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    The comparison of vacuum assisted closure (VAC) and conventional treatment methods in postpneumonectomy empyema cases
    (2019) Gulyuz, Omer Cenap; Yildiz, Ozgur Omer; Temiz, Goktan; Aytekin Celik, Ilknur; Karaoglanoglu, Nurettin
    Aim: Postpneumonectomy empyema is one of the most difficult clinical conditions in thoracic surgery. There is a wide range of conventional treatment options ranging from tube thoracostomy, antibiotic irrigation to open-window thoracostomy. Vacuum-Assisted Closure (VAC) therapy is also among the treatment options. In our study we aimed to compare the outcomes and efficiency of conventional treatment procedures and VAC.Material and Methods: Eighteen male patients (average age 54.8± 18.68), who were diagnosed with postpneumonectomy empyema between July 2012 and November 2014, were divided into two groups. Nine patients (Group I) have been treated with conventional procedures, while the other nine patients (Group II) have been treated with VAC.Results: Five patients in the Group I were cured in an average of 9.6 months. Four patients underwent additional surgical intervention and they remained in the empyema clinic for 12 months in the follow-up period. Seven patients in the Group II were cured during the follow up period of an average of 14.8 months. Two patients who developed bronchopleural fistula remained in the empyema clinic. Average length of hospital stay is 109.3 days for the Group I and 63 days for the Group II. The treatment of the Group II has been found more successful than the Group I in terms of pain status assessment, patient’s comfort and postoperative cosmetic appearance.Conclusions: VAC group success rate has been found higher in terms patient’s comfort, the length of hospital stay and duration of empyema. Further studies are required to establish the success of this procedure.Keywords: Postpneumonectomy empyema; Vacuum-Assisted Closure (VAC); Thoracostomy.
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    Methastatic N2 in T1 Non-small cell lug cancer: Should we go back to invasive staging?
    (2020) Yildiz, Omer; Aytekin Celik, Ilknur
    Aim: T1 patients who were operated due to non-small cell lung cancer (NSCLC)were evaluated retrospectively. The objective of this study was to evaluate metastatic lymph node status in T1 tumors and to discuss staging approaches in these tumors.Material and Methods: A total of 217 patients who met specified criteria between May 2012 and May 2019 were included in the study. Patients operated due to NSCLC who have a tumor size 3 cm were evaluated in terms of age, gender, preoperative diagnostic methods, thorax CT and PET-CT examinations, size, anatomic localization and histopathologic type of tumors, excised mediastinal lymph nodes and pathology results.Results: Of total 292 lymph node stations sampled in patients with adenocarcinoma, 257 (89.73%) were reported as benign and 30 (10.27) as malignant according to pathologic results. Of total 316 lymph node stations sampled in patients with squamous cell carcinoma, 298 (94.3%) were benign and 18 (5.7%) were malignant.N2 positivity was found in 40 (18.43%) of the 217 patients.Conclusion: Mediastinoscopy should be performed for staging in the presence of a tumor size above 2 cm, histopathological type of adenocarcinoma, high mass SUVmax values, lymph node with radiological growth and pathological involvement.