No abstract

Bu çalışmada erken evre küçük hücreli dışı akciğer kanserli hastalarda sublobar rezeksiyonların sonuçları değerlendirildi ve sağkalımı etkileyen faktörler araştırıldı. Ça lış ma pla nı:Ocak 2011 -Ağustos 2013 tarihleri arasında şüpheli veya bilinen erken evre küçük hücreli dışı akciğer kanseri nedeniyle sublobar rezeksiyon yapılan toplam 63 hastanın (52 erkek, 11 kadın; ort. yaş 64 yıl; dağılım 39-81 yıl) tıbbi dosyası retrospektif olarak değerlendirildi. Hastaların demografik özellikleri, eşlik eden hastalıklar, sigara içiciliği, cerrahi sınır, viseral plevra invazyonu, tümörün cerrahi sınıra uzaklığı, tümör boyutu, patolojik N durumu, hücre tipi, tümör yerleşim yeri ve nüksler kaydedildi.Bul gu lar: Sağkalım, cerrahi sınırı tümör için negatif olan (R0) hastalarda, pozitif olan (R1) hastalara kıyasla, anlamlı olarak daha uzun (32.2 aya kıyasla 74.1 ay, p<0.01) idi. Lenfatik invazyon olmayan hastalarda da sağkalım anlamlı düzeyde daha uzun idi (p<0.01). So nuç:Erken evre akciğer tümörlerinde komplet rezeksiyon yapılacak ise, sublobar rezeksiyon yapılabilir. Lenfatik invazyon, sublobar rezeksiyon sonrası sağkalım için negatif prognostik faktördür.

Objectives: To investigate the long-term follow-up results of the patients who underwent surgery with bronchiectasis and whether there is a difference in clinical results compared to complete or incomplete resection. Materials and Methods: A total of 191 patients who underwent surgery with the diagnosis of bronchiectasis were enrolled in Ankara University Faculty of Medicine Department of Thoracic Surgery between 1990 and 2002. The age and the gender of the patients, preoperative symptoms, localization of disease, resection indications, type of resection, complications encountered in the postoperative period, operative mortality and the association between complete/incomplete resection and postoperative symptoms were evaluated, retrospectively. Results: The indications for surgery were failure of medical therapy in 181 patients (94.8%), massive hemoptysis in five (2.6%), lung abscess in three (1.6%) and bronchiectasis due to foreign body aspiration in two (1%). In the postoperative period, 173 patients could be followed up clinically and radiologically with an average of 4.6 years (1 month to 10 years). When complete resection and incomplete resection results were compared, of the 155 patients who underwent complete resection, 135 (87.1%) were asymptomatic, 18 (11.6%) had a significant regression, and two (1.3%) had no change of preoperative symptoms, of the 18 patients who underwent incomplete resection, 14 (77.8%) had a significant regression, while 4 (22.2%) had no change of preoperative symptoms. The results of complete resection were significantly better than those of incomplete resection (p<0.05). Conclusion: Symptomatic localized bronchiectasis cases are the most appropriate candidates for surgical treatment. Resection should be complete. Incomplete resection is the most important determinant in the continuation of symptoms after surgical treatment.

Background: Tumor size is one of the major prognostic determinants of non-small cell lung cancer (NSCLC).In the present study, we evaluated the effect of tumor size on survival in pN0M0 NSCLC patients. Between 1994Between and 2013Between , 1975 NSCLC patients underwent surgery in our center. The study included 774 NSCLC patients with pathological stage N0M0, and these patients were divided into 8 groups according to tumor diameter, as follows, Group 1: 0-10 mm, Group 2: 11-20 mm, Group 3: 21-30 mm, Group 4: 31-40 mm, Group 5: 41-50 mm, Group 6: 51-60 mm, Group 7: 61-70 mm, and Group 8: > 70 mm. We aimed to evaluate the prognostic effect of tumor size on overall survival and to determine a cut-off point for tumor size. Materials and Methods: Results:The 5 year overall survival rate for groups 1 to 8 were 85.6%, 81.3%, 68.6%, 62.2%, 55%, 54.2%, 54.3%, and 45.6%, respectively. The mean follow-up time was 43.8 months. In multivariate analysis, age, tumor size, and surgical resection type had an independent prognostic value on survival. Conclusions:Tumor size is an independent prognostic factor for pN0M0 NSCLC patients. A tumor size of 4 cm was found to be the most suitable cut-off point for survival which may be of help in decisionmaking for adjuvant chemotherapy. Kocaman et al.Effect of tumor size on survival

ÖZParatiroid adenomları primer hiperparatiroidizmin en sık nedenidir. Bu yazıda yorgunluk, hiperkalsemi ve hiperparatiroidisi olan 44 yaşında bir erkek hasta sunuldu. Paratiroid sintigrafisi ve torasik bilgisayarlı tomografisinde, ektopik olarak ön mediastende yerleşim gösteren paratiroid adenomu ile uyumlu bir lezyon görüldü. Paratiroid adenomu ameliyat sırası gama prob kılavuzluğunda başarı ile eksize edildi. Paratiroid adenomlarının yerleşiminin ameliyat öncesinde belirlenmesi gereklidir. Bu nedenle; ultrasonografi, paratiroid sintigrafisi ve paratiroid sintigrafisi pozitif olan hastalarda ameliyat sırasında yapılan gama prob kılavuzluğu tanı ve cerrahi tedavinin başarısı için çok önemlidir.Anah tar söz cük ler: Gama prob; ameliyat sırası; paratiroid adenomu. ABSTRACTParathyroid adenomas are the most frequent cause of primary hyperparathyroidism. In this article, we report a 44-year-old male patient with fatigue, hypercalcemia and hyperparathyroidism. Parathyroid scintigraphy and thoracic computed tomography revealed a lesion consistent with parathyroid adenoma ectopically located in the anterior mediastinum. The parathyroid adenoma was excised successfully under the guidance of intraoperative gamma probe. It is essential to determine the localization of parathyroid adenomas preoperatively. Therefore; ultrasonography, parathyroid scintigraphy and guidance of intraoperative gamma probe in patients with positive parathyroid scintigraphy are crucial for diagnosis and success of surgical treatment.Keywords: Gamma probe; intraoperative; parathyroid adenoma.Primary hyperparathyroidism (PHPT) is among the rarely encountered endocrine disorders and frequently manifests with hypercalcemia. Its incidence in adult population is approximately less than 1%. Whilst adenoma in a single parathyroid gland accounts for 85% to 90% of PHPT patients, hyperplasia is responsible for the etiology in 10% to 15% and parathyroid carcinoma is responsible for the etiology in 1% to 2%. Parathyroid adenomas are localized adjacent to thyroid gland by 80% to 90%, whereas they are ectopic by 10%. Ectopic adenomas are found in the anterior mediastinum primarily in the parathymic localization.[1]The main scanning methods used in the diagnosis of primary hyperparathyroidism include ultrasonography and parathyroid scintigraphy performed using technetium-99m (99mTc) methoxyisobutylisonitrile (sestamibi). Computed tomography (CT) and magnetic resonance imaging (MRI) are useful additional scanning methods particularly to localize ectopic parathyroid adenomas.[2] The use of combined radiological methods such as scintigraphy and ultrasonography or scintigraphy and CT enhances the success of clinical approach. For this purpose, the use of hybrid scanning systems such as single-photon emission computed tomography (SPECT)/CT is preferred. SPECT/CT gives more information on the anatomic localization of the lesion particularly in ectopic lesions and in the cases with the history of neck surgery.[3] The basic therapeutic approach for PHPT is surgery. Surgic...