ABSTRACT
Background: Prolonged air leakage following pneumothorax surgery is a significant issue causing increased hospital stay and morbidity. This study aimed to investigate the cost and efficacy of homologous fibrin sealant in preventing the air leakages.Methods: Among the patients who had undergone bullectomy and subtotal parietal pleurectomy for recurrent primary spontaneous pneumothorax via transaxillary mini thoracotomy between 2010 and 2018, two groups each including 35 cases were conducted as to whether fibrin sealent had been applied. These two patient groups were compared in terms of age, gender, duration of air leakage and cost.Results: Mean age of whole group of patients including 59 males and 11 females was 21.5 years. Mean values of air leakage duration and cost of hospital stay was calculated as 1.94 days and 2777 TL for sealant applied group and 2.97 days and 1200 TL for sealent unapplied group, respectively. The patient groups did not indicate a statistically difference in terms of age and gender whereas duration of air leakage was shorter but cost was higher in the group for whom fibrin sealant had been administered (p<0.001). None of the patients developed mortality but recurrence was present in 4 (5.7%) patients.Conclusions: Although homologous fibrin sealant applied in pneumothorax surgery results in cost increase, it contributes to surgical outcomes by preventing possible additional complications in consideration of shortened duration of air leakage.
ABSTRACT
Background: This study aimed to investigate the feasibility of F-18 fluorodeoxyglucose (FDG) positron emission computed tomography (PET/CT) in identifying the pleural invasion of metastatic breast cancers.Methods: A retrospective study was conducted to include 75 patients with untreated breast cancer who had undergone thoracoscopy to drain pleural effusions and to perform pleural biopsies. Whole group of patients were evaluated in terms of age, type of primary breast cancer, macroscopic appearance of pleura during thoracoscopy, maximum standardized FDG uptake value (SUV) reported by PET/CT scan in addition to presence of malignancy detected in pleura and/or pleural effusion.Results: All of 75 patients were female and mean age was 56.12±11.70. Metastatic disease was diagnosed in the pleura of 40 (53.3%) and in the pleural effusion of 43 (57.3%) patients. The sensitivity and specificity of PET/CT in detecting pleural metastases of breast carcinoma was calculated as 88.2% and 96.2% whereas PET/CT demonstrated sensitivity of 91.9% and specificity of 91.3% in identifying malignant pleural effusion. Cut-off values of FDG uptake were 4.25 for pleural metastases and 3.85 for malignant pleural effusions. PET/CT also indicated a false negative rate of 12.5%, a false positive rate of 16.28% and an overall accuracy rate of 85.33% in the diagnosis of pleural metastasis of breast carcinoma.Conclusions: PET/CT reporting an FDG uptake over 4 in the pleura or pleural effusion is beneficial in managing the patients with the suspicion of pleural metastases from breast cancer.
ABSTRACT
Background: Recurrence of Primary Spontaneous Pneumothorax (PSP) constitutes a serious challenge for both physicians and patients.Methods: A retrospective study was conducted in 115 patients who had chest tubes at their first onset of PSP. Considering the development of recurrence, two groups were composed and comparatively examined in terms of age, body mass index, smoking status, side and size of initial pneumothorax, presence of bulla and duration of chest tube drainage at the first episode.Results: Among 115 patients with PSP, 24 cases developed recurrence. Male gender was prominently relevant to develop recurrent PSP (p=0.034) whereas remaining inspected parameters revealed no significant relationship with a relapse. Interval between first onset and recurrence of PSP was calculated as 9.2 months. Interestingly, most of the patients developed recurrence in low-temperature months.Conclusions: Recurrence of PSP is substantially unpredictable. Therefore, close follow-up of cases in the following year of their first episode and also informing the patients about probability of a relapse and measures to consider under this circumstance is of great importance.