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    Accelerated treatment of concomitant empyema and lung cancer by video-assisted thoracoscopic surgery
    (ELSEVIER DOYMA SL, 2016) Eryigit, Hatice; Orki, Alpay; Unaldi, Mehmet; Ozdemir, Attila; Orki, Tulay; Kosar, Altug; Demirhan, Recep; Arman, Bulent
    Background: The most common cause of pleural empyema are parapneumonic effusions, and lung cancer is a rare cause of empyema. The aim of the present study is to analyse the results of the thoracoscopic treatment of empyema before definitive oncological treatment. Methods: Retrospective descriptive study of 332 patients including different clinical variables between 2002 and 2010. Results: Among 332 patients with empyema, the etiology of this disease was lung cancer in 11 patients. Ten of these patients were male and one was female (median age, 57.9 years; range, 46-76). The initial treatment was tube thoracostomy in 8 patients and video-assisted thoracoscopic surgery in 3 patients. Thoracoscopic debridement was performed in 4 patients whose tube thoracostomy underperformed because of insufficient drainage. The methods used for diagnosis of lung cancer were fiberoptic bronchoscopy and video-assisted thoracoscopic surgery. Surgical resection was performed on 7 suitable patients following infection control. Postoperative bronchopleural fistula and empyema occurred after pneumonectomy in one case. No operative mortality was observed. The mean survival time was 32.8 months for patients undergoing resection. Conclusions: Empyema could be a rare presentation of lung cancer and those suitable for surgical treatment should undergo standard treatment with reasonable results. (C) 2014 AEC. Published by Elsevier Espana, S.L.U. All rights reserved.
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    Lung Cancer Surgery Part I: Carcinoid Tumours of the Lung
    (BENTHAM SCIENCE PUBL, 2013) Kosar, Altug; Orki, Alpay; Orki, Tulay Kayacan; Arman, Bulent; Balci, AE
    Bronchial carcinoid tumours were in the past defined as benign and classified as "bronchial adenomas". Currently bronchial carcinoid tumours are considered to be part of a spectrum of malignant neoplasms with neuroendocrine differentiation. Bronchial carcinoid tumours are classified by pathologic features as typical carcinoid tumours or atypical carcinoid tumours with different clinical course prognosis. The most common symptoms are cough, hemoptysis and recurrent pulmoner infection. Paraneoplastic syndromes are uncommon and include Carcinoid syndrome, Cushing's syndrome, and ectopic growth hormone-releasing hormone secretion. Bronchial carcinoid tumours are generally central location for this reason being visible by bronchoscopy. Endobronchial biopsy via bronchoscopy is safe, with a very low risk of bleeding. Atypical carcinoid tumours affected preferentially patients older than typical carcinoid tumours and demonstrated a more aggressive oncological behaviour with a high percentage of nodal involvement and distant metastases. The primary treatment is complete surgical resection (especially parenchymasparing procedures for typical carcinoid tumours) and formal mediastinal lymph node dissection. Long term prognosis is excellent in typical carcinoid tumours, although it is worse in atypical carcinoid tumours.
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    A rare cause of intercostal neuralgia: Ancient schwannoma of the chest wall
    (MARMARA UNIV, FAC MEDICINE, 2017) Unsal, Mirac Aysen; Kelten, Bilal; Kosar, Altug; Orki, Alpay
    Intercostal neuralgia is a rare condition that causes pain along the intercostal nerves. Neural tumors of the chest mostly arise from mediastinum and only less than 5-10% of primary tumors originate from intercostal nerves. These patients are usually asymptomatic. Herein, we report a 42-year-old male patient with severe intercostal neuralgia due to the schwannoma of the chest wall. The patient underwent surgical resection and his histopathological diagnosis was a very rare type of schwannoma: ancient schwannoma. Resecting the tumor relieved his pain.
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    Spontaneous pneumothorax: retrospective analysis of 348 cases
    (TURKISH ASSOC TRAUMA EMERGENCY SURGERY, 2009) Demirhan, Recep; Kosar, Altug; Eryigit, Hatice; Kiral, Hakan; Yildirim, Mehmet; Arman, Buelent
    BACKGROUND In this study, spontaneous pneumothorax (SP) cases were divided into two groups and retrospectively evaluated according to age, sex, diagnostic methods, treatments, and results. METHODS Between June 1997 and May 2005, 348 patients (320 males, 28 females; mean age 34.5; range 14 to 80 years) with SP were enrolled into our study. There were 274 (78.7%) primary SP and 74 (21.3%) secondary SP patients. Tuberculosis was the most common cause in secondary SP patients. Nasal oxygen and aspiration was the first-line therapeutic option in 10% of patients and tube thoracostomy was performed in 90%. RESULTS Nasal oxygen and aspiration success ratio wits 85.7% in primary SP patients and 66.7% in secondary SP patients. Tube thoracostomy Success ratio was nearly the same in patients with primary and secondary SP (88.4% and 85.7%). Of the 29 patients (11.6%) with primary SP with unsuccessful result of tube thoracotomy, 15 underwent axillary thoracotomy and 14 underwent video-assisted thoracoscopic surgery (VATS). One patient among these 14 who underwent VATS (7.1%) had recurrence. CONCLUSION Tube thoracostomy success ratio was high in both primary and secondary SP patients. Surgical procedures can be applied safely, with low recurrence rate, when the tube thoracostomy remains unsuccessful.