A 51-year-old man with adenoid cystic carcinoma in the main stem bronchus was treated by a left lower lobectomy. A 44-year-old man with adenoid cystic carcinoma in the peripheral small bronchi underwent a right sleeve upper lobectomy with tracheobronchoplasty and neo-carina reconstruction; because of positive tumor margins, radiotherapy was administered postoperatively. Both patients were alive without any signs of tumor after 30 and 24 months of follow-up, respectively.
Bu makale ATUDER'in düzenlediği 1.Ulusal Acil Tıp E Kongresinde11-13 Haziran tarihinde 63 vaka ile bildiri olarak sunulmuştur. ARAŞTIRMA MAKALESİ / Research Article Öz Amaç Toraks travmaları tüm travma türleri arasında sık görülmektedir. Bu çalışmada, acil servise travmatik pnömotoraks ile başvuran hastaların demografik özellikleri, travma nedenleri, gelişen patolojiler, tedavi yaklaşımları ve mortalite nedenlerinin analizlerini yapmak amaçlandı. Gereç ve Yöntem 2018 Ocak ile 2019 Aralık arasında travmatik pnömotoraks nedeniyle acil serviste değerlendirilen 127 hastanın hastane kayıtları geriye dönük olarak değerlendirildi ve analiz edildi. Bulgular Çalışmaya dahil edilen 127 hastanın ortalama yaş 53,49 ±16.96 ve ortalama yatış süresi 7.63 ±3.65 idi. Travmatik pnömotoraks oluşturan künt travmalarda en sık sebebi trafik kazaları iken penetran travmalarda delici kesici alet yaralanması olarak tespit edildi. Kontüzyon şiddeti, kot kırığı sayısı ve yaş ile yatış süreleri arasında anlamlı ilişki tespit edildi (p=0,045, p=0,045 ve P<0,001). Multitravmalı pnömotoraks hastalarında nöroşirurjik patolojinin eşlik ettiği grupta mortalitede anlamlı bir fark görüldü(P<0,001). Sonuç Travmatik pnömotoraks kaburga kırıkları ve kontüzyon sebebiyle varlığında oldukça önemli ve erken müdahale gerektiren bir patolojidir. Özellikle yaşlı hastalarda, kot kırığı sayısı fazla olan hastalarda ve akciğer kontüzyonunun eşlik ettiği durumlarda etkin medikal tedavi ve solunum fizyoterapisi çok büyük önem arz etmektedir.
Background: In this study, we aimed to analyze the effects of admission time to the hospital and different variables on the treatment efficiency and to evaluate the recurrence during the clinical management process in patients with the diagnosis of primary spontaneous pneumothorax.
Methods: A total of 149 patients with primary spontaneous pneumothorax (131 males, 18 females; mean age: 24.8±6.8 years; range, 17 to 35 years) treated in our clinic between January 2015 and December 2019 were retrospectively analyzed. Time from symptom onset to hospital admission (admission time) was classified as three periods: <24 h, between 24 and 72 h, and >72 h. Data including admission time, demographic and clinical characteristics, smoking history, body mass index, the use of pleurectomy or pleural abrasion during surgery were collected from the charts of the patients.
Results: Admission time had no statistically significant effect on the length of hospital stay, recurrence, and the need for surgery. Male sex, smoking history, and lower body mass index had no significant effect on the recurrence. Recurrence and length of hospital stay did not significantly differ between the patients in whom pleurectomy or pleural abrasion added to the procedure during the operation.
Conclusion: A longer interval between symptom onset and hospital admission and lower body mass index have no adverse effect on treatment outcomes and the recurrence in patients with primary spontaneous pneumothorax. Despite the fact that surgical treatment significantly decreases the recurrence rate, pleurectomy and pleural abrasion techniques have no significant difference on the clinical influence and recurrence of these patients.
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