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    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.
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    Malignancy in a simple cystic lung lesion
    (SPRINGER INDIA, 2020) Bilen, Salih; Sezen, Celal Buğra; Kocatürk, Celalettin İbrahim
    Congenital pulmonary airway malformation (CPAM) is the most common congenital lesion of the lung. A 21-year-old man presented with complaints of frequent cough and sputum. Computed tomography of the chest revealed a 7 x 5-cm lesion in the upper lobe of the left lung. Because the cyst originated in the left upper lobe bronchus and was compressing the surrounding parenchyma, a left upper lobectomy was performed. The pathology report indicated adenocarcinoma arising from congenital cystic adenomatoid malformation.
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    Unexpected conversion to thoracotomy during thoracoscopic lobectomy: a single-center analysis
    (Springer Japan Kk, 2019) Sezen, Celal Buğra; Bilen, Salih; Kalafat, Cem Emrah; Cansever, Levent; Sönmezoğlu, Yaşar; Kilimci, Umut; Doğru, Mustafa Vedat; Seyrek, Yunus; Kocatürk, Celalettin İbrahim
    Background The aim of this study was to discuss indications and outcomes for conversion to thoracotomy during thoracoscopic lobectomy. Materials and methods Patients who underwent lobectomy for non-small cell lung cancer between January 2012 and December 2016 were evaluated retrospectively. The study included 129 patients who underwent video-assisted thoracoscopic lobectomy (group-V) and 18 patients converted from thoracoscopic lobectomy to thoracotomy due to unexpected intraoperative complications (group-T). Results The two patient groups showed no statistical differences in terms of demographic characteristics. Causes of unexpected conversions to thoracotomy were hemorrhage in six patients, dense pleural adhesions in seven patients, fused fissure in one patient, and fibrocalcified lymph nodes around the vascular structures in four patients. Operative time was 180.37 +/- 68.6 min in group-V and 235 +/- 72.6 min in group-T (p = 0.003). Intraoperative blood loss was 263.9 +/- 180.6 mL in group-V, compared to 562.7 +/- 296.2 mL in group-T (p < 0.001). Patient age >= 70 years was a significant risk factor for conversion to thoracotomy (p = 0.015, odds ratio 4.73). The 5-year survival rate in group-V was 71.4% {mean: 65.2 months [95% confidence interval (CI) 59.6-70.8]}, while that in group-T was 80% [mean 54.9 months (95% CI 45.9-63.8)] (p = 0.548). Conclusion Advanced age was identified as the main risk factor for conversion to thoracotomy. However, early- and long-term outcomes were similar in the two groups, indicating that video-assisted thoracoscopic surgery is a safe and applicable method.