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Öğe A comparative analysis of giant and smaller hydatid cysts of lung treated surgically(2017) Özpolat, Berkant; Yazkan, Rasih; Günal, Nesimi; Dural, KorayAmaç: Bu çalışmanın amacı akciğerin dev kist hidatiklerinin daha küçük boydaki hidatik kistlerle karşılaştırılmasıdır.Gereç ve Yöntem: Akciğer kist hidatiği nedeniyle ameliyat edilen 62 hasta geriye dünük olarak değerlendirildi. Hastalar dev kist hidatik (Grup A, n=23) ve daha küçük çapta olanlar (Grup B, n=39) olmak üzere iki gruba ayrıldı. Gruplar yaş, cinsiyet, semptomlar, kist yerleşimi ve sayısı, preoperative komplikasyonlar, uygulanan cerrahi girişim şekli, postoperative uzamış hava kaçağı, göğüs tüpü alınma günü, postoperative komplikasyonlar, hastanede kalış süresi, morbidite ve mortalite açısından karşılaştırıldı.Bulgular: Yaş, cinsiyet, kist yerleşim yeri açısından anlamlı fark saptanmadı ((P = 0.925, P = 0.293, P = 0.179). Grup A'da 21 (%91) vakada kistler tek , Grup B'de vakaların yaklaşık 1/3'ünde birden fazla kist saptandı. Kistleri tek olması anlamlı bulundu (P = 0.005). Grup A'da 13 (%56) vakada kistotomi + kapitonaj yapılırken, Grup B'de 8 (%20) vakada yapılmıştı. Kistotomi + kapitonaj yöntemi Grup B'de Grup A'ya göre anlamlı olarak yüksekti. Uzamış hava kaçağı Grup A'da 8 (%20), Grup B'de 2 (%5) vakada gözlendi. Ortalama göğüs tüpü çekilme günü Grup A'da 4.57 ± 2.48 gün, Grup B'de 2.49 ± 1.63 gün ve hastanede kalış süresi Grup A'da 8.48 ± 3.39 gün ve Grup B'de 5.69 ± 1.80 gün olup her iki parametre istatistiksel olarak anlamlıydı (P < 0.001 ve P < 0.001). Postoperatif komplikasyonlar Grup A'da iki, Grup B'de üç vakada gözlendi. Her iki grupta da mortalite yoktu. Sonuçlar: Dev akciğer kistlerinin soliter görülme ihtimali fazla, ortalama göğüs tüpü çekilme ve hastanede kalış süresi uygulanan operasyondan bağımsız olarak uzamıştır. Kapitonajlı veya kapitonajsız yöntemlerin uygulandığı her iki grupta küratif cerrahi girişimlerin sonuçları mükemmeldirÖğe Diaphragmatic Injuries: A Surgical Challenge. Report of Forty-one Cases(Georg Thieme Verlag Kg, 2009) Özpolat, Berkant; Kaya, Oskay; Yazkan, Rasih; Osmanoğlu, GökhanBackground: We present a discussion of the management of diaphragmatic injury and the factors that influence the choice of surgical approach based on our experience and a review of the literature. Methods: Data of 41 patients with diaphragmatic injuries treated between 1996 and 2007 were analyzed retrospectively. Results: A total of 29 men and 12 women between 15 and 56 years of age (mean age 34) were included in the study. Twenty-one patients had penetrating injuries and 20 patients had blunt injuries. The diagnosis was done preoperatively in 21 cases and intraoperatively in 20 cases. Thoracotomy was used in 23 cases, laparotomy in 11 cases, laparotomy-thoracotomy in 5 cases, sternotomy-laparotomy in 1 case, and sternotomy in 1 case. Emergency surgery was performed in 30 cases. Five cases were operated within 24 hours after admission to the emergency department. In 6 cases, surgery was performed 6 months to 4 years after the initial trauma. The mortality rate was 14.6% and the operative morbidity was 2.4%. Conclusion: A high index of suspect is vital for the diagnosis of diaphragmatic injuries in an emergency setting. The type of approach is closely related to the associated injuries.Öğe Identification of the concentration of iodopovidone pleurodesis in rats for the maximal effectiveness(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2013) Yazkan, Rasih; Ozpolat, Berkant; Duman, Levent; Bircan, Sema; Bozkurt, Kemal Kursat; Gunes, SedatBackground: This study aims to investigate the efficacy and safety of different doses of iodopovidone for pleurodesis and to evaluate the histopathological changes in thyroid tissue. Methods: Thirty-eight male Albino Wistar rats (260-320 g, 6-8 months old) included in this experimental study were randomly divided into four groups. Groups 1, 2, and 3 were given 2 mL/kg intrapleural iodopovidone at concentrations of 1%, 2%, 4%, respectively, while group 4 was administered intrapleural saline. The surfaces were graded by macroscopic and microscopic examination on Day 30 and thyroid tissues were histopathologically examined. Results: Iodopovidone at concentrations of 2% and 4% resulted in significantly more adhesions and inflammatory response. Four percent iodopovidone produced nonsignificant microscopic changes in the contralateral visceral pleural surface. No vacuolization in thyroid tissue showing hyperthyroidism was observed in the groups. Conclusion: We suggest that 2% iodopovidone is enough for an effective and safe pleurodesis and the concentration of iodopovidone may be raised to 4% in unsuccessful cases. However, as the study was conducted on rats, it still remains to be elucidated that the similar results can be achieved in human studies.Öğe Intrapericardial Gossypiboma in an Elderly Patient(Derman Medical Publ, 2013) Ozpolat, Berkant; Gunal, Nesimi; Yazkan, Rasih; Dural, KorayWe report a case of surgically retained pericardial sponge in an 82-year-old man who underwent sternotomy for coronary artery bypass operation four years ago. After the operation the chest x-ray showed a radiopaque filament at the retrocardiac region. This case report shows the serial radiological examinations by computed tomographic scans over 4 years demonstrating a well-defined mass adjacent to left ventricle with a radiopaque filament inside with pseudocystic changes in time. As far as we know this case is the first one in the literature showing the changes in a case of gossypiboma, as the patient refused surgery.Öğe Iodopovidone pleurodesis in the treatment of refractory pleural effusions(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2013) Yazkan, Rasih; Özpolat, Berkant; Ergene, GökhanBackground: In this study, we assessed the efficacy of iodopovidone pleurodesis in patients with refractory pleural effusions. Methods: Between March 2009 and April 2012, 43 patients (34 males, 9 females; mean age 65.6 +/- 9.8 years; range 37 to 79 years) received iodopovidone pleurodesis was for the treatment of refractory pleural effusion. Pleural effusion was due to malignancy in 31 and heart failure in 12 patients. Iodopovidone (20 mL 10% plus 80 mL 0.9% NaCl) was delivered through the chest tube. The chest tube was not clamped and raised 60 cm above the chest level. The tube was removed when the amount of drainage reduced to 50 mL/day. Results: In patients with malignant pleural effusion, iodopovidone irrigation produced significant decrease in daily pleural drainage from 574.9 +/- 169.0 mL to 71.7 +/- 25.9 mL (p=0.000), and in patients with heart failure daily drainage decreased from 588.9 +/- 138.4 mL to 63.5 +/- 12.5 mL which was also significant (p<0.001). No clinical side effect related to the procedure was observed. Conclusion: Iodopovidone was shown to be effective in patients with refractory pleural effusions. The use of this agent without clamping the chest tube is safe, inexpensive and effective.Öğe Long-term survival after R0 resection of thymoma(SAGE Publications Inc., 2018) Koçer, Bülent; Kaplan, Tevfik; Günal, Nesimi; Koçer, Bilge Gönenli; Akkaş, Yücel; Yazkan, Rasih; Han, SerdarBackground: The aim of this study was to evaluate the results of R0 resection of thymoma to identify prognostic factors for long-term outcomes. Methods: Data of 62 patients (28 male, 34 female) with a mean age of 47.26 ± 14.42 years, who underwent R0 resection for thymoma and were followed-up between February 2004 and March 2016, were analyzed retrospectively. Results: Eight patients had a video-assisted thoracoscopic thymectomy and 54 had a transsternal extended thymectomy. During a mean follow-up of 128.67 ± 7.95 months, regional recurrence of thymoma was observed in 9 (14.5%) patients. Overall 5- and 10-year survival rates were 85.36% and 78.20%, respectively. The 5- and 10-year survival rates in patients aged < 50 years were significantly better than in those aged ? 50 years (92% and 72% vs. 88% and 39%, p < 0.0001). The 10-year overall survival of patients in Masaoka stage I and II was better than those in stage III (88.9%, 78.4%, 69.8%, respectively, log-rank p < 0.001). The 10-year survival of patients with World Health Organization histological type A, AB, and B1 thymomas was better than those with type B2 and B3 (log-rank test p < 0.001). In multivariate analysis, age < 50 years (p = 0.001), Masaoka stage (p = 0.006), histological type (p = 0.001), and recurrence (p = 0.04) were independent prognostic factors for survival. Conclusion: Our study indicates that age < 50 years, Masaoka stage, histological type, and recurrence are the determinants of survival in surgically resected cases of thymoma. © The Author(s) 2018.Öğe Meteorological Conditions Related to the Onset of Spontaneous Pneumothorax(Tohoku Univ Medical Press, 2009) Özpolat, Berkant; Gözübüyük, Alper; Koçer, Bülent; Yazkan, Rasih; Dural, Koray; Genç, OnurSpontaneous pneumothorax is defined as the rupture of bleb or emphysematous bullae that develop just beneath the pulmonary pleura. Weather changes may influence the incidence of spontaneous pneumothorax. The aim of this study was to examine the influence of rainfall, temperature and atmospheric pressure changes on the onset of spontaneous pneumothorax. The study involved 669 spontaneous pneumothorax admissions to three reference hospitals in Ankara, Turkey between 1996 and 2006 (612 males and 57 females with the mean age of 34.0 +/- 15.5 years). The meteorological data were obtained from Turkish State Meteorological Services for temperature, atmospheric pressure, and rainfall. The correlation between these values and spontaneous pneumothorax clusters, which was defined as the admission of at least two patients with pneumothorax within three days of each other, was evaluated. Among 669 episodes of spontaneous pneumothorax, 472 (70.5%) occurred in 188 clusters. When compared to days without spontaneous pneumothorax, the amount of average rainfall on the day of admission with spontaneous pneumothorax, one day before and two days before the admission was significantly high. Similarly, the atmospheric pressure on one day and two days before the admission of spontaneous pneumothorax patients was significantly low. In addition, maximum temperature level was significantly lower on admission day of spontaneous pneumothorax patients compared to those on the days without spontaneous pneumothorax. This largest series of the literature shows that spontaneous pneumothorax occurs in clusters and suggests that rainfall, temperature and falls in atmospheric pressure might play a role in the pathophysiology of spontaneous pneumothorax.
