Browsing by Author "Yaldiz, D"
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Item Prognostic Effects of Predominant Histologic Subtypes in Resected Pulmonary AdenocarcinomasYaldiz, D; Kaya, SÖ; Ceylan, KC; Acar, A; Aydogdu, Z; Gürsoy, S; Yaldiz, SBackground: Predominant histologic subtypes have been reported as predictors of survival of patients with pulmonary adenocarcinoma. Aims: To evaluate the predictive value of histologic classification in resected lung adenocarcinoma using the classification systems proposed by the International Association for the Study of Lung Cancer, American Thoracic Society, European Respiratory Society, and World Health Organization (2015). Study Design: Cross-sectional study. Methods: The histologic classification of a large cohort of 491 patients with resected lung adenocarcinoma (stages I-III) was retrospectively analyzed. The tumors were classified according to their predominant component (lepidic, acinar, papillary, solid, micropapillary, and mucinous), and their predictive values were assessed for clinicopathologic characteristics and overall survival. Results: The patient cohort comprised 158 (32.2%) patients with solid predominant, 150 (30.5%) with acinar predominant, 80 (16.3%) with papillary predominant, 75 (15.3%) with lepidic predominant, 22 (4.5%) with mucinous, and 5 (1.0%) with micropapillary subtype, and 1 (0.2%) with adenocarcinoma in situ. Overall 5-year survival of 491 patients was found to be 51.8%. Patients with lepidic, acinar, and mucinous adenocarcinoma had 70.9%, 59.0%, and 66.6% 5-year survival, respectively, and there was no statistically significant difference between them. Whereas patients with solid, papillary, and micropapillary predominant adenocarcinoma had 41.0%, 40.5%, and 0.0% 5-year survival, respectively. Compared to other histologic subtypes, patients with solid and papillary predominant adenocarcinoma had significantly lower survival than those with lepidic (p<0.001, p=0.002), acinar (p<0.001, p=0.008), and mucinous (p=0.048, p=0.048) subtypes, respectively. The survival difference between patients with solid subtype and those with papillary subtype was not statistically significant (p=0.67). Conclusion: Solid and papillary histologic subtypes are poor prognostic factors in resected invasive lung adenocarcinoma.Item The Role of Sublobar Resection in T1 N0 Non-Small-Cell Pulmonary CarcinomaYaldiz, D; Yakut, FC; Kaya, SÖ; Gürsoy, S; Yaldiz, MSOBJECTIVES: In this study, we aimed to investigate the effect of resection type on survival in patients with stage IA non-small-cell lung cancer (NSCLC) and other factors affecting the prognosis. MATERIALS AND METHODS: Between January 2005 and December 2016, we retrospectively screened 269 patients who were resected and were having T1N0M0 non-small-cell pulmonary carcinoma. The survival time after surgery was obtained from the National Population Registration System (MERNIS) system. Patients were classified according to the extent of resection. Additionally, age, sex, smoking, concomitant disease, histological type, pathological stage (T1a-T1b-T1c), and the presence of postoperative complications were evaluated to determine whether they are prognostic factors or not. RESULTS: A lobectomy was performed in 257 cases (95.5%), and a sublobar resection was performed in 12 patients (4.5%). The 5-year survival was 62.5% for lobectomies and 73.3% for sublobar resections. Although 5-year survival was better in patients with a limited resection, it was not statistically significant (p=0.301). Histopathological evaluation revealed that 130 patients (48.3%) had adenocarcinoma, 113 (42.0%) had squamous cell carcinoma, and 26 (9.7%) had the other types. The 5-year survival rate was 69.9% in patients with adenocarcinoma and 53.2% in squamous cell carcinoma, and this was statistically significant (p=0.036). The overall 5- and 10-year survival rates in all patients were 65.0% and 47.2%, respectively. CONCLUSION: Although lobectomy is the standard type of resection in the early stage of lung cancer cases in the Thoracic Surgery Department of Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital patients who underwent sublobar resection were found to be having partially better survival, but it was not statistically significant. Owing to the small number of cases, we think that sublobar resections should be prospectively investigated with more extensive series in patients with T1 NSCLC.Item Papillary predominant histological subtype predicts poor survival in lung adenocarcinomaYaldiz, D; Acar, A; Kaya, SÖ; Aydogdu, Z; Gursoy, S; Yaldiz, SBackground: This study aims to investigate whether papillary predominant histological subtype can predict poor survival in lung adenocarcinoma. Methods: Between January 2005 and December 2016, a total of 80 patients with papillary predominant subtype lung adenocarcinoma (70 males, 10 females; mean age 60.7 years; range, 42 to 79 years) operated in our clinic were included in the study. These patients were compared with those having lepidic, acinar, and mucinous subtypes. Overall and five- year survival rates were evaluated. Results: Five-year survival was 40.5% in papillary predominant histological subtype, while this rate was 70.9%, 59.0%, and 66.6% in lepidic, acinar, and mucinous subtypes, respectively. Papillary subtype showed significantly poor survival compared to lepidic (p=0.002), acinar (p=0.008), and mucinous subtypes (p=0.048). In Stage 1 disease, it was more evident (papillary, 47.5%, lepidic 86.9% [p=0.001], acinar 69.3% [p=0.040], and mucinous 90.0% [p=0.050]). Conclusion: Our study results suggest that papillary predominant subtype predicts poor survival in lung adenocarcinoma and these cases may be candidates for adjuvant treatment modalities even in the earlier stages of disease.Item Pitfalls in the surgical treatment of undiagnosed lung lesions and cystic pulmonary hydatidosisYaldiz, D; Batihan, G; Ceylan, KC; Yaldiz, S; Susam, SBackground Hydatid cysts can mimic many lung pathologies radiologically, as well as some malignant or benign lung tumors may show hydatid cyst-like radiological features. The aim of our study is to present our clinical experience and recommendations by analyzing the cases that create diagnostic difficulties by presenting a common radiological pattern with a pulmonary hydatid cyst. Methods The patients who were operated on with a preliminary diagnosis of hydatid cyst but were diagnosed differently, and who were operated on with different prediagnoses and unexpectedly diagnosed with hydatid cyst were included in the study. The clinical and radiological features of the patients were documented, and the features of the cases that could cause difficulties in diagnosis and treatment for the surgeon were revealed. Results A total of 20 patients who were radiologically suggestive of hydatid cyst but were diagnosed differently or unexpectedly diagnosed as hydatid cyst were included in the study. Lung cancer, bronchogenic cyst, or bronchiectasis were detected in 13 patients who were radiologically suggestive of hydatid cyst. There were 7 patients who were diagnosed with hydatid cysts, although they did not have specific radiological findings. Conclusions While hydatid cysts can mimic many lung pathologies, many benign or malign parenchymal lung pathologies may exhibit hydatid cyst-like radiological features. Therefore, in regions where a hydatid cyst is endemic, the surgeon should consider all possibilities while managing the cases. Clinical registration number: Institutional Review Board of the Dr Suat Seren Chest Diseases and Chest Surgery Education and Research Center (No. 49109414-604.02).Item Data Analysis of 1811 Major Trauma Patients Admitted to the Emergency Departments of Thirteen HospitalsYaldiz, D; Akbulut, G; Anil, M; Öztan, MO; Yaldiz, SObjective: Our objective was to determine metrics and measure the trauma-related emergency care quality. Methods: Patients with majortrauma admitted to emergency departments of 13 hospitals in the north region of Izmir between January 01, 2014, and December 31, 2014, were included in this study. For the definition of major trauma, guideline of Centers for Disease Control (CDC) for field triage of injured patients version 2011 was used. Age, time passed in emergency, first order timing, number of consultations and amount of time taken by the consultations, number of deaths in emergency departments and intensive care units, number of radiological tests applied to patients, total score of interventional applications, and total billing were recorded. Results: In one-year period, 2,415,361 patients applied to selected hospitals' emergency departments, and 1811 patients (0.07%) were accepted as major trauma. The mean age of the patients was 29.4 years. The meantime passed in emergency was 28.3 h. The mean number of consultations and amount of time taken by consultations were 1.6 and 26.2 h, respectively. The number and mean X-ray, ultrasound, computerized tomography, and magnetic resonance imaging numbers were 3910 and 2.16; 518 and 0.29; 2805 and 1.55; 114 and 0.06, respectively. The total mortality rate was 1.04% (19 patients). Conclusion: This is a preliminary study presenting the data obtained from different level hospitals in the region, and indicators in such a high number of patient group were evaluated for the first time. We believe that as national emergency care is built and strengthened with data, management of care for patients with trauma will improve.Item Capitonnage Results in Low Postoperative Morbidity in the Surgical Treatment of Pulmonary EchinococcosisYaldiz, S; Gursoy, S; Ucvet, A; Yaldiz, D; Kaya, SBackground. The main surgical techniques in the treatment of pulmonary echinococcosis are cystotomy alone, cystotomy and capitonnage, enucleation, and pericystectomy. Controversy persists regarding the selection of surgical technique. We reviewed our experience to identify the impact of capitonnage on outcomes. Methods. A single-institution retrospective analysis was made of the 308 consecutive patients with thoracic hydatid disease treated surgically during 17 years. Results. The most common presenting symptoms were cough and chest pain. At presentation, 69 patients (22.4%) had complicated hydatid disease, cyst rupture into bronchus in 62 and into pleural cavity in 7. Bilateral involve-ment occurred in 37 patients (12.0%), simultaneous hepatic cysts in 36 (11.6%), and intrathoracic extrapulmonary involvement in 14 (4.5%). Surgery consisted of cystotomy with capitonnage in 271 patients (92.2%), cystotomy and closure of bronchial openings in 20 (6.8%), and lobectomy in 3 (1.0%). Hospital mortality was zero; postoperative complications developed in 21 patients (6.8%). Conclusions. Cystotomy with capitonnage has a low complication rate. Pulmonary resection is best limited to patients with parenchymal destruction secondary to infection. (Ann Thorac Surg 2012;93:962-7) (C) 2012 by The Society of Thoracic SurgeonsItem A thymic neuroendocrine carcinoma presenting with upper gastrointestinal bleeding: A case reportYaldiz, S; Yaldiz, D; Tulay, CM; Isisag, ANeuroendocrine carcinomas of the thymus are rare clinical entities, which can be complicated by endocrine abnormalities. These tumors are frequently associated with ectopic adrenocorticotropic hormone production giving rise to Cushing's syndrome. Herein, we describe a 23-year-old male case with upper gastrointestinal bleeding as the initial presentation of a thymic neuroendocrine carcinoma. This case was reported due to its extremely exceptional occurrence.Item Comparative analysis of two different Turkish hospital reports on polytrauma patients with thoracic traumaYaldiz, S; Tulay, CM; Yaldiz, D; Arpat, AH; Bayülgen, A; Pirzirenli, MG; Balta, CBACKGROUND: The present study aims to assess whether there are any differences in the management and outcome of polytrauma patients with thoracic trauma in trauma units of two different hospitals in the same country; one hospital is near the Syrian border. METHODS: A retrospective analysis (January 2012 to January 2014) of 348 polytrauma casualties with thoracic trauma from Manisa Celal Bayar University Hospital (MH) were compared according to age, gender, mechanism of injury, associated injuries, abbreviated injury scale (AIS), injury severity score (ISS), treatment modalities, and mortality with 917 patients of Sanliurfa Training and Research Hospital (SH) registry (near the Syrian border). RESULTS: Of the 348 patients in the MH, 230 (66%) and of the 917 patients in the SH, 697 (76%) were males (p<0.001). Mean age was 45.6 +/- 18.3 yrs in the MH group and 26.4 +/- 22.4 yrs in the SH group (p<0.001). The SH patients had a larger proportion of stab wounds (MH; 9% vs. SH; 17%, p<0.05), gunshot injuries (MH; 5% vs. SH; 18%, p<0.05), higher mean ISS (MH; 30.2 +/- 8.4 vs. SH; 42.8 +/- 10.2, p<0.001), and increased mortality (MH; 2.6% vs. SH; 11.1%, p<0.001). AIS(abdomen) was the highest component in the SH registry (AIS(abdomen) = 4.8 +/- 0.7), whereas AIS extremities were the highest component in the MH registry (AIS(extremities) = 3.6 +/- 0.2). CONCLUSION: Significantly different demographic features, mechanisms of injury, worse outcomes and higher mortality rates in SH demonstrate and reflect the surgical challenges depending on the combat environment. Two hospitals in Turkey, one seemingly adjacent to a war zone and another with the more standard civilian experience highlight the impact of the Syrian conflict on the Turkish healthcare system.Item A rare complication of video-assisted thoracoscopic surgery: lung herniation retrospective case series of three patients and review of the literatureBatihan, G; Yaldiz, D; Ceylan, KCIntroduction: Lung herniation is defined as a protrusion of the lung parenchyma with its pleura through the intercostal space. It is a rare condition and usually occurs after thoracic trauma and surgical interventions. A few cases of lung herniations have been reported after video-assisted thoracoscopic surgery (VATS) but only two cases have been reported after VATS lobectomy. Aim: The VATS procedure has become the dominant method of lung cancer surgery, but there is no case series about the complications of lung herniation in the literature. We aim to define some risk factors and possible ways of prevention of lung herniation after VATS resection. Material and methods: This study retrospectively analyses 650 (550 anatomic, 100 non-anatomic sublobar resections) patients who underwent lung resections for lung cancer in our department between 2012 and 2018. We detected lung herniation in 3 patients after VATS resection. Results: Asymptomatic lung hernias may be managed by close observation but because of the risk of incarceration of the pulmonary parenchyma, surgery is often necessary. The main steps of treatment involve: identification of the hernia, freeing of all adhesions, reduction of the lung tissue back into the thoracic cavity and repairing the defect of the chest wall. Conclusions: By this retrospective case series, we defined some patient-related and surgeon-related risk factors and some basic recommendations for prevention of this complication.