Introduction The aim of this study was to evaluate the delayed chest closure (DCC) results in patients who underwent lung transplantation. Methods Sixty patients were evaluated retrospectively. Only bilateral lung transplantations and DCC for oversized lung allograft (OLA) were included in the study. Six patients who underwent single lung transplantation, four patients who underwent lobar transplantation, two patients who underwent retransplantation, and four patients who underwent DCC due to bleeding risk were excluded from the study. Forty-four patients were divided into groups as primary chest closure (PCC) (n=28) and DCC (n=16). Demographics, donor characteristics, and operative features and outcomes of the patients were compared. Results The mean age was 44.5 years. There was no significant difference between the demographics of the groups ( P >0.05). The donor/recipient predicted total lung capacity ratio was significantly higher in the DCC group than in the PCC group (1.06 vs . 0.96, P =0.008). Extubation time (4.3 vs . 3.1 days, P =0.002) and intensive care unit length of stay (7.6 vs. 5.2 days, P =0.016) were significantly higher in the DCC group than in the PCC group. In the DCC group, postoperative wound infection was significantly higher than in the PCC group (18.6% vs. 0%, P =0.19). Median survival was 14 months in all patients and there was no significant difference in survival between the groups (16 vs. 13 months, P =0.300). Conclusion DCC is a safe and effective method for the management of OLA in lung transplantation.

Objective: Evaluating the benefits of metastasectomy and the possible prognostic factors associated with overall survival after surgical treatment. Methods:Between January 2000 and January 2012, 148 pulmonary metastasectomy operations were performed on 126 patients (78 males, 48 females), with a median age of 32. Data were examined retrospectively for age, gender, primary tumor histology, number of lesions, operative techniques, resection margins, mediastinal lymph node involvement, time to metastasis, and additional therapies. Effects of possible prognostic factors on 2-year and 5-year survival were then evaluated.Results: Most patients (84%) were asymptomatic; 126 patients underwent 148 metastasectomy operations. Definitive pathology revealed sarcoma in 63 (50%), epithelial tumor in 58 (46%), and melanoma in 5 (4%). Complete resection (R0) was achieved in all patients. Average postoperative hospital length of stay was 5.4 (range: 2-8) days. Morbidity was 6.3%, and 30-day mortality was 1.6%. Median overall survivals were found to be 42, 27, and 11 months (p=0.029), with median disease-free intervals of 32, 21, and 7 months for epithelial tumors, sarcomas, and melanomas, respectively (p<0.001). The median survival of patients with single, 2 to 3, and 4+ metastatic nodules was 30, 18, and 15 months, respectively (p=0.012). Median survival of patients with a disease-free interval of less than 12 months was 16 versus 30 months in those with an interval of more than 12 months (p=0.003). Additional mediastinal lymph node involvement was directly correlated with a worse outcome (p=0.044). Conclusion:Pulmonary metastasectomy is a safe and effective choice of treatment. Univariate analyses verified that histopathology of the tumor, disease-free interval, number of metastatic lesions, and lymph node involvement were significant prognostic factors in patients undergoing pulmonary metastasectomy.Keywords: Lung metastases, pulmonary metastasectomy, secondary neoplasm, surgery, survival analysis ÖzetAmaç: Bu makalede, pulmoner metastazektomilerin sağkalıma olan katkısı ve sağkalıma etki eden diğer prognostik faktörler araştırıldı.Yöntemler: Ocak 2000 -Ocak 2012 tarihleri arasında 126 hastaya 148 pulmoner metastazektomi uygulandı. Hastaların 78'i erkek, 48'u kadın olup ortalama yaş 32 idi. Hastalar yaş, cinsiyet, primer tümör histolojisi, lezyon sayısı, ameliyat teknikleri, komplet ve inkomplet rezeksiyon sayıları, mediasten lenf nodu tutulumu, hastalıksız yaşam süreleri ve ek tedavi yönünden incelendi. Prognostik faktörlerin iki ve beş yıllık sağkalım üzerine etkileri değerlendirildi. Bulgular:Hastaların çoğunluğu (%84) asemptomatik idi. 126 hastaya 148 cerrahi girişim uygulandı. Olguların 63'unde (%50) sarkom, 58'inde (%46) epitelyal tümör ve 5'inde (%4) melanom metastazı saptandı ve tümünde komplet (R0) rezeksiyon gerçekleştirildi. Ameliyat sonrası ortalama hastanede kalış süresi 5,4 (2-8) gün, morbidite oranı %6,3, mortalite oranı %1,6 idi. Epitelyal tümörler, sarkomlar ve melanomlar için ortanca sürvi 42, 27 ve 1...

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