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    Diagnostic and therapeutic approaches in tracheobronchial rupture: Analysis of 23 patients
    (2010) Şahin, Ekber; Nadir, Aydin; Karadayi, Şule; Çelik, Burçin; Manduz, Şinasi; Akkaş, Yücel; Kaptano?lu, Melih
    Background: In this article we examined diagnostic and therapeutic results of tracheobronchial ruptures which we treated. Methods: In our study the records of 23 patients (19 males, 4 females; mean age 21.0±15.8 years; range 1 to 64 years) who were admitted to and treated in our clinic between June 1992 and October 2008 due to tracheobronchial rupture caused by trauma or iatrogenic factors were examined retrospectively. Patients were evaluated in terms of injury type, localization of lesion, diagnostic and therapeutic methods. Results: A bronchus was ruptured in 17 patients (73.9%) and trachea was ruptured in six patients (26.1%). Bronchoscopy provided the diagnosis in 91%. Computed tomography was performed in four patients (17%). Eleven of the ruptures were in the right bronchial tree (47.8%), whereas six were in the left bronchial tree (26.1%) and six were in the trachea (26.1%). While surgical therapy was performed in 17 patients (73.9%), conservative therapy was administered in six (26.1%) patients. Morbidity occurred in two (8.7%) patients and one patient died (4.3%). Conclusion: Immediate or delayed surgical treatment can be successful in rupture or complete disruption of tracheobronchial ruptures. Multitrauma patients should be surgically treated as soon as cardiopulmonary status was stabilized. If there is a suspicion of tracheobronchial trauma, bronchoscopy should not be spared. If suspicion continues, repetitive bronchoscopy shouldn't be avoided.
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    Therapeutic approaches in tracheal stenosis: Analysis of fifteen cases
    (2010) Şahin, Ekber; Nadir, Aydin; Çelik, Burçin; Karadayi, Şule; Manduz, Şinasi; Arslan, Sulhattin; Kaptano?lu, Melih
    Background: In this study, results of treatment of patients who had tracheal stenosis were evaluated. Methods: The clinical records of 15 patients (6 males, 9 females; mean age 39±23.2 years; range 8 to 70 years) who were treated for tracheal stenosis between June 1992 and October 2008 were analyzed retrospectively. The diagnostic method, localization, therapeutic approach and results of tracheal stenosis were investigated. Results: Tracheal stenosis was due to tracheostomy in six, prolonged intubation in five and malignancy in four patients. Rigid bronchoscopy was the most frequent diagnostic tool. Eight patients were treated conservatively. Diathermic resection was the first treatment of choice in nine patients. Resection and end-to-end anastomosis was used in seven patients and tracheal stent was used in six patients. Stents of three patients were removed within 12 to 18 months. Median duration of hospitalization was 12 days. Morbidity was seen in four patients; mortality was seen in three patients. Conclusion: The success rate in tracheal stenosis treated by surgery is 71 to 97% and it is 65 to 70% by conservative methods. Surgical options should be considered first, but conservative methods should keep in mind.
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    Venous thromboembolism risk in patients with lung cancer
    (2010) Arslan, Sulhattin; Karadayi, Şule; Özşahin, Sefa Levent; Şahin, Ekber; Akkurt, Ibrahim
    Background: The incidence of venous thromboembolism in lung cancer patients was investigated and the relationships between venous thromboembolism and histopathological types, stage, and treatment of the cancer, as well as accompanying chronic diseases were evaluated. Methods: This retrospective study was based on the evaluation of the files of 137 lung cancer patients (126 males, 11 females; mean age 58±28 years; range 24 to 78 years), who were diagnosed and treated in our clinic between January 2006 and May 2009. The diagnosis of venous thromboembolism was based on the clinical findings and the findings of the thorax computed tomography-angiography, ventilationperfusion scintigraphy, and Doppler ultrasound. The name of the thrombosed vein was recorded. Results: Venous thromboembolism was determined in 8.8% patients. Of 121 smokers, 9.1% had venous thromboembolism. Other diseases were present in 44.6% of patients. Some patients had more than one accompanying disease (chronic obstructive lung disease, arterial hypertension, coronary artery disease, diabetes mellitus, congestive heart failure). The incidence rate of accompanying diseases in the patients with venous thromboembolism was 58.3%. Of the patients, 22.6% had small cell lung cancer, while 77.4% had non-small cell lung cancer. Venous thromboembolism was present in 6.4% of the patients with small cell lung cancer, and in 9.4% of the patients with nonsmall cell lung cancer. Histopathologically, adenocarcinoma was detected in 50% of the patients with venous thromboembolism. The cancer in 58.3% of the patients with venous thromboembolism was in its advanced stage, and the cancer in 58.3% of the patients developed venous thromboembolism during first step treatment. Metastasis was noted in 53.8% of patients. Conclusion: Although the differences were not statistically significant, the incidence rate of venous thromboemboli was higher in the group of patients with adenocarcinoma, advanced stage cancer, metastasis, and chronic comorbidity. It is also slightly higher in patients who were administered chemotherapy.