Browsing by Author "Erol, Mehmet Muharrem"
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Item Assessment of palliative care in lung cancer in Turkey(Karger, 2017) Erol, Mehmet Muharrem; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Cerrahisi Anabilim Dalı.; CPM-5715-2022; 35605916500Objective: To investigate the symptoms of lung cancer in Turkey and to evaluate approaches to alleviate these symptoms. Subjects and Methods: This study included 1,245 lung cancer patients from 26 centers in Turkey. Demographic characteristics as well as information regarding the disease and treatments were obtained from medical records and patient interviews. Symptoms were evaluated using the Edmonton Symptom Assessment Scale (ESAS) and were graded on a scale between 0 and 10 points. Data were compared using the. 2, Student t, and Mann-Whitney U tests. Potential predictors of symptoms were analyzed using logistic regression analysis. Results: The most common symptom was tiredness (n = 1,002; 82.1%), followed by dyspnea (n = 845; 69.3%), appetite loss (n = 801; 65.7%), pain (n = 798; 65.4%), drowsiness (n = 742; 60.8%), anxiety (n = 704; 57.7%), depression (n = 623; 51.1%), and nausea (n = 557; 45.5%). Of the 1,245 patients, 590 (48.4%) had difficulty in initiating or maintaining sleep. The symptoms were more severe in stages III and IV. Logistic regression analysis indicated a clear association between demographic characteristics and symptom distress, as well as between symptom distress (except nausea) and well-being. Overall, 804 (65.4%) patients used analgesics, 630 (51.5%) received treatment for dyspnea, 242 (19.8%) used enteral/parenteral nutrition, 132 (10.8%) used appetite stimulants, and 129 (10.6%) used anxiolytics/antidepressants. Of the 799 patients who received analgesics, 173 (21.7%) reported that their symptoms were under control, and also those on other various treatment modalities (dyspnea: 78/627 [12.4%], appetite stimulant: 25/132 [18.9%], and anxiolytics/antidepressants: 25/129 [19.4%]) reported that their symptoms were controlled. Conclusion: In this study, the symptoms progressed and became more severe in the advanced stages of lung cancer, and palliative treatment was insufficient in most of the patients in Turkey.Item Basic interrupted versus continuous suturing techniques in bronchial anastomosis following sleeve lobectorny in dogs(Oxford University Press, 2007-09-03) Erol, Mehmet Muharrem; Bayram, Ahmet Sami; Salcı, Hakan; Özyiǧit, Özgür M.; Görgül, Sacit O.; Gebitekin, Cengiz; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Cerrahisi Anabilim Dalı.; Uludağ Üniversitesi/Veteriner Fakültesi/Cerrahi Anabilim Dalı.; 0000-0003-0684-0900; 8347194000; 8680329000; 22954215300; 22953784900; 6602156436Objective: Sleeve resection with or without lung resection is a valid conservative operation for patients with benign or malignant tumors; it enables the preservation of lung parenchyma. The aim of this prospective randomized study was to compare complications, operating time, and bronchial heating between the techniques of interrupted and continuous suturing for bronchial anastomosis in dogs. Methods: Twenty adult mongrel dogs each weighing 18-22 kg (average: 20 kg) were divided into two groups according to the anastomosis technique performed: group A, interrupted suturing and group B, continuous suturing. Each group comprised of 10 dogs. Following right thoracotomy, sleeve resection of the right cranial lobe was performed in all dogs. Basic interrupted sutures using 4/0Vicryl (Ethicon, USA)were used in group A, and continuous sutures were used in group B. Results: The median anastomosis time was 15.2 min (range: 13-21 min) in group A and 9.6 min (range: 8-13 min) in group B. In all dogs, the anastomosis line was resected via right pneumonectomy for histopathological investigation 1 month after sleeve resection. Histopathological examination revealed that the healing of the anastomosis was not affected by the suturing technique applied. One dog from each group died on the fourth postoperative day; Fisher's exact test, p = 0.763. Conclusions: Our research revealed that the heating of the anastomosis was not affected by the suturing technique performed.Item Cerebral blood flow during single lung ventilation(TÜBİTAK, 2012-12) Kul, Sibel; Cansu, Ayşegül; Tekinbaş, Celal; Ertürk, Engin; Topbaş, Murat; Erol, Mehmet Muharrem; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Cerrahisi Anabilim Dalı.; 35605916500Aim: Our aim was to show the effect of one-lung ventilation (OLV) on cerebral blood flow (CBF) by measuring carotid blood flow. This technique has been the subject of experimental and clinical studies. Materials and methods: Carotid doppler flows were measured at 4 different times. Peak systolic velocity (PSV) and end diastolic velocity (EDV) were measured and pulsatility index (PI) and resistive index (RI) calculated. Results: There were no significant changes in PSV, PI, RI, or flow volume in the normal or diseased sides at repeated measures (P > 0.05).There was no significant difference between the flow velocities, PIs, RIs, or flow volumes measured in the supine and decubitus positions during OLV. In addition, there was no significant difference between the flow parameters of the upper and lower carotids measured in the lateral decubitus position before and after OLV. There was no correlation between any of the flow parameters and duration of OLV. Conclusion: OLV poses no additional risk in terms of CBF. However, further studies, supported by biochemical parameters and involving wider patient groups, are now needed.Item Combination of tissue biopsy and fine needle aspiration cytology reduces false negativity of mediastinoscopy for non-small cell lung cancer(Bayçınar Medical-Bayçınar Tıbbi Yayıncılık, 2012-04) Erol, Mehmet Muharrem; Bayram, Ahmet Sami; Dülger, Hüseyin; Balaban, Şaduman Adım; Aygün, Mert; Yerci, Ömer; Gebitekin, Cengiz; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Cerrahisi Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; ABB-7580-2020; 8347194000; 57225229141; 7003295230; 23666403500; 6603810549; 6602156436Background: This study aims to compare tissue biopsy with fine needle aspiration (FNA) and investigate whether the combination reduces false negativity of mediastinoscopy. Methods: Between January 2004 and October 2005, 92 patients with non-small cell lung cancer (NSCLC) who underwent cervical video mediastinoscopy were included in this prospective study. Tissue biopsy samples and FNAs were obtained from the same lymph node and were sent for a pathologic examination. Tissue samples and FNAs were stained with Hematoxilene-Eosine. All specimens were evaluated by two histopathologists. Results: Using tissue biopsy samples, no metastasis was found in 54 patients, while 38 patients were metastatic. Forty-eight patients had no metastasis, while 44 patients were metastatic using FNA samples. The difference was statistically non-significant (p>0.05). The false negativity of the FNA and tissue biopsy were 5.4% and 12%, respectively. Subsequently, 43 patients with negative FNA and tissue biopsy underwent lung resection with thoracotomy and sistematic lymph node dissection. Following lymph node dissection, lymph node metastases were found in two cases (4.6%). As a result, false negativity of mediastinoscopy was reduced to 4.6% when two techniques were combined. There was no complication related to the technique. Conclusion: The FNA of mediastinal lymph nodes is a safe and effective method, compared to tissue biopsy and reduces the false negativity of mediastinoscopy when combined with tissue biopsy.Item Comparison of two suturing techniques in tracheobronchial anastomosis following the wedge carinal resection in dogs(Kafkas Üniversitesi, 2011) Erol, Mehmet Muharrem; Salcı, Hakan; Bayram, Ahmet Sami; Özyiğit, Musa Özgür; Görgül, O. Sacit; Gebitekin, Cengiz; Uludağ Üniversitesi/Veterinerlik Fakültesi/Cerrahi Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Cerrahisi Anabilim Dalı.; Uludağ Üniversitesi/Veterinerlik Fakültesi/Patoloji Anabilim Dalı.; 8680329000; 53264883600; 53264680300; 53264877700; 6602156436Tracheobronchial resection in humans is a still problem in lung cancer invading the carina, because there is not a standard surgical procedure. This study aimed to compare postoperative complications and histopathological results of simple continuous and simple interrupted suturing techniques in tracheobronchial anastomosis following the wedge carinal resection in dogs. Twelve mongrel dogs were divided into A and B groups. Right pneumonectomy with wedge carinal resection technique was performed under general anesthesia, and then tracheobronchial resection line was sutured simple continuously in group A and simple interruptedly in group B. The dogs were checked during two months in terms of postoperative complications, and euthanized at the end of two months to evaluate tracheobronchial anastomosis lines histopathologically. No postoperative complication was encountered in group A; but, 2 dogs in group B died due to respiratory failure on postoperative 4(th) and 12(th) days. Autopsy of the dogs revealed tracheobronchial dehiscence and opening of the simple interrupted suturing line, which was considered operative technique failure of suturing. Histopathologically, the sections taken from tracheobronchial anastomosis line had similar microscopic results in both group. Statistically, Fisher's exact test was applied between groups to determine the differences with regard to postoperative complications and histopathological results. There was no statistically significant differences between the groups in postoperative complications and histopathological results. In conclusion, operative technique failure of suturing is still common in tracheobronchial anastomosis; however, taking the histopathological results of the study into consideration, it has been implied that both suturing technique can be performed in tracheobronchial anastomosis following the wedge carinal resection.Publication Cricothyroidotomy performed by seldinger method in the management postoperative sputum retention and atelectasis after lung resection(Bayçınar Medikal Yayın, 2015-01-01) Melek, Hüseyin; Çetinkaya, Gamze; Erol, Mehmet Muharrem; Kaya, Fatma Nur; Bayram, Ahmet Sami; MELEK, HÜSEYİN; Çetinkaya, Gamze; Erol, Mehmet Muharrem; KAYA, FATMA NUR; BAYRAM, AHMET SAMİ; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Cerrahisi Anabilim Dalı; Uludağ Üniversitesi/Tıp Fakültesi/Anestezi ve Reanimasyon Anabilim Dalı; 0000-0003-0684-0900; 0000-0002-4848-1566; JDW-2654-2023; AAI-5039-2021; ABB-7580-2020; KHE-8874-2024; CXE-4995-2022Mini-tracheotomy is a safe and effective method in the prevention and treatment of postoperative sputum retention and atelectasis. It can be applied under general anesthesia or local anesthesia. Minitracheotomy-related complications are usually preventable and are rare. In this article, we present the outcomes of Mini-Trach II (R) Portex Seldinger kit application technique under the guidance of rigid bronchoscopy in patients with atelectasis and sputum retention after lung resection.Item Descending necrotizing mediastinitis: Increased mortality due to delayed presentation(TÜBİTAK, 2012-12) Ural, Ahmet; Tekinbaş, Celal; Erol, Mehmet Muharrem; Melek, Hüseyin; Bayram, Ahmet Sami; Gebitekin, Cengiz; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Cerrahisi Anabilim Dalı.; 0000-0003-1822-8153; AAI-5039-2021; ABB-7580-2020; 35605916500; 9639938400; 8347194000; 6602156436Aim: To describe the clinical features of descending necrotizing mediastinitis (DNM) and to outline the diagnostic and therapeutic measures to be taken in its management. Materials and methods: We retrospectively analyzed the data from 13 patients with DNM treated between 2001 and 2012 in 2 tertiary care centers, together with their demographics, diagnostic methods, therapeutic interventions, and clinical outcomes. Results: The patients consisted of 10 males and 3 females, aged from 16 to 72 years (mean age: 44). Odontogenic and tonsillar infections were the probable sources of infection in the majority of cases. Computerized tomography is a crucial imaging modality in the diagnosis and follow-up of patients with DNM. All patients underwent surgical treatment in addition to intravenous broad-spectrum antibiotics. Tube thoracostomy, mediastinal drainage, cervical drainage, and thoracotomy were the therapeutic measures utilized in these patients. Five patients were lost (38%) and 8 survived. Conclusion: DNM is a life-threatening condition that may originate from oropharyngeal infections. Emergency surgical intervention is mandatory in the management of DNM. The 2 most important survival factors are early surgical intervention and adequate drainage.Publication Diagnostic value of video-assisted thoracoscopic lung biopsy on diagnosis of diffuse parenchymal lung dissease(European Respiratory, 2013-09-01) Bayram, Ahmet Sami; Melek, Hüseyin; Erol, Mehmet Muharrem; Coşkun, Funda; Akyıldız, Elif Ülker; Gebitekin, Cengiz; BAYRAM, AHMET SAMİ; MELEK, HÜSEYİN; Erol, Mehmet Muharrem; COŞKUN, NECMİYE FUNDA; AKYILDIZ, ELİF ÜLKER; GEBİTEKİN, CENGİZ; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Cerrahisi Anabilim Dalı; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Bölümü; 0000-0003-0684-0900; 0000-0003-3604-8826; JCE-0097-2023; AAE-1069-2022; AAI-5039-2021; ABB-7580-2020; AAD-1271-2019; KHE-8874-2024; JHY-9777-2023Item Is the measurement of total cell death, not solely Apoptosis, better indicator of response to taxane-based chemotherapy in lung cancer patients(Elsevier Science, 2012-09) Evrensel, Türkan; Ulukaya, Engin; Coşkun, Belkıs; Korkmaz, Serhat; Ölmez, Ömer; Çubukçu, Erdem; Bayram, Ahmet; Gebitekin, Cengiz; Erol, Mehmet Muharrem; Kurt, Ender; Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Onkoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Klinik Biyokimya Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Cerrahisi Anabilim Dalı.; 0000-0002-9732-5340; 0000-0003-4875-5472; 0000-0003-0298-4157; 0000-0001-7934-7039; 0000-0003-0684-0900; 0000-0001-8718-9499; 0000-0001-7772-0303; 0000-0002-5446-1254; AAJ-1027-2021; K-5792-2018; EUN-2822-2022; FKB-8675-2022; DJG-4827-2022; ETP-1691-2022; ABB-7580-2020; AAE-1069-2022; CPM-5715-2022; DAS-3088-2022Item Pneumonectomy after neoadjuvant treatment(Bayçınar Medical Publ-Bayçınar Tıbbi Yayıncılık, 2013-09-23) Melek, Hüseyin; Erol, Mehmet Muharrem; Bayram, Ahmet Sami; Çetinkaya, Gamze; Evrensel, Türkkan; Sarıhan, Süreyya; Akyıldız, Elif Ülker; Gebitekin, Cengiz; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Cerrahisi Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Onkoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Radyasyon Onkolojisi Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; 0000-0002-9732-5340; 0000-0003-0684-0900; 0000-0003-1822-8153; AAJ-1027-2021; ABB-7580-2020; AAH-4970-2021; AAI-5039-2021; JCE-0097-2023; 9639938400; 35605916500; 8347194000; 56404505600; 6603942124; 56404684500; 55901306600; 6602156436Background: This study was conducted to investigate the effect of pneumonectomy after neoadjuvant therapy on survival, morbidity, and mortality in patients with non small cell carcinoma (NSCLC). Methods: Files of 130 patients who were performed pneumonectomy in our clinic for NSCLC between November 1995 and August 2012 were retrospectively reviewed. Patients with other malignancies and/or distant metastasis, and who underwent completion pneumonectomy were excluded, and the remaining 116 patients (113 males, 3 females; mean age 57 years; range 31 to 82 years) constituted the study group. Neoadjuvant treatment was administered to 47 patients (group 1) who had advanced stage (T3-4N0-1 or T1-3N2) NSCLC. Pneumonectomy without neoadjuvant treatment was performed in 69 patients with T2-4N0-1 (group 2). Survival, morbidity, and mortality rates were compared between the groups. Results: Sixty-two patients (53%) underwent left pneumonectomy. The median length of hospital stay was 6.4 days (range 1-33 days). Chemotherapy was administered in 29 patients (62%), and chemoradiotherapy in 18 patients (38%) preoperatively. Left pneumonectomy was performed in 29 patients after neoadjuvant treatment. Complications were detected in 31% of patients (group 1: 28%, group 2: 33%). Ninety-day mortality rate was 4.2% in group 1, and 5.8% in group 2. Five-year-survival rate was 41% and 35% for group 1 and group 2, respectively. Median survival time was 41 months and 40 months for group 1 and group 2, respectively. No statistically significant difference was detected between the two groups in terms of morbidity, mortality, and survival. Conclusion: This study showed that pneumonectomy after neoadjuvant treatment may be safely administered in patients with locally advanced NSCLC with acceptable morbidity, mortality, and survival rates.Publication The success of surgery in the first 24 hours in patients with esophageal perforation(Aves Yayıncılık, 2015-02-01) Bayram, Ahmet Sami; Erol, Mehmet Muharrem; Melek, Hüseyin; Çolak, Mehmet Ali; Kermenli, Tayfun; Gebitekin, Cengiz; BAYRAM, AHMET SAMİ; Erol, Mehmet Muharrem; MELEK, HÜSEYİN; Çolak, Mehmet Ali; Kermenli, Tayfun; GEBİTEKİN, CENGİZ; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Cerrahisi Anabilim Dalı.; 0000-0003-0684-0900; 0000-0002-7371-4026; 0000-0003-1822-8153; ABB-7580-2020; KHE-8874-2024; AAI-5039-2021; JIM-7704-2023; A-6612-2019; AAE-1069-2022Objective: Esophageal perforation (EP) is a critical and potentially life-threatening condition with considerable rates of morbidity and mortality. Despite many advances in thoracic surgery, the management of patients with EP is still controversial.Materials and Methods: We retrospectively reviewed 34 patients treated for EP, 62% male, mean age 53.9 years. Sixty-two percent of the EPs were iatrogenic. Spontaneous and traumatic EP rates were 26% and 6%, respectively. Three patients had EP in the cervical esophagus and 31 in the thoracic esophagus.Results: Mean time to initial treatment was 34.2 hours. Twenty patients comprised the early group <24 h) and 14 patients the late group (>24 h). Management of the EP included primary closure in 30 patients, non-surgical treatment in two, stent in one and resection in one. Mortality occurred in nine of the 34 patients (26%). Mortality was EP-related in four patients. Three of the nine patients that died were in the early group (p<0.05). Mean hospital stay was 13.4 days.Conclusion: EP remains a potentially fatal condition and requires early diagnosis and accurate treatment to prevent the morbidity and mortality.Item Video-assisted thoracoscopic laser ablation in the treatment of primary spontaneous pneumothorax(Bayçınar Medical Publ-Bayçınar Tıbbi Yayıncılık, 2014-07) Bayram, Ahmet Sami; Köprücüoğlu, Mustafa; Melek, Hüseyin; Erol, Mehmet Muharrem; Gebitekin, Cengiz; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Cerrahisi Anabilim Dalı.; 0000-0003-1822-8153; 0000-0003-0684-0900; JCE-0097-2023; AAI-5039-2021; ABB-7580-2020; AAE-1069-2022; 8347194000; 56365763600; 9639938400; 35605916500; 6602156436Background: This study aims to investigate the feasibility of the video-assisted thoracoscopic (VAT) laser ablation technique in the treatment of primary spontaneous pneumothorax (PSP). Methods: Between January 2006 and June 2012, 60 patients with complicated PSP were included. Patients were prospectively randomized into two groups including 30 patients in each. Video-assisted thoracoscopic blebectomy and/or bullectomy with staplers was performed for group 1, whereas VAT laser ablation was performed for group 2. Pleural abrasion using the Marlex mesh was performed in both groups. A single chest tube (28 F) per patient was inserted. The operating time, number of complications, duration of hospital stay, duration of tube thoracostomy, and PSP recurrence rate were compared between the groups. Results: The median stapler use was 1.6 (1-4) in group 1, and the median energy use was 2700 J (1800-3700 J) in group 2. The median operating time was 31 min (17-65 min) in group 1 and 34 min (15-59 min) in group 2. Delayed lung expansion occurred in only two patient (6%) in group 1 and 22 patients (75%) in group 2 (p <= 0.05). The mean hospital stay was 2.75 (2-4) days in group 1 and 3.7 (2-10) days in group 2 (p <= 0.05). The duration of chest tube use was 2.3 (1-7) days in group 1 and 7.9 (2-14) days in group 2 (p<0.001). There was two PSP recurrence (5%) in group 1 and one lung collapse following chest tube removal in group 2. Conclusion: Although delayed lung expansion due to thermal damage may develop, VAT laser ablation appears to be safe and effective with comparable results to those of VATS bullectomy.