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Öğe False Positive 18F-FDG Uptake in Mediastinal Lymph Nodes Detected with Positron Emission Tomography in Breast Cancer: A Case Report(Hindawi Ltd, 2013) Ugurluer, Gamze; Kibar, Mustafa; Yavuz, Sinan; Kuzucu, Akin; Serin, MeltemBreast cancer is the most frequently diagnosed cancer among females. It is accepted that lymph node involvement with metastatic tumor and the presence of distant metastasis are the most important prognostic factors. Accurate staging is important in determining prognosis and appropriate treatment. Positron emission tomography with computed tomography detectsmalignancies using 2-[18F]-fluoro-2-deoxy-d-glucose (18F-FDG PET CT) with high accuracy and they contribute to decisions regarding diagnosis, staging, recurrence, and treatment response. Here, we report a case of false positive metastatic mediastinal lymph nodes that were diagnosed by 18F-FDG PET CT in a 40-year-old breast cancer patient who had undergone preoperative evaluation. Right paratracheal, prevascular, aorticopulmonary, precarinal, subcarinal, hilar, and subhilar multiple conglomerated mediastinal lymph nodes were revealed in addition to left breast mass and axillary lymph nodes. Mediastinoscopy was performed with biopsy and pathology was reported as granulomatous lymphadenitis. In conclusion, any abnormal FDG accumulation in unusual lymph nodes must be evaluated carefully and confirmed histopathologically.Öğe Fibrinolytic therapy for parapneumonic empyema during pregnancy(Elsevier Science Bv, 2012) Ulutas, Hakki; Yekeler, Erdal; Sak, Zafer Hasan Ali; Doru, Ihsan; Kuzucu, AkinPneumonia and parapneumonic complicated effusion during pregnancy is uncommon but poses potentially serious risks to both mother and fetus. Enzymatic debridement of the pleural cavity with fibrinolytic agents is a noninvasive option that can facilitate drainage and prevent the need for surgery. Herein, we describe the cases of two pregnant women with parapneumonic empyema who were successfully treated with intrapleural fibrinolytic therapy. (C) 2011 Elsevier Ltd.Öğe Hydatid cysts of the lung: lesion size in relation to clinical presentation and therapeutic approach(Springer, 2014) Kuzucu, Akin; Ulutas, Hakki; Celik, M. Reha; Yekeler, ErdalThe aim of this study was to assess the relationship between the pulmonary hydatid cyst size and the clinical presentation, surgical approach, and postoperative outcome. We review the problems encountered in treating large pulmonary hydatid cysts and highlight the risks associated with the rupture of the cyst and a delay of the surgical treatment. The medical records of 169 patients surgically treated for lung hydatid cysts were reviewed. Patients were divided into two groups based on cyst size: group 1 (n = 128) with small (< 10 cm) cysts and group 2 (n = 41) with giant (a parts per thousand yen10 cm) cysts. Data related to symptoms, preoperative complications, surgical procedures performed and postoperative morbidity were analyzed and compared. In both groups, the most common symptom was chest pain, followed by dyspnea and cough, respectively. There were no differences between the two groups with respect to cyst-associated parenchymal or pleural complications before surgery (p = 0.80). In the large majority of cases, the surgical treatment was cystotomy, removal of the cystic membrane and capitonnage. Wedge resection was performed in nine patients in total (seven in group 1, two in group 2) and one patient in group 2 required a lobectomy. Decortication was required significantly more frequently in group 2 than in group 1 (p = 0.001). Sixteen patients in group 1 and 10 patients in group 2 developed postoperative complications (p = 0.19). There was no peri or postoperative mortality. There was no difference between the groups with respect to the duration of hospitalization (p = 0.17). Two patients with complicated hydatid cysts in group 1 had recurrent lesions during follow-up, whereas there was no recurrence in group 2. All pulmonary hydatid cysts should be surgically treated as soon as possible after their diagnosis in order to avoid complications. Most of these lesions, regardless of size, can be surgically managed with procedures that preserve the maximal lung parenchyma and yield excellent outcomes.Öğe The role of current surgical therapy for pediatric/adolescent and adult patients with bronchiectasis(Baycınar medıcal publ-baycınar tıbbı yayıncılık, ornek mh dr suphı ezgı sk saray apt no 11 d 6, atasehır, ıstanbul 34704, turkey, 2017) Ulutas, Hakki; Celik, Muhammet Reha; Kuzucu, AkinBackground: This study aims to compare clinical manifestations, surgical indications, surgical procedures, postoperative complications, and outcomes of surgical treatment in pediatric and adult patients with bronchiectasis. Methods: Between January 2000 and December 2013, a total of 99 patients (40 males, 59 females; mean age 33.3 years; range 10 to 67 years) who underwent surgery for bronchiectasis at the Department of Thoracic Surgery were retrospectively analyzed. Group 1 (n=28) were pediatric patients (<= 18 years) and group 2 (n=71) were adult patients (>18 years). Clinical symptoms, criteria surgical treatments applied, surgical treatment approaches, postoperative complications, the length of hospital stay, and treatment outcomes were evaluated. Results: In both groups, the most common symptom was productive cough, followed by recurrent infections. There were no significant differences in the frequency of these symptoms between the groups. In total, 104 surgeries were performed. Of 29 surgeries in group 1, 26 were thoracotomies and three were video-assisted thoracoscopic surgery. Of 75 surgeries in group 2, 60 were thoracotomies and 15 were video-assisted thoracoscopic surgery. Postoperative complications were seen in eight operations (27.6%) in group 1 and 18 operations (24%) in group 2. There was no intra- or postoperative mortality. All 28 patients in group 1 showed improvement after surgery, while 23 outcomes (82.1%) were rated excellent (complete remission) and five outcomes (17.9%) were rated improved (reduced symptoms). In group 2, 63 outcomes (88.7%) were excellent and seven outcomes (9.9%) were rated improved; however, one patient (1.4%) showed no improvement. Conclusion: In selected cases, surgical treatment for bronchiectasis is satisfactory and associated with acceptable mortality and morbidity rates, irrespective of the age of the patient. Based on our study results, surgery can cure this condition and can improve the quality of life, even when not curative.Öğe Surgical management of upper- and lower-lobe bronchiectasis without middle lobe involvement: is middle lobectomy necessary?(W B Saunders Co-Elsevier Inc, 2012) Ulutas, Hakki; Celik, M. Reha; Kuzucu, AkinPostoperative quality of life is a crucial factor in decisions regarding surgical management of bronchiectasis. The goal of surgical treatment in such cases is to eradicate diseased portions of lung while preserving as much healthy lung parenchyma as possible. The volume of remaining lung must be sufficient to fill the pleural space. In patients with bronchiectasis, it is extremely unusual to have upper- and lower-lobe involvement without middle lobe involvement. A normal-sized middle lobe alone is usually not adequate to fill the right hemithorax. When the disease involves both the upper and lower lung lobes, surgeons must assess whether pneumonectomy is required. Herein, we describe the case of a patient with bronchiectasis who was successfully treated with upper and lower lobectomy and preservation of the middle lobe. (C) 2012 Elsevier Inc. All rights reserved.
