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Y Akçali

Publications and source records attributed to Y Akçali.

4 recordsLinked to original sources

Surgical treatment of vasculo-Behçet's disease. A review of patients with concomitant multiple aneurysms and venous lesions.

BACKGROUND: Vascular complications can be seen in patients with Behçet's disease. Arterial and venous complications may be found separately or concomitantly in patients. PATIENTS AND METHODS: Out of 29 patients with vasculo-Behçet's disease 7 patients with multiple aneurysms and venous lesions were documented over a period of 20 years. All patients were male, ranging in age from 24 to 52 years. The mean duration of the disease was 6 +/- 2 years. The aneurysms were found in the following locations: one pulmonary artery, two abdominal aorta, four iliac, five femoral, and two popliteal artery. Both aneurysmal and occlusive lesions were present in three patients. In the venous lesions associated with the aneurysms there were three deep and three superficial venous thrombosis. Two patients had caval involvement-superior and inferior vena caval syndromes. RESULTS: We performed seven interposition grafting by polytetrafloroethylene, one Y-grafting, one aneurysmorrhaphy, one lobectomy. Re-anastomosis was performed in two patients who had anastomotic aneurysms and graft occlusion without disabling ischemia. Venous pathologies were treated by medical therapy. The patients were followed up between 1 to 8 years. One of the patients with iliac artery aneurysm died due to gastrointestinal bleeding 15 months after the operation. CONCLUSIONS: In conclusion, when an aneurysm has been found in a patient with Behçet's disease, the patient should be scanned for possible multiple aneurysms and venous lesions since they might be found together. Surgical treatment, when feasible, should be performed in cases with Behçet aneurysms because of a high risk of rupture. However, the possibility of an anastomotic aneurysm developing after surgery should also be kept in mind.

Adult↗

Chest wall deformities.

BACKGROUND: Pectus deformities and atypical costal anomalies are congenital thoracic wall defects that can cause a marked cosmetic defect with attendant psychological trauma and limited physical performance. PATIENTS AND METHODS: We reviewed 43 patients with chest wall deformities, 24 (55.8%) were pectus excavatum, 13 (30.2%) pectus carinatum and 6 (14%) atypical costal anomalies, in the last sixteen years. There were nine female and 34 (79.1%) male patients. The mean age of the patients was 14.4 years (range, 5 to 23). Scoliosis (13.5%), Poland's syndrome (5.4%), Marfan's syndrome (5.4%), neurofibromatosis (2.7%), atrial septal defect (2.7%) and mitral valve prolapse (13.5%) were associated with pectus deformities. The modified Ravitch's technique was used in pectus cases. Concomitant surgery was performed in two patients with pectus carinatum. RESULTS: The complications of pectus deformity repair were pneumothorax (24.3%), wound infection (8.1%), and local tissue necrosis (2.7%). There was no major recurrence, while minor recurrence rate was 10.8%. There was no mortality. CONCLUSION: Timely surgical procedures for the treatment of pectus deformities result in an excellent cosmetic outcome and improve cardiorespiratory function, providing both physical and psychological benefits.

Adolescent↗

Tracheobronchial foreign body aspirations in childhood: a 10-year experience.

OBJECTIVE: Tracheobronchial foreign body aspirations comprise the majority of accidental deaths in childhood. Diagnostic delay may cause an increase in mortality and morbidity in cases without acute respiratory failure. We report our diagnostic and therapeutic modalities. METHODS: In our department, bronchoscopy was performed on 548 patients with the diagnosis of tracheobronchial foreign body aspirations (from 1987 to 1997). Of these cases, 55.6% were male and 44.4% female. Their ages ranged from 2 months to 16 years (average 5.5 years). Diagnosis was made on history, physical examination, radiological methods and bronchoscopy. RESULTS: Foreign bodies were localized in the right bronchial tree in 312 cases (56.9%), the left in 126 cases (23.0%) and in the trachea in 62 cases ( 1.3%). Foreign body was not found during bronchoscopy in 48 cases (8.7%). The majority of the foreign bodies were vegetable matters. Foreign bodies were removed with bronchoscopy in all but two cases which underwent limited thoracotomy. In the late period, pulmonary resection was performed in five cases because of irreversible complications. After bronchoscopy, hypoxia developed in four patients, requiring mechanical ventilation. Pneumothorax developed in two cases and mediastinal emphysema in two. Four patients (0.7%) died because of respiratory failure. CONCLUSION: Proper use of diagnostic techniques provides a high degree of success, and the treatment modality to be used depending on the type of the foreign body is mostly satisfactory.

Adolescent↗

Unusually located hydatid cysts: intrathoracic but extrapulmonary.

BACKGROUND: Hydatid cyst disease is still a problem in Turkey, as well as in many other places in the world. Extrapulmonary location of the disease in the thorax is very rare, and surgical procedures can be considered that differ from those used for pulmonary hydatid cysts. METHODS: We reviewed retrospectively our experience in the surgical treatment of 22 patients with intrathoracic, extrapulmonary hydatid cysts. In our department, 297 patients with thoracic hydatid cysts were managed surgically in the last 14 years, in 22 (7.4%) of whom the cysts were localized extrapulmonarily in the thorax. The locations of these hydatid cysts were a fissure, the pleural cavity, chest wall, mediastinum, myocardium, and diaphragm. RESULTS: Total resection was chosen as the surgical procedure in all patients except 4 (18.2%), 1 of whom had cystectomy and capitonnage for cardiac hydatid cyst and 3 of whom had cystectomy and local curettage for cysts located in the chest wall. Empyema developed postoperatively in 1 case (4.5%) with a cyst in the fissure. The follow-up period was 1 year, and there were no deaths. CONCLUSIONS: Hydatid cyst may be found in many different sites, including extrapulmonarily in the thorax, and bearing this in mind will facilitate planning of the operation.

Adolescent↗