The Role Of Serum Uric Acid And Uric Acid To Albumin Ratio For Predicting Of Lymph Node Metastasis In Lung Cancer Treated Surgically By Vats.

OBJECTIVES: In recent years, a correlation between prognosis of various cancers and inflammation has been emphasized in many studies. Uric acid which is a purine metabolite is one of the serum inflammation markers. Albumin is a major component of serum protein and it is used as a parameter reflecting nutritional status and cancer aggressiveness. Here, we have investigated whether preoperative serum uric acid levels, albumin levels, and uric acid to albumin ratio predict lymph node metastasis in non-small cell lung cancer treated surgically by VATS. METHODS: The medical records of patients underwent VATS lobectomy-segmentectomy for non-small cell lung cancer between January 2015 and December 2020, were reviewed retrospectively. Cut-off values of preoperative serum uric acid, albumin and uric acid to albumin ratio were determined by Receiver Operating Characteristics (ROC) analysis. Groups with and without lymph node metastasis were created according to hilar and/or mediastinal lymph node metastasis. In addition, high and low groups were created according to preoperative uric acid levels and uric acid to albumin ratio. Pearson chi-square test was used investigate whether any significant correlation between the groups. RESULTS: A total of 115 patients were included in the study. Lymph node metastasis in N1 and N2 stations was detected in 11 and 18 patients, respectively. Cut-off values for uric acid and uric acid to albumin ratio were 5.97 mg/dL and 1.28x10-3, respectively. There was a statistically significant correlation between lymph node metastasis and high uric acid levels (p=0.008, OR: 3.2) and high uric acid to albumin ratio (p=0.03, OR: 2.6). CONCLUSION: Preoperative serum uric acid and uric acid to albumin ratio can predict the lymph node metastasis in non-small cell lung cancer treated surgically by video assisted thoracic surgery.

IS GAMMA-GLUTAMYL TRANSFERASE A PROGNOSTIC INDICATOR FOR EARLY-STAGE LUNG CANCER TREATED SURGICALLY?

OBJECTIVE: The aim: Gamma-glutamyl transferase (GGT) is a membrane-dependent enzyme and is primarily involved in glutathione metabolism. While a correlation between high GGT levels and oxidative stress, cardiovascular diseases, and some cancers has been shown in the literature, its prognostic ef f ect in patients with non-small-cell lung cancer remains unclear. The aim of this study was to investigate the correlation between the preoperative GGT levels and the prognosis of non-small-cell lung cancers treated surgically. PATIENTS AND METHODS: Materials and methods: Following the approval of the loc al ethics committee, the medical records of patients surgically treated in our department for stage-I non-small-cell lung cancer between January 2010 and December 2019 were retrospectively reviewed. The patients were classif i ed into a high group (high-GGT) and low group (low-GGT) according to the preoperative GGT cut-of f levels, which were specif i c to our series and calculated by receiver operating characteristic (ROC) analysis. Survival dif f erences between the groups were also investigated by Kaplan-Meier, log-rank, and Cox regression tests. RESULTS: Results: A total of 219 patients fulf i lled the inclusion criteria and were included in the study. The median survival was 75 (range: 58.4-91.1) months in the high-GGT group and 91 (range: 85-96.8) months in the low-GGT group, and this dif f erence was statistically signif i cant (Hazard Ratio: 2.0, 95% CI 1.0-3.9, p = 0.03). CONCLUSION: Conclusions: Preoperative GGT may be an inexpensive and easily applicable prognostic indicator in early-stage non-small-cell lung cancers.

The analysis of pleural complications of COVID-19 pneumonia

Background/aim: As the number of case reports related to the new type of coronavirus (COVID-19) increases, knowledge of and experience with the virus and its complications also increase. Pleural complications are one relevant issue. We aimed in this study to analyze pleural complications, such as pneumothorax, pneumomediastinum, and empyema, in patients hospitalized with the diagnosis of COVID-19 pneumonia. Materials and methods: The files of patients who have pleural complications of COVID-19 pneumonia and were consulted about thoracic surgery between March 2020 and December 2020 were retrospectively reviewed. The data of the patients were analyzed according to age, sex, length of stay, treatment method for pleural complications, mortality, severity of COVID-19 pneumonia, tube thoracostomy duration, and presence of a mechanical ventilator. Results: A total of 31 patients fulfilling the inclusion criteria were included in the study. There were 11 female (35.5%) and 20 male (65.5%) patients. The most common complication was pneumothorax in 20 patients (65%). The median duration of hospitalization was 22 days and the mortality rate was 71%. Mortality was significantly higher in patients on mechanical ventilation (p = 0.04). Conclusion: The mortality rate is very high in patients with pleural complications of COVID-19 pneumonia. Pneumothorax is a fatal complication in critically ill patients with COVID-19 pneumonia.

Hemopneumothorax as an Unusual and Delayed Complication of Coronavirus Disease 2019 Pneumonia: A Case Report.

The increasing number of studies published on coronavirus disease 2019 (COVID-19) pneumonia has improved our knowledge of the disease itself and its complications. Despite a considerable number of publications on COVID-19 pneumonia-associated pneumothorax, no article on spontaneous hemopneumothorax has been found in the English-language literature. According to published case reports, pneumothorax generally occurs in hospitalized patients during treatment, whereas cases that arise in the late period after discharge are exceptional. Herein, we present a case of spontaneous hemopneumothorax occurring as a late complication of COVID-19 pneumonia on day 17 after discharge.

Various Uses of Laryngeal Mask Airway during Tracheal Surgery.

BACKGROUND: The use of laryngeal mask airway (LMA) ventilation in surgeries to be performed in upper tracheal stenosis has been reported in the case series. However, there is no generally accepted standardized approach for the use of LMA. In this study, LMA usage areas and advantages of trachea surgery were examined. METHODS: The records of 21 patients who underwent tracheal surgery using LMA ventilation between March 2016 and May 2020 were evaluated retrospectively. The patient data were analyzed according to age, gender, mean follow-up time, surgical indication, mean tracheal resection length, anastomosis duration, mean oxygen saturation, mean end-tidal CO2 levels, and postoperative complications. RESULTS: Four patients were female and 17 were male, their median age was 43 (11-72 range) and the mean follow-up time was 17.6 months. The most common surgical indication was postintubation tracheal stenosis. The mean tracheal resection length was 26.6 mm and the mean anastomosis duration was 11.3 minutes. The mean pulse oximetry and mean end-tidal CO2 during laryngeal mask ventilation was 97.6% ± 2.1 and 38.1 ± 2.8 mm Hg, respectively. Postoperative complications were higher in patients with comorbidities. CONCLUSION: LMA-assisted tracheal surgery is a method that can be used safely as a standard technique in the surgery of benign and malignant diseases of both the upper and lower airway performed on pediatric patients, patients with tracheostomy, and suitable patients with tracheoesophageal fistula.