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January 2013

Original Article

Analysis of 54 Patients Who Underwent Thoracoscopic Sympathectomy

Sezai Çubuk, Orhan Yücel, Okan Karataş, Kuthan Kavaklı, Hasan Çaylak, Sedat Gürkök, Ersin Sapmaz, Hakan Işık, Alper Gözübüyük, Onur Genç

Gulhane Military Medical Academy, Thoracic Surgery Department, Ankara, Türkiye

DOI: 10.4328/AEMED.4


Aim: Thoracoscopic sympathectomy is performed with a high success rate and low morbidity for the treatment of primary hyperhidrosis. However the compensatory sweating remains the most commonly reported side effect. In this study, we aimed to present our experience with thorascopic sympathectomy in 54 patients who were operated from various levels of sympathetic trunk. Methods: Medical records of 61 patients who underwent thorascopic sympathectomy for primary hyperhidrosis were analysed retrospectively. Seven patients were excluded because of one sided operation. The variables such as age, sex, indications for surgery, level of resection, type of resection, number of ports, complications and hospitalisation time were recorded. We contacted with all patients except four via telephone. Results: A total of 54 patients were treated between January 2006 and December 2008. There were 44 male and 10 female. The median age was 24,3 years (17–37). All of the 54 patients with primary symptoms of palmar and axillary hyperhidrosis reported excellent satisfaction (100%). Compensatory sweating was reported in 6 (100%) of the T3-4-5 group, 16 (53%) of the T2-3 group, and 3 (21%) of the T2 group. The mean hospitalisation time was 2,7 days (2- 8). Compensatory sweating was significantly higher when we resected the sympathetic trunk longer. Conclusion: Thorascopic Sympathectomy is the cornerstone of treatment of primary hyperhidrosis with low morbidity and high satisfaction rate. However serial studies are needed that will evaluate the relationship between the compensatory sweating and resection level of sympathetic trunk.


Sympathectomy; Hyperhidrosis; Compensatory Hyperhidrosis

Corresponding Author: Sezai Çubuk, GMMA, Thoracic Surgery Department, Ankara, Türkiye. T.: +90 3123045184 F.: +90 3123045404
How to Cite: Sezai Cubuk, Orhan Yucel, Okan Karatas, Kuthan Kavakli, Hasan Caylak, Sedat Gurkok, Ersin Sapmaz, Hakan Isik, Alper Gozubuyuk, Onur Ersin Sapmaz, Hakan Isik, Alper Gozubuyuk, Onur Genc . Analysis of 54 Patients Who Underwent Thoracoscopic Sympathectomy. J Ann Eu Med 2013;1(1): 1-3

Surgery in Bronchogenic Cysts: Report of 33 Patients

Pinar Bicakcioglu1 , Erkmen Gulhan1 , Seray Hazer1 , Hakan Erturk2 , Leyla Acar1 , Funda Demirag3 , Gokturk Findik1 , Nurettin Karaoglanoglu1

1 Department of Thoracic Surgery, 2 Department of Radiology, 3 Department of Pathology, Ataturk Education and Research Hospital for Chest Diseases and Thoracic Surgery, Ankara, Turkey

DOI: 10.4328/AEMED.8


Aim: The aim of this study was to analyze bronchogenic cysts treated surgery. Material and Method: Histopathological results of the cases that were operated in our clinic between January 2003 and December 2012 were examined retrospectively and 33 cases with bronchogenic cyst were analyzed. All medical records were available for all patients with bronchogenic cyst and reviewed for age, sex, clinical presentations, diagnostic investigations, lesions features, operative procedures, duration of hospitalization, postoperative complications, and postoperative outcomes. Results: There were 17 female and 16 male patients with a mean age of 37.78 years (range, 6 to 64 years) at the time of diagnosis. Five of the patients were under 18 years of age. While 25 cases (75.7%) were symptomatic, only 8 cases (24.2%) were asymptomatic, and the lesions were detected on chest radiography taken for other nonrelated conditions. Symptoms were dyspnea in 12 patients, chest pain in 10, cough in 9, hemoptysis in 3, and sputum in1. Seven patients had more than one symptom. Twenty-two of the lesions were located in mediastinum and 11 of them were intrapulmonary. Posterolateral thoracotomy was performed in 30 cases and thoracoscopic surgery in 2 cases; 22 of them were right and the others were left. Mediastinoscopy was performed in one case. Total cystectomy was performed in 19 cases, and partial cyst excision with deepithelialization in 3 cases for patients with mediastinal cystic lesions. Nine patients with intrapulmonary cysts had wedge resection, 1 underwent segmentectomy, and 1 underwent lobectomy. The postoperative follow- up period ranged from 7 months to 10 years and the mean follow- up period was 4.1 years. No mortality or recurrences were seen in all the patients except one. The patient died in postoperative 24th day. Discussion: Bronchogenic cysts are rare foregut anomalies and are treated by surgical resection.


Bronchogenic Cyst; Lung; Mediastinum; Surgery

Corresponding Author: Pinar Bicakcioglu, Department of Thoracic Surgery, Ataturk Education and Research Hospital for Chest Diseases and Thoracic Surgery, Kecioren 06280 Ankara, Turkey. T.: +90 3123552110 F.: +90 3123552135 E-Mail: piyaren@gmail.com

How to Cite: Pinar Bicakcioglu, Erkmen Gulhan, Seray Hazer, Hakan Erturk, Leyla Acar, Funda Demirag, Gokturk Findik, Nurettin Karaoglanoglu Gokturk Findik, Nurettin Karaoglanoglu . Surgery in Bronchogenic Cysts: Report of 33 Patients. J Ann Eu Med 2013;1(1): 14-7

Intrathoracic Pleural Lipomas

Pınar Bıçakçıoğlu1 , Erkmen Gülhan1 , Ebru Sayılır1 , Leyla Acar1 , Funda Demirağ2 , Şeref Özkara3 , Sadi Kaya1

1 Department of Thoracic Surgery, 2 Department of Pathology, 3 Department of Chest Diseases, Ataturk Education and Research Hospital for Chest Diseases and Thoracic Surgery, Ankara, Turkey

DOI: 10.4328/AEMED.6


Aim: Lipomas are benign tumors composed of adipose tissue. They are usually located in the subcutaneous region, particularly in the upper back, neck, and shoulder. However, they rarely seen in the intrathoracic cavity. The objective of this study is to analyze intrathoracic pleural lipomas. Material and Method: We analyzed a retrospective review of the clinicopathological records of 8 patients who had undergone surgical resection for intrathoracic lipomas between 1990 and 2012. The clinical records of all patient was examined with regard to age, sex, body mass index, presenting symptoms, lesion locations and sizes, diagnostic methods, operative procedures, histopathological features, and prognosis. Results: There were 5 men and 3 female with a mean age 60,1 (range, 29-75 years). Symptoms noticed were chest pain in three, dyspnea in one, neck swelling in one. Four patients had no symptoms, and lesions were found incidentally on chest radiography. Radiographically, the tumors showed well-defined, homogenous, and fatty density lesions. Tumor excision was carried out, 4 right sided and 4 left; video-assisted thoracoscopy in one case, thoracotomy in 7 cases. All lesions were intrathoracic lipomas sourced from parietal pleura. The size of the lesions ranged between 3-12cm, the average was 7.6 cm. Complete resection was achieved in all patients except one. There were no recurrences in postoperative followup of patients and mean follow-up was 7.4 years. Discussion: Intrathoracic lipomas are rare benign lesions. Our series is the largest in the literature. Because lipomas cannot be differentiated from malignant lesions, and they have invasive growth capability, surgery should be performed for the purpose of diagnosis and treatment.


Lipoma; Intrathoracic; Surgery; Video-Assisted Thoracoscopic Surgery

Corresponding Author: Pinar Bicakcioglu, Department of Thoracic Surgery, Ataturk Education and Research Hospital for Chest Diseases and Thoracic Surgery, Kecioren 06280 Ankara, Turkey. T.: +90 3123552110 F.: +90 3123552135 E-Mail: piyaren@gmail.com

How to Cite: Pinar Bicakcioglu, Erkmen Gulhan, Ebru Sayilir, Leyla Acar, Funda Demirag, Seref Ozkara, Sadi Kaya Sadi Kaya . Intrathoracic Pleural Lipomas. J Ann Eu Med 2013;1(1): 10-3

Intraluminal Cervical Esophageal Perforations in Rats (Experimental Study)

Sezai Çubuk1 , Orhan Yücel1 , Alper Gözübüyük1 , Hasan Çaylak1 , Armağan Günal2 , Elmir Memmedov1 , Özlem Öztürk3 , Sedat Gürkök1

1GATA Göğüs Cerrahisi AD., 2GATA Patoloji AD., 3GATA Tıbbi Biyokimya AD., Ankara, Türkiye

DOI: 10.4328/AEMED.5


Aim: Esophageal perforation has high morbidity and mortality rate. Morbidity and mortality rates have been decreased slightly by the progress in surgical technics and intensive care conditions. We here aimed to search the effect of both (a) cervical esophageal perforation from anterior and lateral locations and (b) safe time interval for repair on mortality and morbidity. Material and Method: In our study,we have used 40 rats. The rats were first grouped into anterior and lateral perforation groups, afterwards these two groups were divided into two subgroups as early (12 h) and late (24 h) repair groups. Perforation was made with 22 gauge angiocath and repaired in early or late time periods. Before the perforation and treatment, blood samples were collected from tail vein in order to measure leucocyte levels. Blood sampled before the perforation and while sacrifying the rats-by cardiak puncture- were used to measure IL-10 levels. Contamination status were analysed and radiological studies were made. Histopathologic examination of the esophageus was made after the sacrification. In order to evaluate the rupture status in treated rats, contrast esophagograms were studied before the sacrification. Results: The groups were evaluated according to the perforation localisation, time interval for treatment, white blood cell values revealing the infection, contamination status, IL-10 and fibrosis. We have found significant difference in white blood cell count and contamination between the rats that were perforated anteriorly, repaired early and perforated laterally, repaired in late time period. Also we have found significant difference in contamination between anterior perforation early repair group and lateral perforation early and late repair group. No statistical differences was found within the groups for IL-10, fibrosis, location of the perforation and the time of the treatment. Discussion: As a result, we think that our findings show us anterior perforation of the cervical esophageus is better tolarated and has a wider safe time interval for treatment.


Esophageus; Perforation; Trauma; IL-10

How to Cite: Sezai Cubuk, Orhan Yucel, Alper Gozubuyuk, Hasan Caylak, Armagan Gunal, Elmir Memmedov, Ozlem Ozturk, Sedat Gurkok Ozlem Ozturk, Sedat Gurkok. Intraluminal Cervical Esophageal Perforations in Rats (Experimental Study). J Ann Eu Med 2013;1(1): 4-9

Case Report

Pulmonary Embolism Treated with Low-Molecular-Weight Heparin After Pneumonectomy; Case Report

Ali Çelik1 , İlknur Aytekin1 , Mustafa Demiröz1 , Muhammet Sayan1 , Seyda Andac2 , İsmail Cüneyt Kurul1
1 Department of Thoracic Surgery, 2 Department of Radiology, Gazi University Medical Shool, Ankara, Turkey
DOI: 10.4328/AEMED.3
Pulmonary embolism after pneumonectomy is a well-recognised complication but it can be fatal. In this report we present a case of a 59-year-old male patient who admitted to our clinic with suddenly occured dyspnea and chest pain after right pneumonectomy for lung cancer on 20th day of discharge. Computed tomography pulmonary angiography (CTPA) showed massive pulmonary embolism in the distal part of the left main pulmonary artery and partial-total filling defects in the upper and lower lobe segmenter-subsegmenter arteries. After diagnosis, we started to low molecular weight heparin (LMWH) for treatment twice a day. On sixth day of treatment patient was discharged with uneventful recovery.
Pulmonary Embolism; Pneumonectomy; Anticoagulant Treatment
Corresponding Author: Ali Celik, Gazi University School of Medicine, Department of Thoracic Surgery, Besevler, 06500, Ankara, Turkey. GSM: +905304045467 P.: +90 3122025891 E-Mail: alicelik78@gmail.com
How to Cite: Ali Celik, Ilknur Aytekin, Sevki Mustafa Demiroz, Seyda Andac, Ismail Kurul . Pulmonary Embolism Treated with Low-Molecular-Weight Heparin After Pneumonectomy; Case Report. J Ann Eu Med 2013;1(1): 21-3

Congenital Arteriovenous Malformation Located in the Posterior Mediastinum

Ali Celik1 , İlknur Aytekin1 , Sevki Mustafa Demiröz1 , Özgür Ekinci2 , Ismail Cüneyt1
1 Department of Thoracic Surgery, 2 Department of Pathology, Gazi University Medical Shool, Ankara, Turkey
DOI: 10.4328/AEMED.2
Congenital arteriovenous malformations are not real tumor bodies and usually do not have endothelial proliferation. They arise from abnormal development of vasculary structures and cause aberrant capillary network connections between arteries and veins. While the most usual sites of location for these pathologies are lower extremities and the neck, mediastinal location is very rare. A posterior mediastinum located lesion was found in the 50 years old patient examined due to back pain. Total excision performed and the pathologic examination revealed an arteriovenous malformation. In this article, we reviewed the clinical features and treatment approaches of the mediastinum located arteriovenous malformations in light of the literature.
Arteriovenous Malformation; Posterior Mediastinum; Surgery
Corresponding Author: Ali Celik, Gazi University School of Medicine, Department of Thoracic Surgery, Besevler, 06500, Ankara, Turkey. GSM: +905304045467 P.: +903122025891 E-Mail: alicelik78@gmail.com
How to CiteAli Celik, Ilknur Aytekin, Sevki Mustafa Demiroz, Muhammet Sayan, Ozgur Ekinci, Ismail Cuneyt Kurul . Congenital Arteriovenous Malformation Located in the Posterior Mediastinum. J Ann Eu Med 2013;1(1): 18-20


The Best Article of the Year

Zeki İlker Kunak1 , Orhan Yücel2

1 Department of Medical CBRN Defense, 2 Department of Thoracic Surgery, Gulhane Military Medical Academy, Ankara, Turkey

DOI: 10.4328/AEMED.7

Derman medical publishing annually rewards the original and scientific articles printed in the “Journal of Clinical and Analytical Medicine (JCAM)” and “The Annals of Eurasian Medicine (AEMED)”, which are owned by the company, as “The Best Article of The Year”. In 2013, 1445 articles have been submitted with the intention of being printed. Accepted articles have been published online averagely in ten days and by wet print in a year. In article evaluation procedure due to our restricted resources, many of them had to be rejected unintentionally. In this period we have been elated by the scientists’ indulgence despite whatever the editorial board decides. It was a hard work to choose the nominees of the best article beyond the others. Since we had to put forward some of them in any way, we spent lots of time by thinking how we could manage this. Our endeavors yielded and we found a way about how we could succeed this election. Articles to be rewarded were elected by the proposal of the editorial boards of both JCAM and AEMED and the approval of the editor. The rewarded articles have been broadcasted via online and e-mails to the readers. The purpose of these rewards is to share with you at least some of the articles that have been published in our journal, cited internationally and pulled the attentions of the readers intensely. Till today, the articles proposed by the JCAM editorial board beyond the published articles in Journal of Clinical and Analytical Medicine have been rewarded as the “Best Article of the Year” and all our authors regarded this application. We mean to prolong this tradition in years to come (Table 1). The articles deserved to have the “Best Article of the Year” award in Journal of Clinical and Analytical Medicine between 2010 and 2012.


1. Ahmet Tüzün, Bülent Değertekin, Zeki Yeşilova, İlkin Naharcı, Ayşe Eken, Ahmet Aydın, Ahmet Uygun, Ahmet Sayal. Plasma MDA Levels, GSH-Px Activities and Nitrite/Nitrate Levels in Patients with Familial Mediterranean Fever. J.Clin.Anal.Med. 2010;1(1):1-5 2. Hans K. Pilegaard. Thoracoscopic Sympathectomy. J.Clin.Anal.Med. 2010;1(3):65 -67 3. Richard W Light. Management of Parapneumonic Effusions. J.Clin.Anal.Med. 2010;1(2).48-51 4. Zeki İlker Kunak, Emin Özgür Akgül, Hakan Yaren, Tuncer Cayci, Yasemin Gülcan Kurt , Ibrahim Aydin, Halil Yaman, Levent Kenar, Tuna Subaşı, Erdinç Çakır, Enis Macit, Ayhan Sıtkı Demir, Mehmet Kemal Erbil, Jana Zdarova Karasova. Measurement of TS-131, a New Monopyridinium Oxime, by High Performance Liquid Chromatography in Rat Plasma Samples. J Clin Anal Med 2011;2(2):19-21 5. Frank Martin Haecker. The vacuum bell for treatment of pectus excavatum:an effective tool for conserative therapy. J Clin Anal Med 2011;2(1):1-4 6. Berkant Özpolat, Tarık Çavuşoğlu, Seyhan Yılmaz, Ünase Büyükkoçak, Serdar Günaydın. Clinical and Laboratory Evaluation of Anti-Microbial Efficacy of Photocatalysts. J Clin Anal Med 2011;2(2):32- 5 7. Dogan Atılgan, Adem Yaşar, Fikret Erdemir, Bekir Suha Parlaktas, Nihat Uluocak, Fatih Fırat. Comparison the Efficacy of Four Different Alpha Blockers in the Treatment of Benign Prostatic Hyperplasia. J Clin Anal Med 2011;2(2):27-31 8. İbrahim Tekeoğlu, Özcan Hız, Bülent Özbay, Murat Toprak, Serhat Avcu. Pulmonary Involvement in Rheumatic Diseases: HRCT Findings. J Clin Anal Med 2011;2(2):36-9 9. Rasih Yazkan, İbrahim Ethem Özsoy, Gökhan Ergene, Mehmet Avcılar. Single Stage Transthoracic Approach to the Right Lung and Liver Dome Hydatid Cysts. J Clin Anal Med 2011;2(3):7-10 10. Celalettin Sever, Yalçın Külahçı, Haluk Duman. Prediction of Mortality and Causes of Death in a Burn Centre: A Retrospective Clinical Study. J Clin Anal Med 2011;2(3):24-6 11. Serkan Bilgiç, Tolga Ege, Ömer Ersen, Kenan Koca, Erbil Oguz, Ali Şehirlioğlu. Posterior Fixation of Lumbar Burst Fractures. Comparison of Short Segment and Long Segment Pedicle Fixation. J Clin Anal Med 2011;2(2):15-8 12. Murat Ayan, Erkan Sogut, Ufuk Taş, Fikret Erdemir, Serkan Karaman, Semih Arıcı, Mehmet Esen. Compare the Analgesic Effectiveness of Diclofenac and Paracetamol in Patients with Renal Colic. J Clin Anal Med 2013;4(1): 16-8 13. Yekta Altemur Karamustafaoğlu, Fazlı Yanık, Yener Yörük. Intrathoracic Desmoplastic Fibroblastoma: A Rare Localization. J Clin Anal Med 2013;4(1): 56-7 14. Abdullah İrfan Tastepe, Ülkü Yazıcı, Pınar Yaran Bicakcioğlu, S.S. Erkmen Gülhan, Yetkin Ağackiran. Simultaneous Pulmonary and Transdiaphragmatic Surrenal Resection in Non-small Celled Lung Cancer. J Clin Anal Med 2013;4(2): 140-2 15. Zekeriya Arslan, Gökhan Arslan, Adem Güler. The Interaction of Clopidogrel and Proton Pump Inhibitors. J Clin Anal Med 2013;4(2): 158-60 16. Abdullah Çetin Tanrıkulu, Abdurrahaman Abakay, Özlem Abakay, cengizhan Sezgi, Hadice Selimoğlu Şen, Ömer Faruk Önder, Abdurrahaman Şenyiğit.Clinical Characteristics of Patients with Mesothelioma: A University Hospital of 2011 Data. J Clin Anal Med 2013;4(3): 186-8 17. Hasan Soydan, Ercan Malkoç, Furkan Dursun, Sezgin Okçelik, Ferhat Ates, Cüneyt Adayener, Kadir Vehbi Baykal. Radical Prostatectomy and Active Surveillance in Prostate Cancer; The Evaluation of Erectile Function and Depression. J Clin Anal Med 2013;4(3): 189-92 18. Ahmet Baris Durukan, Hasan Alper Gurbuz, Nevriye Salman, Elif Durukan, Fatih Tanzer Serter, Murat Tavlasoglu, Halil Ibrahim Ucar, Cem Yorgancioglu. Evaluation of HbA1c Levels and Postoperative Atrial Fibrillation in Diabetic Patients. Clin Anal Med 2013;4(3): 204-8 19. Yeşim Hoşcan, Halil Olcay Eldem, Haldun Müderrisoğlu. Use of Ivabradine in a Patient Having Pacemaker and Inappropriate Sinus Tachycardia. J Clin Anal Med 2013;4(3): 228-9 20. Levent Sarıyıldız, Turan Akdağ. A New Predictor AMH (anti-müllerian hormone) to Determining Ovarian Reserve and Menoposual Aging in the Women. J Clin Anal Med 2013;4(3): 241-4 21. Mehtap Özdemir, Nurten Bakan, Ömer Torun Şahin, Nevin Kurtçelebi, Zeynel Abidin Erbesler, Savaş Taner Tunca. The Comparison of Sevoflurane-Remifentanyl and Propofol-Remifentanyl in Robotic Prostatectomies. J Clin Anal Med 2013;4(4): 313-7

Corresponding Author: Orhan Yücel; Gulhane Military Medical Academy, Department of Thoracic Surgery, Ankara, Turkey. GSM: +905303042583 E-Mail: orhanycl@gmail.com

How to Cite: Zeki Ilker Kunak, Orhan Yucel . The Best Article of the Year. J Ann Eu Med 2013;1(1): 24-5