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    Clinical experience of repair of pectus excavatum and carinatum deformities
    (Clinics Cardive Publ Pty Ltd, 2013) Oncel, Murat; Tezcan, Bekir; Akyol, Kazim Gurol; Dereli, Yuksel; Sunam, Guven Sadi
    Background: We present the results of surgical correction of pectus excavatum (PE) and pectus carinatum (PC) deformities in adults, and also report a new method of sternal support used in surgery for PE deformities. Methods: We present the results of 77 patients between the ages of 10 and 29 years (mean 17) with PE (n = 46) or PC (n = 31) deformities undergoing corrective surgery from 2004 to 2011, using the Ravitch repair method. Symptoms of the patients included chest pain (15%) and tachycardia (8%). Three patients underwent repair of recurrent surgical conditions. Results: All of the patients with dyspnoea with exercise experienced marked improvement at five months post operation. Complications included pneumothorax in 5.1% (n = 4), haemothorax in 2.6% (n = 2), chest discomfort in 57% (n = 44), pleural effusion in 2.6% (n = 2), and sternal hypertrophic scar in 27% (n = 21) of patients. Mean hospitalisation was eight days. Pain was mild and intravenous analgesics were used for a mean of four days. There were no deaths. Results after surgical correction were very good or excellent in 62 patients (80%) at a mean follow up of three years. Three patients had recurrent PE and were repaired with the Nuss procedure. In three patients who underwent the Ravitch procedure, a stainless steel bar was used for sternal support instead of Kirschner wire. Conclusions: Pectus deformities may be repaired with no mortality, low morbidity, very good cosmetic results and improvement in cardiological and respiratory symptoms.
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    A comparison of the efficacies of heterologous blood, rifamycin, and talc as pleural sclerosants in rabbits: An experimental study
    (Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2012) Dongel, Isa; Sunam, Guven Sadi; Kulahci, Ozgur; Ceran, Sami
    Background: In this study, we aimed to investigate the efficacy of rifamycin pleurodesis in rabbits. Methods: A total of 21 male New Zealand-type albino rabbits with an average weight of 3433 grams, were used in the study. One rabbit was used for blood supply. The other 20 rabbits were divided into four groups, including the control group, the heterologous blood group, the rifamycin group, and the talc group. Distilled water, heterologous fresh blood, rifamycin, and sterile liquid talc were administered through the catheter to the left hemithorax of rabbits. The rabbits were sacrificed using high-dose anesthesia on day 28. The pleural spaces were grossly assessed for evidence of pleurodesis and microscopic thickness of the pleura, and evidence of inflammation and fibrosis were examined. The degree of pleurodesis was rated on a scale of 0 to 4. Results: No statistically significant differences were observed between the control and heterologous blood groups at the macroscopic and microscopic level (p>0.05). The degree of pleurodesis in the talc and rifamycin groups was higher than in the control and heterologous blood group (p=0.04). No significant difference was observed between the talc and rifamycin groups in terms of macroscopic and microscopic examination (p>0.05). The median values of fibrosis thickness of the control, heterologous blood, rifamycin, and talc groups were 10 (10-29), 26 (10-71), 312 (264-351) and 304 (238-331) mu m, respectively. Conclusion: The efficacy of rifamycin pleurodesis in rabbits was microscopically and macroscopically similar to the talc group and superior to the control and heterologous blood group.
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    Giant Benign Mediastinal Masses Extending into the Pleural Cavity
    (Thieme Medical Publ Inc, 2016) Sunam, Guven Sadi; Oncel, Murat; Ceran, Sami; Odev, Kemal; Yildiran, Huseyin
    Introduction The aim of the study was to evaluate the results of surgery to remove huge mediastinal masses and their pathology. Surgical resection was chosen for accurate diagnosis and treatment of the huge mediastinal masses extending into the pleural cavity. Methods Records were reviewed for eight patients who had the diagnosis of huge benign mediastinal masses and who underwent operation; details of the patients and operations were recorded. Results Mean age was 34.5 (range 22 to 44) years, and male-to-female ratio was 2:6. Computed tomography and magnetic resonance imaging (MRI) were used to evaluate the location and extent of the abnormality and to characterize the tissue components of the mass. Most of the tumors were located in the posterior mediastinum. The most frequent presenting symptom was exertional dyspnea. The majority of cases underwent posterolateral thoracotomy, and complete resection was possible in seven patients. Partial resection could only be performed in one. The mean diameter of the resected masses was 15 x 10 cm. Histopathologic examination revealed 3 neurogenic tumors, 2 teratomas, 1 thymolipoma, and 1 ectopic thyroid, and 1 hemangioma. Minor complication was seen in two cases. Conclusion The presurgical thoracic MRI provided correct diagnosis along with radiologic characterization and topography. Surgery must be the preferred treatment in huge benign mediastinal masses.
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    Traumatic Aortic Rupture
    (Modestum Ltd, 2015) Altuntas, Bayram; Ceran, Sami; Sunam, Guven Sadi
    Acute disruption of the thoracic aorta due to blunt chest trauma is a life-threatening injury. The majority of patients with an aortic tear die at the scene while approximately 15-20% of the victims reach the hospital alive. A 25 years old man was admitted to emergency service because of traffic accident. On the chest X ray; left pleural effusion, left apical pleural cap, the evanescence of aortic knob and aorticopulmonary window, mediastinal widening (> 8 cm), tracheal deviation to right side were seen. The patient was transferred to the operating room by the diagnosis of aortic rupture. At the operation, the tear was seen on proximal site of subclavian artery pointed from aorta. After the primary repair, the patient arrested. The cardiac rescucitation was performed but he didn't answer. In this case, we aimed that the chest x-ray is useful measurement in the radiological evaluation of the traumatic aortic rupture.
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    Traumatic Aortic Rupture
    (Modestum Ltd, 2015) Altuntas, Bayram; Ceran, Sami; Sunam, Guven Sadi
    Acute disruption of the thoracic aorta due to blunt chest trauma is a life-threatening injury. The majority of patients with an aortic tear die at the scene while approximately 15-20% of the victims reach the hospital alive. A 25 years old man was admitted to emergency service because of traffic accident. On the chest X ray; left pleural effusion, left apical pleural cap, the evanescence of aortic knob and aorticopulmonary window, mediastinal widening (> 8 cm), tracheal deviation to right side were seen. The patient was transferred to the operating room by the diagnosis of aortic rupture. At the operation, the tear was seen on proximal site of subclavian artery pointed from aorta. After the primary repair, the patient arrested. The cardiac rescucitation was performed but he didn't answer. In this case, we aimed that the chest x-ray is useful measurement in the radiological evaluation of the traumatic aortic rupture.