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    Autologous Blood Patch Pleurodesis in the Management of Prolonged Air Leak
    (Georg Thieme Verlag Kg, 2010) Ozpolat, B.
    Objective: Prolonged air leak is a common problem for thoracic surgeons. In this study, the efficacy of autologous blood patch pleurodesis for prolonged air leak in spontaneous pneumothorax and secondary to pulmonary hydatid cyst operations was evaluated. Methods: Between 1997 and 2007, autologous blood patch pleurodesis was used to treat prolonged air leak in 24 patients. Prolonged air leak was due to spontaneous pneumothorax in 17 patients and secondary to pulmonary hydatid cyst operation in 7 patients. Venous blood (2 mL/kg) was withdrawn from the patient's antecubital vein and given into the chest tube. The chest tube was unclamped and kept at 60 cm above the patient's chest. After the procedure, the tube was left in its natural position. The procedure was repeated 24 hours after the first attempt in cases of persistent air leak. The chest tube was removed after 24 hours if no air leak was observed. Results: Air leaks stopped within 24 hours in 20 patients. Four patients received an extra instillation of autologous blood of the same dose the next day. The rate of successful treatment was 87.5%. The chest tube was removed 24 hours after termination of the air leak. No specific clinical symptoms resulting from the procedure were observed. Conclusion: Management of prolonged air leak with autologous blood patch pleurodesis is a safe, easy and effective method. To our knowledge, this is the first report in the literature on the use of this method after hydatid cyst surgery.
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    Polylactic acid and polyethylene glycol prevent surgical adhesions
    (Comenius Univ, 2016) Ozpolat, B.; Gunal, N.; Pekcan, Z.; Ayva, E. S.; Bozdogan, O.; Gunaydin, S.; Dural, K.
    OBJECTIVES: Re-mediastinoscopy could be risky because of adhesions from the previous mediastinoscopy. The aim of this study was to evaluate the efficacy of a bio-resorbable barrier on adhesion formation in a re-mediastinoscopy rat model. METHODS: Mediastinal dissection similar to mediastinoscopy was done in twenty-eight rats and a polymeric film comprising of polylactic acid and polyethylene glycol (Repel-cv (R), SyntheMed Inc., NJ, USA) was placed on trachea in the study groups. Group 1 (sham, sacrificed at day 30), Group 2 (single barrier, sacrificed at day 30), Group 3 (single barrier, sacrificed at day 60), Group 4(double layer barrier, sacrificed at day 60). Mediastinal adhesions, degree of inflammation, vascular proliferation, foreign body reaction and fibroblast proliferation was compared. RESULTS: Macroscopic dissection showed significantly dense adhesions in Sham Group and Group 3 (p < 0.05). Histopathologic examination showed that there was a significant difference between groups when the foreign body reaction and fibroblast proliferation was evaluated (p<0.05). No significant difference was present between the groups in terms of inflammation and vascular proliferation (p>0.05). CONCLUSIONS: This unique experimental study showed that adhesion barrier was effective as single layer application at day 30 and double layer application at day 60. At clinical conversion, by the application of barrier, the formation of adhesions might be decreased to provide a safe re-mediastinoscopy (Tab. 2, Fig. 4, Ref. 23). Text in PDF www.elis.sk.