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Mehmet Ali Bedirhan

Publications and source records attributed to Mehmet Ali Bedirhan.

8 recordsLinked to original sources
PubMed2005

[The clinical approach to the isolated traumatic hemothorax.].

BACKGROUND: The aim of this study was to evaluate the systematic approach to the isolated traumatic hemothorax. MATERIAL AND METHODS: The treatment modalities of 103 cases with isolated hemothorax was analyzed retrospectively between 1995 and 2003. RESULTS: We observed 103 isolated hemothorax cases. Eighty eight of them were male and 15 were female. The mean age was 39.4 years. The hemothorax was left sided at 41 cases, right sided at 60 cases and bilateral at 2 cases. Fifty three (51,4%) penetrating, forty nine (47,5%) blunt, and one (0,9%) iatrogenic traumas with resultant hemothoraxes were investigated. We performed tube thoracostomy in ninety nine cases. One case required an urgent thoracotomy. We operated twenty one cases and thoracoscopy was performed for six of them. The conservative approach was sufficient for eighty two patients. Mortality was seen in only one case (0,9%), because of a multiorgan failure. The mean rate of the hospital stay was 8,7 days. During operation, we explored for major pulmonary and systemic artery injury. CONCLUSIONS: The decision of exploration or conservative treatment must be made according to the patient stabilization status after the thoracostomy tube insertion. Thoracoscopic evacuation of blood clots from hemothoraxes must be attempted during the early posttraumatic stages, especially in cases refractory to classical drainage methods.

Adolescent↗
PubMed2004

Management of traumatic diaphragmatic rupture.

PURPOSE: Diaphragmatic rupture following trauma is often an associated and missed injury. This report documents our experience of treating traumatic diaphragmatic rupture (TDR). METHODS: We retrospectively analyzed 18 patients who presented between 1993 and 2000 with TDR, caused by blunt injuries in 14 and by penetrating injuries in 4. RESULTS: The average age of the patients was 32 years and the female to male ratio was 4 : 14. The TDR was right-sided in 5 patients and left-sided in 13. The diagnosis was made by chest X-ray, thorax and upper abdominal computed tomography, and upper gastrointestinal contrast studies. The most common herniated organs were the omentum (n = 11), stomach (n = 10), spleen and colon (n = 9), and liver (n = 2). Sixteen diaphragmatic injuries were repaired primarily, and two were repaired using a prolene mesh graft. The mortality rate was 5.5% (n = 1). CONCLUSIONS: A high index of suspicion and early surgical treatment determine the successful management of TDR, with or without the herniation of abdominal organs. The surgical approach to TDR is individualized. Acute left-sided injuries are best approached through the abdomen, although we prefer the chest approach, adding laparotomy when necessary. Acute right-sided injuries and chronic injuries should be approached through the chest.

Adult↗
PubMed2004

Surgical management of childhood bronchiectasis due to infectious disease.

BACKGROUND: The purpose of this study was to estimate operative risk and to identify indicators of adverse prognosis in patients undergoing resection for childhood bronchiectasis. METHODS: From January 1985 to February 2001, patients undergoing resection for bronchiectasis were studied. The indications for operation were failure of medical therapy in 33 patients (94.2%) and hemoptysis in 2 (5.7%). The mean duration of symptoms was 4.2 years (range, 1-9 years). Surgical treatment included lobectomy in 17 patients (48.5%), pneumonectomy in 7 (20%), lobectomy plus segmentectomy in 5 (14.2%), bilobectomy in 2 (5.7%), and segmentectomy in 4 (11.4%). RESULTS: The operative mortality rate was 2.8%, and the morbidity rate was 17.6%. The mean follow-up in 34 patients was 5.4 years (range, 1-12 years). Overall, 22 patients (64.7%) were asymptomatic after surgery. Clinical improvement was noticed in 8 patients (23.5%), and no improvement was noticed in 4 (11.7%). Complete resection resulted in a significantly better clinical outcome than incomplete resection (P <.05). CONCLUSIONS: Surgery for childhood bronchiectasis can be performed with low mortality and morbidity. Complete resection should be performed when possible.

Adolescent↗
PubMed2004

[Urgent partial sternotomy for the treatment of iatrogenic vascular injury to the thoracic outlet: a report of two cases].

Two patients underwent surgery for iatrogenic vascular injuries at the thoracic outlet. Injuries occurred during mediastinoscopy in one patient (male, aged 60 years) and removal of a Portovac catheter in the other (female, aged 49 years). We performed partial sternotomy in both cases to expose the proximal of a. carotis communis and vena cava superior, respectively. After distal and proximal control of the vessels, the injured vessel was primarily sutured in the first patient, and the tip of the catheter was removed through a venotomy incision in the latter. No postoperative complications occurred in both patients. Partial sternotomy incision provides an appropriate and quick access to the injured vessels and surrounding structures at the thoracic outlet.

Female↗
PubMed2002

Bilateral elastofibroma dorsi.

Elastofibroma dorsi was diagnosed in a 48-year-old woman with bilateral subscapular tumor masses diagnosed asynchronously in an interval of 4 months in spite of presence of another lesion at first admittance. She underwent subsequent resections of the lesions. They were diagnosed as elastofibroma. Reevaluation of the initial computerized tomography of thorax indicated an omitted small lesion with a 2-cm diameter and 25.2-day doubling time. Although the real neoplastic nature of elastofibroma is unknown, bilateral presence of the masses with different sizes and relatively short doubling times of the lesions must be kept in mind.

Elastic Tissue↗
PubMed2002

Surgical treatment of pulmonary hydatid cysts: is capitonnage necessary?

BACKGROUND: Hydatid disease of the lung caused by Echinococcus granulosus is frequently encountered in Mediterranean countries. The ideal surgical method for treating this disease is still unknown. METHODS: Between 1994 and 2001, 71 patients with pulmonary hydatid cysts were treated surgically. There were 41 male and 30 female patients with a mean age of 30.2 years (range, 5 to 70 years). Cystotomy and closure of bronchial openings were performed in all patients. Obliteration of the residual cavity by imbricating sutures from within (capitonnage) was achieved in 39 patients (group 1). There were 34 patients with intact cysts and 37 patients with at least one complicated cyst. The average diameter of the cysts was 6.4 cm, and the mean number of cysts per patient was 1.4. The surgical outcome was assessed in group 1 patients and in patients who had undergone closure of bronchial openings without capitonnage (group 2; n = 32). The groups were comparable in regard to clinical characteristics. RESULTS: There was no mortality. The total hospitalization time (mean +/- standard error of the mean) was 5.0 +/- 5.0 days for group 1 and 5.9 +/- 6.9 days for group 2 (p = 0.91). Stay in the intensive care unit was 1.64 +/- 1.22 days in group 1 and 1.60 +/- 1.52 days in group 2 (p = 0.90). The duration of air leak was 2.56 +/- 4.73 days in group 1 and 2.38 +/- 4.74 days in group 2 (p = 0.87). There was no significant difference between groups in the development of empyema (1 patient in group 2 only) and prolonged air leak (5 patients in group 1 and 4 in group 2). There was also no significant difference in the rate of recurrence (3 patients in group 1 only). CONCLUSIONS: We conclude that capitonnage provides no advantage in operations for pulmonary hydatid cysts.

Adult↗
PubMed2002

Comparison of clinical and surgical-pathologic staging of the patients with non-small cell lung carcinoma.

OBJECTIVE: Clinical staging of non-small cell lung cancer helps to determine the extent of disease and separate patients with potentially resectable disease from those that are unresectable. Since, clinical staging is based on radiologic and bronchoscopic findings, overstaging or understaging may occur comparing to the final surgical-pathologic evaluation. We aimed to analyze preoperative and postoperative stagings in order to evaluate stage migrations and our surgical strategy for marginally resectable patients. METHODS: We did a retrospective analysis of 180 patients with non-small cell lung cancer who underwent resectional surgery between 1994 and 2000. In all patients, a thoracic computerized tomography and bronchoscopy were performed to define clinical staging (cTNM). RESULTS: In 86 patients (47.7%) clinical and surgical-pathologic staging concurred. When comparing T subsets alone, correct staging, overstaging and understaging occurred in 133 (73.9%), 28 (15.5%), 47 (26.1%) patients, respectively. Only 13 of 21 patients (61.9%) who were thought to have T4 tumor preoperatively were found to have pT4. Also six patients with cT2 and five patients with cT3 were subsequently found to have T4 disease according to pathology. Clinical staging overestimated the nodal staging in 35 patients (19.4%), while underestimated the lymph node involvement in 45 patients (25%). CONCLUSION: Construction of cTNM stage remains a crude evaluation, preoperative mediastinoscopy in every patient must be performed. Preoperative limited T4 disease is not to deny surgery to patients since a considerable number of patients with cT4 are to be understaged following surgery.

Adult↗