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    The factors affecting persistent pneumothorax and mortality in neonatal pneumothorax
    (Turkish J Pediatrics, 2008) Esme, Hidir; Dogru, Oemer; Eren, Sevval; Korkmaz, Mevluet; Solak, Okan
    The aim of this study was to present our experience in management of neonatal pneumothorax and factors contributing to persistent pneumothorax and mortality. Forty-two newborns were analyzed according to gestational age, birth weight, Apgar score, age of admittance, type of delivery, mother's age, side of pneumothorax, causes of pneumothorax, accompanying disorders, tube thoracostomy and mechanical ventilation durations, mean hospital stay, and deaths. Sixteen patients (38%) weighed less than 2500 g and 28 (66%) were preterm. The mean Apgar score at 5(th) minute was 6.2 (2-10). The pneumothorax was bilateral in 9 patients (21%). There was a defined underlying lung pathology in 26 (61%) patients and accompanying disorder in 14 (33%). Mean tube thoracostomy duration was 5 days (2-12). Twenty-five patients (59%) needed mechanical ventilation. Overall 10 babies died. Our findings indicated that underlying primary lung pathology, need for mechanical ventilation, and bilateral pneumothorax were major determinants of persistent pneumothorax and mortality in newborns.
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    Monitorization Of Pulmonary Nodules In Turkey (MONITUR)
    (European Respiratory Soc Journals Ltd, 2024) Ozlu, Tevfik; Ozcelik, Neslihan; Aksu, Betul; Esme, Hidir; Pazarli, Ahmet Cemal; Yavasoglu, Gunhan; Baris, Serap Argun
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    Primary Mediastinal Cysts Clinical Evaluation and Surgical Results of 32 Cases
    (Texas Heart Inst, 2011) Esme, Hidir; Eren, Sevval; Sezer, Murat; Solak, Okan
    The purpose of this retrospective study was to analyze our experience with mediastinal cysts, emphasizing the clinical presentations and results of surgery Thirty-two patients with mediastinal cysts underwent surgery from January 2000 through June 2005. The records of these patients were reviewed for age at presentation, sex, signs and symptoms at presentation, results of the imaging techniques, types of mediastinal cysts, location and size of cysts, types of surgical procedure, length of hospital stay early postoperative complications, death, and other follow-up information. The 32 mediastinal cysts comprised 12 bronchogenic, 9 pericardial, 7 thymic, and 2 enteric cysts, together with 2 cystic teratomas. Overall, 14 of the 32 patients with mediastinal cysts were asymptomatic. The surgical approach was thoracotomy in 30 patients and median sternotomy in 2 patients. The mean length of hospital stay was 77 +/- 2.6 days. All patients were free from recurrence during the mean follow-up period of 4.4 +/- 3.3 years. Surgery for mediastinal cysts is associated with low morbidity and mortality rates and a very low recurrence rate. It offers a definitive diagnosis and cure, avoiding the higher morbidity and mortality risks associated with conservative observation. (Tex Heart Inst J 2011;38(4):371-4)
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    Risk factors affecting outcome and morbidity in the surgical management of bronchiectasis
    (Mosby-Elsevier, 2007) Eren, Sevval; Esme, Hidir; Avci, Alper
    Objective: Bronchiectasis continues to be a major cause of morbidity and mortality in developing countries. The purpose of this study was to present the results of our 14 years of surgical experience to re-evaluate our indications for using surgical therapy and to analyze several factors that might affect the outcome and postoperative complications of this disease. Method: Age, sex, etiologic factors, symptoms, the duration of symptoms, radiologic and radionuclide examinations, preoperative evaluation, surgical procedures, postoperative morbidity and mortality, and the follow-up results from 143 patients operated on for bronchiectasis between January 1992 and January 2006, were reviewed retrospectively. Results: One hundred forty-three patients underwent 148 operations for bronchiectasis. The mean age was 23.4 years. Complete resection was achieved in 118 patients. The morbidity rate was 23.0% and the mortality rate was 1.3%. Postoperatively, 75.9% of the patients were free of symptoms, 15.7% were improved, and 8.2% showed no improvement or were worse. The logistic regression analysis showed that a history of tuberculosis and incomplete resection were independent predictors of the operative result. Moreover, the lack of a preoperative bronchoscopic examination, a forced expiratory volume in 1 second of less than 60% of the predicted value, a history of tuberculosis, and incomplete resection were independent predictors of postoperative complications. Conclusions: A history of tuberculosis and incomplete resection were risk factors both for postoperative complications and for a worse operative result. The lack of a preoperative bronchoscopic examination and a low forced expiratory volume in 1 second were risk factors for postoperative complications. Surgery for multiple segments on different lobes should be performed whenever possible.
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    The risk factors and management of posttraumatic empyema in trauma patients
    (Elsevier Sci Ltd, 2008) Eren, Sevval; Esme, Hidir; Sehitogullaric, Abidin; Durkan, Atilla
    Background: Posttraumatic empyema increases patient morbidity, mortality and length of hospital stay, and the cost of treatment. The aim of this study was to identify the risk factors for posttraumatic empyema and to review our treatment outcomes in patients with this condition. Methods: A total of 2261 patients who were admitted with thoracic traumas and underwent tube thoracostomy between January 1989 and January 2006 were investigated retrospectively. Posttraumatic empyema developed in 71 patients. Logistic regression was used to assess the association between potential risk factors for posttraumatic empyema. All values were expressed as the mean +/- S.D. Results: Eight hundred and thirty-six (37%) of the patients had penetrating type trauma, white 1425 (63%) had blunt type trauma. The rate of posttraumatic empyema development was 3.1% for all patients. Pulmonary contusion was seen in 221 (9.8%) patients and fractures of more than two ribs were seen in 191 (8.4%) patients. Tube thoracostomy placement was performed in the emergency room in 1728 (76.4%) patients, in the hospital ward in 197 (8.7%), in the intensive care unit in 182 (8.0%), and in the operating room in 154 (6.8%). The duration of tube thoracostomy was 6.11 +/- 2.99 (1-21) days. Retained haemothorax was seen in 175 (7.7%) patients. The mean lengths of hospital and intensive care unit stay were 6.42 +/- 3.45 and 2.36 +/- 2.66 days, respectively. The analysis showed that duration of tube thoracostomy (OR, 2.49, p < 0.001), length of intensive care unit stay (OR, 4.21, p < 0.001), and presence of contusion (OR, 3.06, p < 0.001), retained haemothorax (OR, 5.55, p < 0.001), and exploratory laparotomy (OR, 2.46, p < 0.001) were independent predictors of posttraumatic empyema. The relative risk of posttraumatic empyema was higher than 1 for each of the following risk factors: penetrating trauma (OR, 1.59, p = 0.055), associated injuries (OR, 1.12, p = 0.628) and fractures of more than two ribs (OR, 1.60, p = 0.197). Conclusion: Prolonged duration of tube thoracostomy and length of intensive care unit stay, and the presence of contusion, laparotomy and retained haemothorax are independent predictors of posttraumatic empyema. Use of prophylactic antibiotics may be recommended in patients with these risk factors. (c) 2007 Elsevier Ltd. All rights reserved.