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Öğe Bilateral thoracoscopic sympathectomy for primary hyperhydrosis: a review of 335 cases(CLINICS CARDIVE PUBL PTY LTD, 2013) Öncel, Murat; Sunam, Güven Sadi; Erdem, Eşref; Dereli, Yüksel; Tezcan, Bekir; Akyol, Kazım GürolObjective: The goal of this retrospective study was to evaluate the outcomes of bilateral video-assisted thoracoscopic sympathectomy for primary hyperhydrosis. Methods: Between January 2007 and December 2011, a total of 335 patients (192 male, 143 female, mean age 28.3 years) who underwent bilateral thoracoscopic sympathectomy for primary hyperhydrosis were reviewed retrospectively. Results: Hyperhydrosis occurred in the palmar and axillary region in 175 (52.23%) patients, in only the palmar region in 52 (15.52%), in the craniofacial region in 44 (13.13%), in only the axillary region in 42 (12.53%), and in the palmar and pedal regions in 22 (6.56%) patients. Bilateral thoracoscopic sympathectomy was performed in all patients. The mean follow-up period was 24 (6-48) months. The initial cure rate was 95% and the initial satisfaction rate was 93%. There was no mortality in this study. The complication rate was 15.82% in 53 patients. Conclusion: Video-assisted thoracoscopic sympathectomy for the treatment of primary hyperhydrosis was effective, with low rates of morbidity and mortality. Despite the appearance of postoperative complications, such as compensatory sweating, patient satisfaction with the procedure was high and their quality of life improved.Öğe Clinical experience of repair of pectus excavatum and carinatum deformities(CLINICS CARDIVE PUBL PTY LTD, 2013) Öncel, Murat; Tezcan, Bekir; Akyol, Kazım Gürol; Dereli, Yüksel; Sunam, Güven SadiBackground: 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.Öğe Parenchyma-preserving and minimally invasive thoracotomy technique in giant pulmonary hydatid cysts(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2015) Oncel, Murat; Sadi, Sunam Guven; Tezcan, Bekir; Sua, Sumer; Dongel, IsaBackground: This retrospective study aims to present our parenchyma-preserving and minimally invasive operation experiences on giant pulmonary hydatid cysts. Methods: Nineteen patients (13 males, 6 females; mean age 22 years) with giant hydatid cysts were operated. The outermost layer of the giant cyst, the adventitia, was excised up to the normal parenchyma, and the previously detected bronchial leaks were closed. The released adventitia were reciprocally sutured into the parenchyma. Results: Hydatid cysts were in the right hemithorax in 13 patients, in the left hemithorax in five patients, and bilateral in one patient. The safe bronchial closure prevented pulmonary volume loss without stretching the parenchyma. Operative complications were pleural effusion in one patient, atelectasis in two patients, wound infection in one patient, and pneumonia in three patients. The diameter of cysts, measured by computed tomography, was approximately 10 cm. The mean duration of hospitalization was 7.5 days. Conclusion: Current treatment of hydatid cysts should allow pulmonary expansion after complete surgical removal of the cyst. Thanks to parenchyma-preserving and minimally invasive thoracotomy technique, none of the operated patients required resection. Advantages of our technique include low rate of complications, and removal of the cyst using a single thoracic drain with minimally invasive thoracotomy without requiring capitonnage.Öğe Sigara bıraktırma polikliniğinden yardım isteyen hastaların 1 yılık takip sonuçları(2012) Tezcan, Bekir; Öncel, Murat; Sunam, Güven SadiAmaç: Bu çalışmada bir sigara bırakma polikliniğinin ilk verilerinin değerlendirilmesi amaçlanmıştır. Yöntem:; 2009-2010 yılları arasında Konya Numune hastanesinde sigara bıraktırma polikliniğine, sigarayı kendi kendine bıraktıktan sonra sigara içiciliğine yeniden başlamamak için yardım isteyen 8 kadın, 17 erkekten oluşan toplam 25 sigara içicisinin bir yıllık takip sonuçları retrospektif olarak değerlendirilmiştir. Bulgular: 25 olgunun ilk bir ay içerisinde yardım istediği belirlenmiştir. Sigara bırakımı akabinde bu olgularda sıklık sırasına göre aşırı sinirlilik, oral aft, kabızlık, kilo alma yakınmalarının ortay a çıktığı bildirilmiştir. Hiçbir olguya nikotin yerine koyma tedavisi verilmemiş ve 20 olguya serotonin geri alım inhibitörü başlanmıştır. Bir yıllık takip periyodunda olgulardan 9,u yeniden sigara içmeye başlarken, 16,sında sigara bırakmışlığın devamlılığı sağlanabilmiştir. Sonuç: Kendi kendine sigarayı bırakan kişilerin yeniden sigara içmemek için yardım istediğinde, erken dönemde kendilerine yapılan motivasyonel ve/veya farmakoterapi, sigara bırakmışlığın süregenliğinde büyük önem taşımaktadır.
