Biomedical subjects
Publications and source records attributed to M Unlü.
The endobronchial lipoma is one of the rarest tumours of the tracheobronchial tree. They are histologically benign tumours. But, they can produce pulmonary damage or irreversible bronchiectasis if diagnosis and treatment are delayed. The treatment of choice in most cases is bronchoscopic removal. A case report of this rare tumour is presented with its clinical features, early clinical course, and treatment.
From June 1977 to January 1987, 175 patients underwent surgical treatment of childhood pleural empyema. The surgical treatment consisted of tube drainage in 159 (90%) cases, decortication in 31 (17%) cases, pleuropneumonectomy in 2, lobectomy in 1, and partial thoracoplasty in one cases. There were 2 hospital deaths (14 and 26 days after admission). Late recurrences didn't occur, except in one case where a partial thoracoplasty was necessary. During the follow-up of 11 to 120 months (mean 32 months) examinations were done by chest radiographs. We believe that, children with loculated empyema can be treated successfully with antibiotics and chest tube drainage in early stage. The tube drainage is a more effective method than the other surgical procedures. Few patients require open drainage, and further surgery is rarely required.
Mesothelioma which is the primary tumor of the pleura has recently been subject to many researches because of its poor prognosis and the difficulties met in radical therapy. Between 1974-1986 total 46 patients with pleural mesothelioma were treated surgically at our center. Finally it was concluded that only the cases in stage I and with epithelial malignant pleural mesothelioma should be subjected to radical surgery. The remaining patients should be treated with conservative methods.
Bronchogenic cysts are relatively rare anomalies with a congenital origin resulting in an abnormal branching of the tracheo-bronchial tree. They either develop in the pulmonary parenchyma or in the mediastinal region. Between 1975 and 1987, 21 cases of bronchogenic cysts were operated upon. Eighteen of these cysts had a pulmonary localisation and 3 were mediastinal. Only 8 of these were diagnosed pre-operatively by bronchoscopy. The major reason for delay in diagnosis is persistent or recurrent pulmonary infection. Eight cases were treated by cystectomy, 4 by simple wedge resection, 4 by segmental resection, 3 were extirpated and 2 by lobectomy.
The low-grade malignant potential of bronchial adenoma has been widely reported in the medical literature. During the past 12 years we have treated 29 patients with this disease, 18 (62%) of whom required conventional lobectomy or pneumonectomy, because most of our cases had come to our center after having inappropriate treatments in other centers and loosing time. In these cases we observed either a total obstruction of a bronchus or a destroyed parenchyma due to recurrent pulmonary infections. For this reason, the number of pulmonary resections is more important than conservative surgical procedures in our center. The other 11 cases (38%) were treated by bronchoplasty or more conservative resectional procedures. There was no recurrence and the survival rate was about 96 per cent at 5 years. We believe that, in our series, we would have mostly been able to perform conservative types of resections if we could have diagnosed the disease in its early stages.