Female and male differences in the survival of patients undergoing resection for lung cancer.

OBJECTIVE: In recent years much attention has been focused on the rapidly increasing incidence of primary lung cancer in women. The aim of this study was to determine gender differences in patients treated surgically for lung cancer. METHODS: We performed a retrospective review of patients who had lung resection for primary lung cancer from January 1994 to December 1998. RESULTS: There were 530 men and 42 women. Women were younger than men (55.6 +/- 10 versus 57 +/- 9.9). The difference was not statistically significant (p = 0.9). The mean cigarette consumption was greater in men than in women (p < 0.001). We observed a higher operative morbidity and mortality rate in men compared to women (p < 0.05). Men had more squamous cell carcinoma (61.7%). In female patients, squamous cell cancer and adenocarcinoma were found with almost the same incidence (35.7% versus 33.3%). There was a significant difference in the distribution of cell types (p < 0.001). Pathologic stages for women were; I = 38.2%, II = 21.4%, IIIa = 21.4%, IIIb = 9.5%, IV = 9.5% and for men; I = 40.4%, II = 26.6%, IIIa = 24%, IIIb = 6%, IV = 3%. There was no significant difference in the stage distribution between genders (p = 0.2). Median survival for female and male patients were 38 +/- 9.2 and 35 +/- 3.2 months. Female patients' survival was longer than male patients but the difference was not statistically significant (p > 0.05). CONCLUSIONS: This study emphasizes sex differences in cigarette consumption, operative mortality and the distribution of cell types of patients with primary lung cancer. These initial results should strongly encourage additional studies in different countries on the interaction between sex and lung cancer characteristics to improve clarity.

Transthoracic approach in surgical management of Morgagni hernia.

OBJECTIVE: Morgagni hernia is an uncommon type of diaphragmatic hernias. Numerous approaches have been described and, particularly the significance of laparatomy has been emphasized as an operative technique. We present our experience on patients with Morgagni hernia operated on via transthoracic approach in our department. MATERIALS AND METHODS: Between January 1986 and March 2000, 16 patients with Morgagni hernia were operated in our department. Their ages ranged from 16 to 68 years (mean 51.5). Five (31.25%) patients were male, and 11 (68.75%) patients were female. Chest roentgenograms, thorax CT, barium enema roentgenographic studies were used as diagnostic utilities. Right posterolateral thoracotomy was performed in all patients. RESULTS: Hernia sac was present in all cases. Exploration revealed omentum in hernia sac in eight patients (50%), colon and omentum in seven patients (44%), only colon in one patient (%6). Postoperative course was uneventful. The mean follow-up was 5.7 years. There was no recurrence or symptoms related to the operation. CONCLUSIONS: We advocate transthoracic approach for surgical exposure as it provides wide exposure and easy repair of the hernia sac in Morgagni hernia.

Chest wall echinococcosis.

The chest wall is an uncommon localization for hydatid cyst. In this article, six patients were operated on because of chest wall hydatid cysts between the years 1989 to 1991 have been reported. Four of them had previously undergone surgery for pulmonary or hepatic hydatidosis; the chest wall was the primary site in two patients. Operative procedures for chest wall echinococcosis were cystectomy (four patients), cystotomy and evacuation (one patient), and chest wall resection (one patient). There was no mortality. Mean follow-up was 26 months (range, 14 to 36 months). No recurrence has occurred yet.