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Öğe Bilateral Chylothorax After Severe Vomiting in a Child(Elsevier Science Inc, 2012) Yekeler, Erdal; Ulutas, HakkiIn the etiology of chylothorax, traumas and malignancies are the first two leading causes. Today in pediatric patients, the most common cause of chylothorax includes the complications secondary to cardiothoracic operations. Bilateral chylothorax is rarely observed after severe vomiting leading to increase in intrathoracic pressure. In idiopathic chylothorax, bilateral localization is dominant. A 9-year-old girl who presented to our emergency department with the complaints of dyspnea and back pain following severe vomiting received a diagnosis of bilateral chylothorax. The patient was treated with the insertion of a bilateral chest tube, and pleurodesis was performed in left hemithorax. Examination did not reveal a pathology to this condition, except the vomiting observed 2 days previously after the meal. (Ann Thorac Surg 2012;94:e21-3) (C) 2012 by The Society of Thoracic SurgeonsÖğe 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 Gastro-Bronchial Fistula in the Long-Term Follow-up of Operated Case with Esophageal Carcinoma(Modestum Ltd, 2013) Yekeler, Erdal; Ulutas, Hakki; Altuntas, BayramThe development of a fistula between the gastric tube and the bronchial system represents a very rare but potentially catastrophic complication after intrathoracic esophagogastrostomy for esophageal carcinoma. A 67-years-old male patient, who underwent Ivor-Lewis surgery due to esophageal carcinoma six years ago, had persistence of complaints especially to increased cough immediately after food intake.Öğe A Giant Primary Liposarcoma of the Anterior Mediastinum(Derman Medical Publ, 2015) Yekeler, Erdal; Ulutas, Hakki; Ozmen, Sevilay AkalpLiposarcomas are uncommon tumors originated from the primitive mesenchymal cells. Mediastinal liposarcoma is a very rare localization, accounting less than 1% of all the mediastinal tumors. These tumors may remain asymptomatic until they reach a giant size due to pleural space and elasticity of the lungs. Complete resection is not always possible in the poorly differential types invading the mediastinal vital organs. In this article, we presented a 34 years-old man patient with an anterior mediastinum localized liposarcoma that was asymptomatic until last 3 months and reached to giant sizes and complete successful surgical intervention.Öğe Hydatid cysts of the lung lesion size in relation to clinical presentation and therapeutic approach(Surg Today, 2014) Kuzucu, Akın; Ulutaş, Hakkı; Çelik, Muhammet Reha; Yekeler, ErdalPurposes The 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. Methods 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 (C10 cm) cysts. Data related to symptoms, preoperative complications, surgical procedures performed and postoperative morbidity were analyzed and compared. Results 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. Conclusion 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 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 Metastatik akciğer kanserini taklit eden bilateral nodüler pulmoner tüberküloz olgusu(İzmir Göğüs Hastanesi Dergisi, 2012) Ulutaş, Hakkı; Yekeler, Erdal; Sak, Zafer Hasan Ali; Şener, EbruÖz: Akciğer Tüberküloz'u (TB ) ülkemizde önemli derecede morbitide ve mortaliteye neden olmaktadır. Mycobacterium tüberculosis complex'in infeksiyonu oldukça heterojendir. Farklı radyolojik görünümle karşımıza çıkan ve metastatik akciğer kanserini taklit eden akciğer TB olgusunun sunulması uygun görüldü. Elli dokuz yaşında erkek hasta nefes darlığı, göğüs ağrısı şikayeti ile başvurduğu merkezimizde çekilen PA akciğer grafisinde; bilateral multipl sayıda nodüler lezyonlar, üst zonlarda hiperlüsensi saptandı. Bilgisayarlı toraks tomografisinde; bilateral multipl sayıda, multisentrik özellikte lezyonlar ve büllöz amfizem görünümü mevcuttu. Biyokimyasal ve hematolojik laboratuar bulguları normal sınırlar içerisinde idi. Yapılan bronkoskopide bronşiyal sistem doğal olarak izlendi. Balgam ve bronş lavaj sıvısında ARB negatif olarak bulundu. Tüm vücut malignite taramalarında patoloji saptanmadı. Hastaya sağ mini torakotomi ile nodul eksizyonu yapıldı. Patoloji sonucu amfizem, interstisyel pnömoni bulguları ve kazeifiye granulomatöz hastalık olarak raporlandı. Radyografide yaygın nodüler lezyonları olan olguların ayırıcı tanısında granülomatöz hastalıklar mutlaka düşünülmeli, ülkemiz şartlarında akciğer TB'unun hala ilk sıralarda değerlendirilmesi gerektiği unutulmamalıdır.Öğe Role of Prolene Mesh in Late Postpneumonectomy Empyema: Esophageal Pleural Fistula(Elsevier Science Inc, 2012) Yekeler, Erdal; Altuntas, Bayram; Ulutas, Hakki[Abstract Not Available]
