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BOSTANCI, KORKUT

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BOSTANCI

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    PublicationOpen Access
    No Adverse Outcomes of Video-Assisted Thoracoscopic Surgery Resection of cT2 Non-Small Cell Lung Cancer during the Learning Curve Period
    (2017-08-05) YILDIZELİ, BEDRETTİN; Bilgi, Zeynep; Batırel, Hasan Fevzi; Yıldızeli, Bedrettin; Bostancı, Korkut; Laçin, Tunç; Yüksel, Mustafa
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    PublicationOpen Access
    Postoperative psychiatric disorders in general thoracic surgery: incidence, risk factors and outcomes
    (OXFORD UNIV PRESS INC, 2010-05) YILDIZELİ, BEDRETTİN; Ozyurtkan, Mehmet Oguzhan; Yildizeli, Bedrettin; Kuscu, Kemal; Bekiroglu, Nural; Bostanci, Korkut; Batirel, Hasan Fevzi; Yuksel, Mustafa
    Objective: Postoperative psychiatric disorders (PPDs) may complicate the post-surgical outcome. We analysed the types, incidences, risk factors and outcomes of the PPDs in non-cardiac thoracic surgery patients. Methods: All patients (n = 100) undergoing major non-cardiac thoracic surgery from January 2004 to March 2005 were investigated prospectively. The diagnosis of PPD was made based on the Diagnosis and Statistical Manual of Mental Disorders. The patients were grouped into two according to the presence (group I) or absence (group II) of PPD. Data on pre-, per- and postoperative factors, and the adverse outcomes were analysed. Results: Eighteen patients (18%) developed PPD, including delirium in 44%, adjustment disorders in 22%, panic attack in 17%, minor depression in 11% and psychosis in 6%. The patients who developed PPD were older (58 +/- 17 vs 50 +/- 15 years, p = 0.05), had a longer operation time (6 +/- 1 vs 5 +/- 2 h, p = 0.015) and hospital stay (13 +/- 9 vs 8 +/- 5 days, p = 0.019). The morbidity and mortality rates were not significantly different between the groups (67% vs 46%; 11% vs 1%, respectively). The causative factors in the development of PPD were older age, longer operation time, abnormal serum chemistry values of sodium, potassium, calcium and glucose, hypoalbuminaemia, the presence of the postoperative respiratory distress and infection and blood transfusion (p < 0.05). Conclusions: PPDs are associated with adverse outcomes including a longer hospital stay, and increased morbidity and mortality rates. The identification, detection and elimination of these risk factors are recommended. (C) 2009 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.
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    PublicationOpen Access
    Endobronchial ultrasound-guided cryobiopsies in peripheral pulmonary Lesions: a feasibility study
    (EUROPEAN RESPIRATORY SOC JOURNALS LTD, 2014-01-01) BOSTANCI, KORKUT; Schuhmann, Maren; Bostanci, Korkut; Bugalho, Antonio; Warth, Arne; Schnabel, Philipp A.; Herth, Felix J. F.; Eberhardt, Ralf
    Peripheral lung lesions are sometimes difficult to reach even with endobronchial ultrasound (EBUS) and insufficient material is often obtained by transbronchial forceps biopsy. Cryoprobes can be used for performing tissue biopsies. We evaluated the safety and feasibility of the cryoprobe in combination with EBUS for the diagnosis of peripheral lung lesion. Patients with peripheral lung lesions of up to 4 cm were enrolled. After identifying the lung lesion by radial EBUS, forceps biopsies and cryobiopsies were performed in a randomised order. We evaluated safety and feasibility,, and compared diagnostic yield and sample size. 39 patients were randomised and the peripheral lung lesion was reached in 31. The overall diagnostic yield was 60.5% and, in the lesions reached by EBUS, it was 74.2%. In 19 cases, the diagnosis was made with forceps as well as cryobiopsy and, in four cases, only with cryobiopsy. Cryobiopsies were significantly larger than forceps biopsies (11.17 mm(2) versus 4.69 mm(2), p<0.001). We observed one case of moderate bleeding. Transbronchial cryobiopsy with EBUS guidance is safe and useful to obtain histological samples. Larger tissue samples can be obtained by cryoprobe.
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    PublicationOpen Access
    Fissureless fissure-last video-assisted thoracoscopic lobectomy for all lung lobes: a better alternative to decrease the incidence of prolonged air leak?
    (2016-07) BOSTANCI, KORKUT; Stamenovic, Davor; Bostanci, Korkut; Messerschmidt, Antje; Jahn, Tillmann; Schneider, Thomas
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    PublicationOpen Access
    Minimally invasive repair of pectus carinatum using a newly designed bar and stabilizer: a single-institution experience
    (ELSEVIER SCIENCE BV, 2011-01-11) BOSTANCI, KORKUT; Yueksel, Mustafa; Bostanci, Korkut; Evman, Serdar
    Objective: A modified technique of the Nuss procedure for the minimally invasive repair of pectus carinatum was defined by Abramson, and it has been gaining support for the last few years. We have been performing the Abramson procedure in our institutions since 2006. This article describes our recent experience with a novel instrument for pectus carinatum correction. Methods: In 2008, we developed a new pectus bar and stabilizing system for this procedure and started using it on our pectus carinatum patients. Between July 2008 and December 2009, 18 patients were operated on with these newly designed implants. Results: Excellent esthetic results obtained regarding the postoperative course, verified with the patients' and parent's answers on a satisfaction questionnaire; all patients except one (94.4%) feeling satisfied with the operation. Two of the bars have been removed during the 18-month follow-up. Three fixating steel wire breakages requiring re-fixing of the stabilizers and two local skin adhesions over the bar were seen as postoperative complications. Conclusion: This article describes a novel instrument and surgical technique that is safely and easily used in minimally invasive correction of pectus carinatum deformities, with minimal complications and high satisfaction rates. (C) 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.
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    PublicationOpen Access
    Comparison of postoperative pain and pain control techniques in uniportal and biportal VATS and open surgery patients
    (MARMARA UNIV, FAC MEDICINE, 2021-10-29) YILDIZELİ, BEDRETTİN; Cetinkaya, Cagatay; Bilgi, Zeynep; Lacin, Tunc; Bostanci, Korkut; Yildizeli, Bedrettin; Yuksel, Mustafa; Batirel, Hasan Fevzi
    Objectives: Thoracotomy causes intense postoperative pain which may become chronic. Video-assisted thoracic surgery (VATS) leads to less postoperative pain compared with thoracotomy. In this study, we analyzed pain scores in patients who underwent lung resections with VATS or thoracotomy. Patients and Methods: Patients who underwent lung resections with uniportal, biportal VATS or thoracotomy between May 2015 - May 2017 were included in the study. Visual Analogue Scale (VAS) pain scores were recorded on postoperative day 1, 5 (or at discharge), 2nd week, 1st and 3rd months. Patients were classified in 3 groups, uniportal VATS (n=178), biportal VATS (n=15), thoracotomy (n=60). Demographics, resection type, mortality, morbidity and epidural catheter use were recorded. Results: Two hundred and fifty-three patients (average age was 57.3 +/- 12.7, 94 females) were included in the study. Median hospital stay was 5 days. Uniportal and biportal groups had significantly lower pain scores in all intervals compared with thoracotomy. No chronic pain was seen in VATS groups. Uniportal and biportal groups had similar pain scores at all times. Epidural use or size of specimen did not affect pain in VATS patients (p=0.18 vs p=0.68). Conclusion: Video-assisted thoracic surgery decreases the need for epidural patient control analgesia. Specimen size does not affect postoperative pain and chronic pain is rare.
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    PublicationOpen Access
    Do Nuss bars compromise the blood flow of the internal mammary arteries?
    (OXFORD UNIV PRESS, 2013-09) YILDIZELİ, BEDRETTİN; Yuksel, Mustafa; Ozalper, Mehmet Hakan; Bostanci, Korkut; Ermerak, Nezih Onur; Cimsit, Cagatay; Tasali, Nuri; Yildizeli, Bedrettin; Batirel, Hasan Fevzi
    OBJECTIVES: Minimally invasive repair of pectus excavatum, the so-called Nuss procedure, has become a popular technique in recent years. The internal mammary arteries (IMAs) lie on the posterolateral surface of the sternum, and the Nuss bar is likely to obstruct the blood flow in these arteries. This obstruction could become important in the later stages of the lives of these young people if they were to require coronary artery bypass grafting. The goal of this study is to investigate the extent of obstruction of the IMAs caused by Nuss bars. METHODS: Data were collected prospectively on all patients who underwent the Nuss procedure between October 2011 and May 2012. Patients with a history of pectus excavatum repair by open surgery and those who were younger than 16 years of age were excluded. Computed tomography-angiography (CTA) was performed for the detection of IMA blood flow preoperatively and on the 10th postoperative day. Blood flow in the IMAs was evaluated blindly by two radiologists and classified as blood flow unaffected (group I) or affected (group II) by comparing the assessment of preoperative and postoperative CTAs. The patients in group II were also categorized as having blood flow obstructed bilaterally, blood flow obstructed unilaterally and others (diminished unilaterally/diminished on one side or obstructed on the other side). RESULTS: Thirty-four patients (31 male and three female; mean age 20.7 +/- 4.2 years) underwent surgery. Blood flow was affected in 15 patients (44%), with bilateral obstruction in five, unilateral obstruction in seven, and unilateral diminished flow in two patients. In one patient, blood flow was diminished on one side and obstructed on the other. There was no significant difference between unaffected group I patients and affected group II patients in terms of sex, age, type of deformity, Haller index and the number of bars placed. CONCLUSIONS: Nuss bars cause pressure on the IMAs, but a risk factor for this effect could not be identified. This is a relatively common clinical consequence of minimally invasive repair of pectus excavatum, and the long-term effects will be apparent following bar removal.
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    PublicationOpen Access
    Ebus: hasta başı değerlendi̇rmeni̇n önemi̇
    (2018-03-06) BOZKURTLAR, EMİNE; OLGUN YILDIZELİ, ŞEHNAZ; KOCAKAYA, DERYA; BOSTANCI, KORKUT; AHISKALI, ASİYE RENGİN; BOZKURTLAR E., ERÇETİN Y., OLGUN YILDIZELİ Ş., KOCAKAYA D., BOSTANCI K., AHISKALI A. R.
    Amaç: Endobronşial ultrasonografi (EBUS) aracılı biyopsi tüm dünyada yaygın olarak kullanılan ve hastaların morbidite sebebi olabilecek mediastinoskopi gibi işlemlerden kaçınmasını sağlayabilen kabul görmüş bir yöntemdir. Yapılan çalışmalarla duyarlılığı ve özgüllüğü kanıtlanmış bu yöntemin yakın zamanda merkezimizdeki uygulamalarda ortaya koyduğu sonuçları ve bunların klinikopatolojik yansımasını göstermeyi amaçlıyoruz. Gereç ve Yöntem: Mayıs 2016-Temmuz 2017 tarihleri arasında Marmara Üniversitesi Pendik Eğitim ve Araştırma Hastanesi Patoloji Laboratuvarın’da değerlendirilen EBUS aracılı biyopsiler çalışmamıza alınmıştır. Olgulara ait klinik bilgiler retrospektif olarak merkezimiz sistemi üzerinden ve patolog eşliğinde işlem yapılan olgularda olgu patoloji formu üzerine patolog tarafından alınan notlardan elde edilmiştir. Bulgular: Toplam 61 olgunun değerlendirildiği çalışmamızda, 3 olguya 2 defa EBUS aracılı biyopsi uygulandığı görülmüştür. Bu olguların yalnız 5’inde hasta başı değerlendirme yapılmamıştır. Olgularda ortalama yaş 58, kadın/erkek oranı 20/41’dir. Olguların ön tanılarında sırasıyla malignite (%70, n=42), sarkoidoz (%30, n=18), enfeksiyon (tüberküloz dahil)(%16, n=10), lenfoma (%3, n=2) ve son olarak moleküler inceleme için yeni tümör dokusu (%2, n=1) yer almaktadır. Elli beş (%90) olguda mediastinal lenf noduna girilmiş, 4 (%7) olguda akciğerdeki kitleye, 2 (%3) mediastendeki kitleye ve 1 (%2) olguda hiler lenf noduna girilmiştir. Olgu başına yapılan ortalama girişim sayısı 4’tür. Dokuz olguda yetersiz sitolojik materyal değerlendirmesi yapılmıştır. Bu olguların 2’sinde hasta başı değerlendirme yapılamamış, 3 olguda 1’er girişim sonrası hasta uyumsuzluğu veya lezyon/lezyonların uygunsuzluğu nedeniyle işlem sonlandırılmak zorunda kalınmış, 4 olguda hasta başı değerlendirmede yetersiz ya da sınırlı sayıda hücre içeren materyal olduğu bildirilmiş kalıcı patolojik incelemede olgulara ait tüm materyal incelendiğinde tanı için yeterli materyalin olmadığı görülmüştür. Olguların kalıcı patoloji incelemesi/ hasta başı değerlendirme uyumuna bakacak olursak malignite pozitif olgularda %100 uyum (18/18) saptanırken, yetersiz olguları göz ardı edersek, malignite negatif olgularda da uyum %100 olarak saptanmaktadır. Granülom olarak raporlanan olgularda uyum %70 (10/7) olarak saptanmıştır. Malignite pozitif olgularımızdan 5’inde klinik istek üzerine hücre bloklarından moleküler inceleme yapılmış, bir olgudaki EGFR mutasyonu incelemesi açısından yetersizlik dışında, EGFR-ALK-ROS1 moleküler incelemelerinin tamamından sonuç alınabilmiştir. Sonuç EBUS aracılı biyopsi uygulamalarında klinik ön tanılarda sıkça yer alan malignite ve granülomatöz patolojiler çalışmamızda özellikle ele alınmıştır. Malignite pozitif olgularda hasta başı değerlendirme ve kalıcı patoloji incelemeleri uyumu %100 olarak saptanmıştır. Bu durum başta yeni tanı alan olgular olmak üzere klinik yönlendirmede hızlı ve doğru adımlar atılmasını sağlamaktadır. Ayrıca hasta başı değerlendirmenin “yetersiz” patoloji raporlarının sayısını azaltacağını düşündürmektedir. Aynı değerlendirme granülomatöz patolojiler açısından yapıldığında %70 olarak bulunmuştur. Bunun sebebinin büyük oranda işlem sırasındaki patoloji incelemesinde olguya ait tüm yayma lamlarının ve hücre bloğunun incelenememesinden kaynaklandığı görülmüştür.
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    PublicationOpen Access
    Quality of life of patients who have undergone the minimally invasive repair of pectus carinatum
    (OXFORD UNIV PRESS INC, 2013-01) BOSTANCI, KORKUT; Bostanci, Korkut; Ozalper, Mehmet Hakan; Eldem, Barkin; Ozyurtkan, Mehmet Oguzhan; Issaka, Adamu; Ermerak, Nezih Onur; Yuksel, Mustafa
    Several studies previously demonstrated an improvement in the quality of life (QoL) of the patients undergoing a minimally invasive repair of pectus excavatum, but there are no data about such improvement following the minimally invasive repair of pectus carinatum (PC) deformity. The purpose of this study was to investigate the effects of the minimally invasive repair of PC deformity on the psychosocial and physical functioning of the patients. Among 40 patients who underwent minimally invasive repair for PC deformity from July 2008 to March 2011, 35 patients accepted to answer the QoL questionnaires, and 30 of them who had completed the postoperative 6th month were evaluated in this study. The modified two-step Nuss questionnaire was used for the QoL assessment. All patients and their parents completed the appropriate questionnaires regarding the patients' preoperative psychosocial and physical functioning, and they were asked to answer the same questions on the postoperative 6th month. The results from these questionnaires were analysed using Wilcoxon signed rank test to investigate the effects of the minimally invasive repair of PC deformity on psychosocial and physical functioning of the patients. The questionnaires used in the study confirmed the positive impact of the surgical correction on psychosocial and physical well-being in the patients and their parents. Spearman's rho correlation coefficient determined how well the answers to the same question at two different times correlated with each other, and Cronbach's alpha demonstrated the internal consistency of these answers. These two parameters showed that the statistical results of the study were reliable enough. Statistical analysis of the scoring of the individual questions and the total scoring of individual patients revealed a statistically significant improvement (P < 0.05) following surgery. Similar significant improvements were observed in the total scoring of individual parents and in most scoring of the individual questions (10 of 13, 77%) in the parental questionnaire (P < 0.05). The results of this study confirm for the first time that minimally invasive repair of PC deformity has a positive impact on both psychosocial and physical functioning of the patient, which is supported by parental assessment.
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    PublicationOpen Access
    Validity and Reliability of the Turkish Version of the Nuss Questionnaire Modified for Adults
    (2015-04-05) BAHADIR, ALİYE TUĞBA; Bahadir, A. Tugba; Kuru, Pinar; Afacan, Ceyda; Ermerak, Nezih Onur; Bostanci, Korkut; Yuksel, Mustafa