Yazar "Bedirhan, Mehmet Ali" seçeneğine göre listele

Listeleniyor 1 - 3 / 3
  • Küçük Resim
    Öğe
    Long-term outcomes of carinal sleeve resection in non-small cell lung cancer
    (Georg Thieme Verlag Kg, 2020) Sezen, Celal Buğra; Kocatürk, Celalettin İbrahim; Bilen, Salih; Kalafat, Cem Emrah; Cansever, Levent; Dinçer, Seyyit İbrahim; Bedirhan, Mehmet Ali
    Background Carinal resections for non-small cell lung cancer (NSCLC) invading the carina are challenging cases that require a therapeutic strategy. The aim of this study was to compare the oncologic outcomes and complications of patients who underwent carinal resection. Methods Sixty-four patients who underwent carinal resection between 2005 and 2016 were evaluated. Data were retrospectively reviewed for indications, complications, and factors influencing long-term survival. Results The study included 51 patients (79.7%) who underwent sleeve pneumonectomy (sP) and 13 patients who underwent carinal sleeve lobectomy (csL) as a curative therapy. Nine patients (14.1%) received induction chemotherapy. Complications were observed in 31 patients (48.8%), including 24 patients (47.1%) in the sP group and 7 patients (53.8%) in the csL group ( p = 0.662). Six patients (9.4%) developed bronchopleural fistula. The 30-day mortality rate was 10.9% ( n = 7). The 5- and 10-year survival rates were 42.2 and 23.1%, respectively. N2 and R1 were identified as factors affecting survival ( p = 0.029 and p = 0.047). Conclusion Carinal resections have acceptable morbidity, mortality, and long-term survival outcomes in central NSCLC. The main factors affecting survival are complete resection and nodal status. The results of csL were similar to those of sP. Therefore, we believe that csL should be performed in all eligible patients.
  • Küçük Resim
    Öğe
    Morbidity, mortality and survival rates of non-small cell lung cancer patients who underwent lobectomy with pulmonary artery reconstruction compared to those of the patients who underwent pneumonectomy
    (2020) Çınar, Hüseyin Ulaş; Kocatürk, Celalettin; Cansever, Levent; Ceyhan, Süleyman; Bedirhan, Mehmet Ali
    Background: Pulmonary artery reconstruction can be preferred as an alternative to pneumonectomy, to spare the functional lung parenchyma in lung cancer. This study aimed to evaluate the morbidity, mortality and survival rates of the patients who had undergone pulmonary artery reconstruction due to central non-small cell lung cancer (NSCLC) and also to compare their data with those of the patients who had undergone pneumonectomy. Materials and Methods: In this study, 88 patients who underwent pneumonectomy (group PN) and 20 patients who underwent standard or sleeve lobectomy (double sleeve) with pulmonary artery reconstruction (group PAR) for NSCLC with stages I-IIIA between January 2005 and December 2010 were evaluated retrospectively. The morbidity and mortality rates, durations of the hospital and intensive care unit stay, 5-year and mean survival rates of the homogenous patient groups were analyzed comparatively. Results: The postoperative morbidity rate was 30% in the PAR group and 53% in the PN group (p = 0.77). The bronchial complication rate was 0% in the PAR group and 15% in the PN group (p = 0.04). The 30-day mortality rate was 5% in the PAR group and 5.6% in the PN group (p = 1). The median follow-up period for all patients was 31.5 months (range: 0-84 months) and total 5-year survival was 56.2%. In early-stage tumors (stage I + stage II), total 5-year survival rate was 64% in the PAR group and 60% in the PN group (p = 0.7). In late-stage tumors (stage III), total 5-year survival rate was 52% in the PAR group and 30% in the PN group (p = 0.04). No local recurrence was observed in either group during the follow-up period. Conclusions: In central lung tumors, to avoid pneumonectomy, major anatomical lung resection with pulmonary artery reconstructions can safely be performed with acceptable morbidity and mortality rates. Oncological outcomes of pulmonary angioplasty procedures regarding survival and local recurrence are not worse than those of pneumonectomy. Even in advanced stage lung tumors, these procedures can be an alternative to more radical operations such as pneumonectomy.
  • Küçük Resim
    Öğe
    Transcervical mediastinoscopy in patients with a permanent tracheostomy: is it feasible?
    (Oxford Univ Press, 2019) Cansever, Levent; Seyrek, Yunus; Kutluk, Ali Cevat; Akın, Hasan; Kocatürk, Celalettin İbrahim; Bedirhan, Mehmet Ali
    OBJECTIVES: Cervical mediastinoscopy may become essential in patients with pathological lymph nodes at mediastinum after laryngectomy. However, having had a previous tracheostomy has been reported to be a contraindication for cervical mediastinoscopy. METHODS: Between January 2010 and December 2017, cervical mediastinoscopy was performed for lung cancer staging in 1985 patients at the Department of Thoracic Surgery, Yedikule Chest Diseases and Thoracic Surgery Education and Research Hospital, Istanbul, Turkey. Eighteen of these patients (1%) had a permanent tracheostomy after total laryngectomy and cervical radiotherapy due to laryngeal carcinoma. RESULTS: Cervical mediastinoscopy was performed in 18 patients with a permanent tracheostomy after total laryngectomy. The negative predictive value of cervical mediastinoscopy was 13/14 (93%). The average operative time was 63min (SD 12.0, range 50-90min). The negative predictive value of endobronchial ultrasonography was 4/7 (57%). Positron emission tomography-computed tomography had a positive predictive value of 3/15 (20%) and a negative predictive value of 2/3 (67%). CONCLUSIONS: Contrary to the claims of 2 textbooks, cervical mediastinoscopy is a viable method for patients with a tracheostomy after laryngectomy. The negative predictive values of standard cervical mediastinoscopy and mediastinoscopy for patients with a tracheostomy after total laryngectomy are approximately equivalent. Our results indicate that cervical mediastinoscopy is a feasible method in patients with a permanent tracheostomy when applied by experienced thoracic surgeons in specialized hospitals.