) underwent thoracentesis. The cystotomy and capitonnage were the most commonly performed procedures in open surgery (89.95%). The prolonged air leakage was the most common (30.43%) postoperative complication, and cases that developed massive air leakage and broncho-pleural fistula were re-operated, and of these cases, three (10.5%) underwent lobectomy and one patient (4.34%) underwent segmentectomy. None of the cases in our series developed mortality. Discussion: A clinical picture involving empyema, pneumothorax, or both will constitute a diagnostic conundrum for hydatid cyst. Early recognition of the hydatid cysts will prevent the development of complications and reduce postoperative morbidity and mortality.
Pleural Effusion Resultant After Upper Abdominal Surgery: Analysis of 47 Cases
(derman Medical Publ, 2011) Cobanoglu, Ufuk; Bartin, Mehmet Kadir; Mergan, Duygu; Yilmaz, Ozkan; Demir, Ali; Toktas, Osman
Aim Postoperative pulmonary complications, following upper abdominal surgery, occur at a rate which is higher, than lower abdominal surgery. One of these complications is pleural effusion. In this study, the frequency and causes of pleural effusions and the changes of the blood gas values and pulmonary functions of the patients with pleural effusions, occured after upper abdominal surgery are discussed in the accompaniment of the literature. Material and Methods 148 patients to whom upper adominal surgery is performed and in 47 of these patients pleural effusion is developed (31.75%), were examined restrospectivitely. Preoperative and postoperative pulmonary function tests (PFT) and arterial blood gas (ABG) results and the blood proteins, albumin values were recorded. The anesthesia type, the surgery properties, involving type of surgery and the surgical incision were determined. Results Pleural effusion is detected bilaterally in 8 patients (17: 02), at the right side in 21 patients (44.69%), and at the left side in 18 patients (38.29%). The 40.42% (19 cases) of the patients who has pleural effusion in the postoperative period, had liver and gallbladder surgery, the % 23.41 (11 cases) had spleen and pancreas surgery and the % 36.17 (17 cases) had the other surgical procedures. Conclusions While the upper abdominal surgery, impairment of the integrity of the diaphragm's peritoneum that covers the abdominal cavity where there is a highliquid pressure, may cause the liquid transition to the pleural space that has a negative pressure. Hypoalbuminemia and hipoproteinemia, that will occur due to the changes of oral intake and diet regulation in the postoperative period, may cause a reason for the pleural effusion. For this reason, doctors who performed these surgery procedures, should not ignore this complication, in the period of postoperative follow-ups of the patients.
A Rare Case of Mediastinal Cyst: Thoracic Duct Cyst
(derman Medical Publ, 2015) Mergan, Duygu; Cobanoglu, Ufuk; Yildiz, Hanifi; Sertogullarindan, Bunyamin; Sayir, Fuat
Thoracic duct cysts are very rarely observed cysts of the mediastinum. These cysts, which can become established in the costovertebral sulcus or the visceral compartment, have generally been reported at the level of the 10th and 11th vertebrae; however, they can be observed at any location along the ductus [11, A 37-year-old male patient complained of chest pain for the last 3 months that especially increased after meals. He complained of shortness of breath while walking or going up the stairs, for the last month. The lung graphy showed an increased darkening at a 5x6cm smooth (clean-cut, regular, orderly) bordered shadow just behind the heart shadow. The patient's computed thorax tomography showed a retrocardiac-paravertebral, middle line positioned, 8.5x7x6 cm proportioned, regular bordered, thin walled, homogenous cystic bulk at the subcarinal level. The patient, who could not be relieved with medical treatment, was taken to surgery. The lesion was reached by right posterolateral thoracotomy, and drainage of lymph-containing cystic fluid and excision of the cyst walls were performed by incising the thoracic duct cyst with a mediastinal pleura incision. Mass ligation was then performed to the thoracic duct. We wanted to present our thoracic duct cyst case in this article due to the currently limited number of actual cases reported in the literature.
Reactive Oxygen Metabolites Can Be Used To Differentiate Malignant and Non-Malignant Pleural Efffusions
(Medknow Publications, 2010) Cobanoglu, Ufuk; Sayir, Fuat; Mergan, Duygu
Objective : Increase in reactive oxygen metabolites (ROM) and free radicals is an important cause of cell injury. In this study, we investigated whether determination of ROM in pleural fluids of patients with malignant and non-malignant pleural effusions can be used as a tumor marker indicating malignant effusions in the differential diagnosis. Methods :Sixty subjects with exudative pleural effusion and 25 healthy individuals as the control group were included in the study. Of the subjects with pleural effusion, 50 were malignant and 50 were non-malignant. ROM was studied in the pleural fluids and sera of the subjects with pleural effusion and in the sera of those in the control group. The ROM values of smokers and non-smokers were compared in each group. The Students t-test and the Mann-Whitney U test were used in order to detect differences between groups for descriptive statistics in terms of pointed features. The statistical significance level was set at 5 in computations, and the computations were made using the SPSS (ver.13) statistical package program. Results : It was determined that the difference between the ROM values of subjects with malignant and non-malign pleural effusions and the sera of the control group was significant in the malignant group compared to both groups (P = 0.0001), and the sera ROM values of patients with non-malignant pleural effusion were significant compared to the control group (P = 0.0001), and the ROM values of smokers were significant compared to non-smokers in each of the three groups (P = 0.0001). Conclusion : These findings indicate that sera ROM levels are increased considerably in patients with exudative effusions compared to that of the control group. This condition can be instructive in terms of serum ROM value being suggestive of exudative effusion in patients with effusions. Furthermore, the detection of pleural ROM values being significantly higher in subjects with malignant pleural effusions compared to non-malignant subjects suggests that ROM can be used as a tumor marker in the differential diagnosis of pleural effusions of unknown origin.
Reexpansion Pulmonary Edema: Analysis of Eight Cases
(Aves, 2011) Cobanoglu, Ufuk; Sayir, Fuat; Mergan, Duygu
Aim: Reexpansion pulmonary edema (RPE) is a rarely seen clinical condition. RPE is a complication of the treatment of lung collapse secondary to pneumothorax, pleural effusion or atelectasis. In this article, eight cases of RPE were presented with treatment steps and clinical progress. Material and Metods: The data of 8 cases with RPE were evaluated retrospectively between 2004 and 2010. Patients were evaluated for symptoms, primary pathologies, treatment modalities, clinical course, morbidity and mortality. All patients were monitored with arterial blood gases and oxygen saturation, before and after surgical intervention. Results: Of the cases, five were (67,5%) famale, 3 (37,5%) were male with a mean age of 40 +/- 3,7. All cases had dyspnea and 3 cases had chest pain at the admission. Primary pathologies were pneumothorax at 2, malignant pleural effusion at 2, empyema at 3 cases and chronic pleuritis at 1 case. RPE developed after decortication in one case and after tube thoracostomy in 7 cases. It was demonstrated that the cases had compensatory respiratory acidosis before the treatment. Respiratory acidosis were improved after surgery. However, blood gases and oxygen saturation levels were worsened 2-4 hours after surgical intervention. It was noticed that the patients with tube thoracostomy showed a faster clinical improvement. The case of decortication had clinical deterioration and died. Conclusions: We think that the surgical correction of chronic lung collapse and lung collapse which appears after thoracic surgery should be regarded as hazardous for RPE development. For the prevention of this situation the first step is to identify the risk factors for each patient. These risk factors should be corrected and compensated. When there is a clinical or radiological suspicion, considering the high risk of mortality, it is necessary to take the required care to avoid this rare, though potentially severe condition, as well as earlier and more aggressive therapeutic measures be taken.
Removal of Chest Tubes: a Prospective Randomized Study
(Ekin Tibbi Yayincilik Ltd Sti-ekin Medical Publ, 2011) Cobanoglu, Ufuk; Melek, Mehmet; Edirne, Yesim; Mergan, Duygu
Background: This study aims to determine which method and timing of chest tube removal is associated with a lower risk of developing recurrent pneumothorax. Methods: This prospective study was designed to evaluate the removal method and time in 144 patients (57 females, 87 males; mean age 43.2 years; range 8 to 72 years) with chest tubes inserted for trauma and other causes. Patients were randomly assigned into two groups according to the respiratory phase of the chest tube removal. Subgroups were assigned by subdividing these groups according to whether or not suction was performed and according to whether chest tube removal occurred at 6-12 hours or 24-48 hours. Results: Results supported that tube removal at the end-inspiration phase is more appropriate than removal at the end-expiration and no suction phases (p<0.013). In addition, recurrent pneumothorax was observed significantly more often in patients whose chest tubes which were removed at 6-12 hours rather than at 24-48 hours (p<0.028). The mean duration of hospital stay was significantly longer in patients with recurrent pneumothorax (p<0.01). Conclusion: Removal of chest tubes at the end of inspiration with suction and after 24-48 hours is associated with a lower rate of recurrence of pneumothorax and a significantly shorter duration of hospital stay.
A Review of Our Clinical Experience: 107 Spontaneus Pneumothorax Cases
(derman Medical Publ, 2011) Cobanoglu, Ufuk; Sayir, Fuat; Melek, Mehmet; Mergan, Duygu; Selvi, Fatih
Aim Pneumothorax is the common and life threatening problem of thoracic surgery, needs urgent intervention. In this study, spontaneous pneumothorax (SP) cases were divided into two groups and evaluated retrospectively according to age, sex, diagnostic methods, treatments, and results. Material and Methods Between June 2003 and May 2006, 107 patients with SP were enrolled into our study. There were 44 (41.13%) primary spontaneous pneumothorax (PSP) and 74 (58.87%) secondary spontaneous pneumothorax (SSP) patients. Age, gender, underlying lung disease, smoking history, symptoms, diagnosis, treatment type, surgical indication, morbidity, recurrence, mortality, and hospital stay of the patients were reviewed. Results 77 patients (71.96 %) were male and 30 patients (28.04 %) were female and their mean age was 45.7 +/- 19.1 years. Chronic obstructive lung disease (COLD) was the most common (39.68%) cause detected in the cases with secondary spontaneous pneumothorax. In twenty (18.695%) patients recurrence was observed and sixteen (14.95 %) of these patients underwent surgery. Whereas 49 (% 45.79) patients were managed by tube thoracostomy, 21(19.62%) patients were managed by tube thoracostomy+surgery and 19 (17.75%) patients were managed by tube thoracostomy+ pleurodesis. Operative indications were prolonged air leak and bullae + recurrence. Hospital mortality was 1.86%. The mean postoperative hospitalization time of the patients was 9.1 +/- 3.5 days. Conclusions Spontaneous pneumothorax is a pathology with low mortality and curable disease when diagnosed and treated in time. The primary treatment modality for spontaneus pneumothorax is conservative treatment or the thoracotomy depending on the degree of pneumothorax. Surgical procedures can be applied safely, with low recurrence rate, when the tube thoracostomy remains unsuccessful.
Sexual Dysfunctions and Prevalence of Depression Among the Fertile Age Partners of Men With Bronchiectasis: How Do the Symptoms of the Disease Affect the Partners
(Wolters Kluwer Medknow Publications, 2011) Cobanoglu, Ufuk; Karasu, Umut; Selvi, Yavuz; Gulec, Mustafa; Sayir, Fuat; Aydin, Adem; Mergan, Duygu
Introduction: Despite the numerous studies available on sexual disorders and psychological status in patients with chronic diseases, data regarding the sexual function and the psychological status of the patients' partners are insufficient. Aim: In this study we aimed to put forth the changes in sexual functions and psychological status in women caused by partners' symptoms such as productive cough and foul smelling sputum that accompany chronic disease in bronchiectasis patients. Methods: The study was conducted with fertile age partners of 41 male patients for whom an operation due to bronchiectasis was decided. The subjects were assessed using the Female Sexual Function Index (FSFI) for sexual functions and the Beck Depression Inventory (BDI) for depression before and 1 year after the operations. Results: It was found that 24.4% of the women had exhibited severe depression symptoms according to BDI, and the number of the patients with severe depression was found to decrease to 4.9% after their spouses became asymptomatic in the postoperative period (p=0.001). In the assessment of cases with FSFI, while the scores indicating sexual dysfunction wereobtained in the preoperative period, these values were found to improve significantly in the postoperative period (p=0.001). Conclusion: In this study we have seen that the health problems of the partners caused significant alterations in sexual functions and mood of the women, and it was concluded that increasing the level and maintaining the health of the partners is essential for improvement of the quality of sexual and psychological health of women.
Should Videothorascopic Surgery Be the First Choice in Isolated Traumatic Hemothorax? a Prospective Randomized Controlled Study
(Turkish Assoc Trauma Emergency Surgery, 2011) Cobanoglu, Ufuk; Sayir, Fuat; Mergan, Duygu
BACKGROUND In this study, patients with hemothorax due to blunt or penetrating thorax trauma and treated by tube thoracostomy were compared with the patients treated by videothoracoscopic surgery (VATS) in order to determine whether VATS can be the first choice in treatment. METHODS Sixty patients with hemothorax due to trauma were examined prospectively. Thirty patients with isolated hemothorax and treated by tube thoracostomy were classified as Group I (50%), and 30 patients treated by VATS were classified as Group II (50%). Patients were compared according to healing duration, tube thoracostomy duration, hospitalization duration, success rate of treatment, morbidity, and mortality. RESULTS When Group I and II were compared according to the duration of tube thoracostomy and hospitalization, Group I was found to have longer duration statistically (p = 0.001). When the two groups were compared according to morbidity, statistical morbidity was found higher in Group I (p = 0.030). CONCLUSION VATS seems to be better in the treatment of hemothorax when compared with traditional drainage method because of its advantage of direct diagnosis and hemostasis by diagnostic thoracoscopy. If clotted blood is evacuated, empyema and fibrothorax are preventable. In these cases, chest tube duration and hospital length of stay are shorter. Therefore, these patients can be discharged early.