Browsing by Author "Demirkaya, Ahmet"

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A prospective randomized trial comparing homologous and autologous fibrin sealants for the control of alveolar air leak
(AME PUBL CO, 2017-01-01) Kilic, Burcu; Ersen, Ezel; Demirkaya, Ahmet; Kara, H. Volkan; Alizade, Nurlan; Iscan, Mehlika; Kaynak, Kamil; Turna, Akif
Background: Postoperative air leak is a common complication seen after pulmonary resection. It is a significant reason of morbidity and also leads to greater hospital cost owing to prolonged length of stay. The purpose of this study is to compare homologous sealant with autologous one to prevent air leak following pulmonary resection. Methods: A total of 57 patients aged between 20 and 79 (mean age: 54.36) who underwent pulmonary resection other than pneumonectomy (lobar or sublobar resections) were analyzed. There were 47 males (83\%) and 10 females (17\%). Patients who intraoperatively had air leaks were randomized to receive homologous (Tisseel
Comparative study of video-assisted thoracoscopic surgery versus open thymectomy for thymoma and myasthenia gravis
(TERMEDIA PUBLISHING HOUSE LTD, 2018-01-01) Ersen, Ezel; Kilic, Burcu; Kara, Hasan Volkan; Iscan, Mehlika; Sarbay, Ismail; Demirkaya, Ahmet; Bakan, Selim; Tutuncu, Melih; Turna, Akif; Kaynak, Kamil
Introduction: Thymectomy is the preferred standard treatment in younger non-thymoma patients with myasthenia gravis as well as in patients with early stage thymoma. Total thymectomy by median sternotomy has been the surgical approach since resection of the thymus with video-assisted thoracoscopic surgery (VATS). Aim: To compare the clinical outcomes of VATS thymectomy with conventional open thymectomy for neoplastic and non-neoplastic thymic diseases. Material and methods: Forty patients underwent thymectomy between October 2012 and January 2016. Fifteen patients were male and 25 patients were female. The mean age was 40.3 +/- 17.7 years. Seventeen (55\%) patients underwent VATS thymectomy and 23 (45\%) patients underwent an open procedure. We retrospectively reviewed the data of the patients and compared these two techniques. Results: The mean tumor size was 5.17 +/- 3.2 cm in the thymoma group (VATS 2.5 +/- 2.4 cm vs. open access 4.7 +/- 3.7 cm). None of the patients experienced a myasthenic crisis. Conversion to thoracotomy was required in 1 patient in the VATS group due to bleeding from the right internal mammary artery
Management of a primary cardiac leiomyosarcoma in a young woman
(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2021-01-01) Onalan, Mehmet Akif; Demirkaya, Ahmet; Behzatoglu, Kemal; Erek, Ersin
Cardiac leiomyosarcoma is an extremely rare tumor with a poor prognosis. An 18-year-old female patient was admitted to our clinic with a left atrial leiomyosarcoma extending to the right lower pulmonary veins. We performed complete tumor excision by the right anterolateral mini-thoracotomy approach using minimally invasive techniques. After pathological confirmation of the tumor, right lower lobectomy was performed with the same incision one week later to prevent recurrence. Although no tumor remnant was found in the lobectomy specimen, adjuvant chemotherapy was started. No recurrence was detected during the 12-month follow-up. In conclusion, the right submammarian minithoracotomy approach has the advantages of its less invasive nature and suitability for complete tumor resection with lobectomy.
Minimally invasive repair of pectus excavatum (MIRPE) in adults: is it a proper choice?
(TERMEDIA PUBLISHING HOUSE LTD, 2016-01-01) Ersen, Ezel; Demirkaya, Ahmet; Kilic, Burcu; Kara, Hasan Volkan; Yaksi, Osman; Alizade, Nurlan; Demirhan, Ozkan; Sayilgan, Cem; Turna, Akif; Kaynak, Kamil
Introduction: The Nuss procedure is suitable for prepubertal and early pubertal patients but can also be used in adult patients. Aim: To determine whether the minimally invasive technique (MIRPE) can also be performed successfully in adults. Material and methods: Between July 2006 and January 2016, 836 patients (744 male, 92 female) underwent correction of pectus excavatum with the MIRPE technique at our institution. The mean age was 16.8 years (2-45 years). There were 236 adult patients (28.2\%) (> 18 years) 20 female, 216 male. The mean age among the adult patients was 23.2 years (18-45 years). The recorded data included length of hospital stay, postoperative complications, number of bars used, duration of the surgical procedure and signs of pneumothorax on the postoperative chest X-ray. Results: The MIRPE was performed in 236 adult patients. The average operative time was 44.4 min (25-90 min). The median postoperative stay was 4.92 +/- 2.81 days (3-21 days) in adults and 4.64 +/- 1.58 (2-13) in younger patients. The difference was not statistically significant (p = 0.637). Two or more bars were used in 36 (15.8\%) adult patients and in 44 (7.5\%) younger patients. The difference was not statistically significant either (p = 0.068). Regarding the overall complications, complication rates among the adult patients and younger patients were 26.2\% and 11.8\% respectively. The difference was statistically significant (p = 0.007). Conclusions: MIRPE is a feasible procedure that produces good long-term results in the treatment of pectus excavatum in adults.
Single stage bilateral uniportal videothoracoscopic sympathicotomy for hyperhidrosis: can it be managed as an outpatient procedure?
(TERMEDIA PUBLISHING HOUSE LTD, 2016-01-01) Demirkaya, Ahmet; Ersen, Ezel; Kilic, Burcu; Kara, Hasan Volkan; Iscan, Mehlika; Kaynak, Kamil; Turna, Akif
Introduction: The videothoracoscopic approach is minimally invasive with benefits that include less postoperative pain and shorter hospital stay. It is also a safe procedure which can be performed on an outpatient basis. Aim: To determine whether videothoracoscopic sympathicotomy can be performed safely in most patients as an outpatient procedure. Material and methods: Between July 2005 and October 2015, a total of 92 patients underwent bilateral and single port thoracoscopic sympathicotomy in our department on an outpatient basis. The level of sympathicotomy was T2 in 2 (2.2\%) patients, T2 to T3 in 31 (33\%) patients, T2 to T4 in 46 (50\%) patients and T3 to T4 in 12 (13\%) patients. Demographic data, length of postoperative stay, substitution index (SI), admission rate (AR) and readmission rate (RR), complications and patient satisfaction were reviewed retrospectively. Results: Two (2.2\%) patients suffered from chest pain, while 4 (4.3\%) patients complained about pain at the port site. Mean discharge time after surgery was 5.1 h (range: 4-6 h), mean duration of hospital stay was 0.15 days (0-3 days) postoperatively and the mean operation time was 43.6 min (15-130 min). In 8 (8.6\%) patients, pneumothorax was detected on postoperative chest X-ray while 5 (5.4\%) patients required chest tube drainage. Mild or moderate compensatory sweating developed in 32 (34.7\%) patients. No recurrence was observed, and the satisfaction rate was 96.7\%. Substitution index and admission rate were 91.3\% and 11\% respectively, while RR was 0\%. Conclusions: Bilateral video-assisted thoracoscopic sympathicotomy can be performed safely in most patients as an outpatient procedure.
Uniportal versus multiport video-assisted thoracoscopic surgery for anatomical lung resections: a glance at a dilemma
(TERMEDIA PUBLISHING HOUSE LTD, 2018-01-01) Ersen, Ezel; Kilic, Burcu; Kara, Hasan Volkan; Iscan, Mehlika; Alizade, Nurlan; Demirkaya, Ahmet; Turna, Akif; Kaynak, Kamil
Introduction: As the number of operations performed by videothoracoscopy is increasing, there is also a tendency to decrease the number of port incisions. Apart from the reduced number of surgical incisions, there are a few reports and systematic reviews that demonstrate some potential advantages of the uniportal video-assisted thoracoscopic surgery, but the impact of the reduced incisions in the clinical setting still remains uncertain. Aim: To compare uniportal video-assisted thoracoscopic surgery to multiport video-assisted thoracoscopic surgery for anatomical lung resections in patients with malignant and benign lung diseases. Material and methods: From August 2010 to April 2016, a total of 102 patients with malignant and benign lung diseases underwent videothoracoscopic lobar and sublobar lung resections in our department. Comorbidities, tumor stage, tumor localization, mortality, operative time, pain visual analogue scale, length of hospital stay, perioperative blood loss, duration and amount of postoperative drainage and air leak, number of harvested lymph nodes and complication rates were analyzed. Results: No significant difference was found in the duration of chest tube drainage, pain visual analogue scale score, length of hospital stay, perioperative blood loss, amount of postoperative drainage, number of harvested lymph nodes or complication rate. There was no surgical mortality in either of the two groups. However, operative time was shorter (189 min vs. 256 min, p < 0.005) in the multiport group than in the uniportal group. Conclusions: Compared with the uniportal approach, the multiport approach is associated with a significantly shorter operative time in our study.