A new technique for closure of pericardial defects: pericardial rug weave.

BACKGROUND: Pericardial defect that occurs after intrapericardial pneumonectomy can cause many fatal complications, and closing the defect with mesh is a widely used surgical method to prevent these complications. METHODS: Data of patients who underwent intrapericardial pneumonectomy and pericardial resection in our clinic between October 2010 and June 2022 were retrospectively reviewed. Patients were divided into two groups, those who had prolene mesh used to close the pericardial defect and those who underwent the "Rug Weave" technique we proposed as an alternative, and the results were compared. RESULTS: The study included 23 patients, one of whom was female. All patients underwent surgery due to malignancy. The vast majority of the patients had a diagnosis of squamous cell lung carcinoma (86.9%). Atrium was added to three patients and rib resection was added to one patient during intrapericardial pneumonectomy and pericardial resection. There was no significant difference between the two groups in terms of average age, gender, and length of hospital stay. There was no significant difference between the two groups in terms of complications, including atrial fibrillation, which is commonly seen in these patients (p = 0.795). The Rug Weave group had an average defect width of 23.96 cm2 and was found to be advantageous in terms of overall survival compared to the mesh group (p = 0.017). CONCLUSIONS: The "Rug Weave" technique we proposed for closing pericardial defects after pneumonectomy can be used as a cheaper method safely and effectively that reduces complications as much as the traditional method of using mesh.

Efficiency of pulmonary nodule risk scoring systems in Turkish population.

Malignancy risk calculation models were developed using the clinical and radiological features. It was aimed to compare pulmonary nodule risk calculation models and evaluate their effectiveness and applicability for the Turkish population. Between 2014 and 2019, 351 patients who were operated on for pulmonary nodules were evaluated with the following data: age, gender, smoking history, family history of lung cancer, extrapulmonary malignancy and granulomatous disease, nodule diameter, attenuation character, side, localization, spiculation, nodule count, presence of pulmonary emphysema, FDG uptake in PET/CT of the nodule, and definitive pathology data. Malignancy risk scores were calculated using the equations of the Brock, Mayo, and Herder models. The results were evaluated statistically. The mean age of the 351 patients (236 men, 115 women) was 57.84 ± 10.87 (range 14-79) years, and 226 malignant and 125 benign nodules were observed. Significant correlations were found between malignancy and age (p < 0.001), nodule diameter (p < 0.001), gender (p < 0.009), speculation (p < 0.001), emphysema (p < 0.05), FDG uptake (p < 0.001). All three models were found effective in the differentiation (p < 0.001). The ideal threshold value was determined for the Brock (19.5%), Mayo (23.1%), and Herder (56%) models. All models were effective for nodules of > 10 mm, but none of them were for 0-10 mm. Brock was effective in ground-glass nodules (p = 0.02) and all models were effective for semi-solid and solid nodules. None of the groups could provide AUC values as high as those achieved in the original studies. This suggests the need to optimize models and malignancy risk thresholds for Turkish population.

Post-tuberculosis Pneumocytoma.

Pneumocytoma is a rare benign tumor of the lung that usually manifests as a solitary pulmonary nodule. A 69-year lady, who had history of tuberculosis treatment 20 years ago, admitted to the hospital. A round mass was seen on chest radiography. Thorax computed tomography was reported as a round lesion in the left lung. Fiberoptic broncoscopy, computed tomography-guided fine-needle aspiration cytology and intraoperative frozen section analyses were undiagnostic. We performed wedge resection with minithoracotomy. Pathologic examination was reported as pneumocytoma. The patient did not receive any chemotherapy or radiotherapy after the operation. After 41 months' follow-up, no recurrent lesion was seen.

Is the treatment for osteochondrolipomas and lipomas the same? Case report and review of the literature on osteochondrolipoma of chest wall.

Lipomas containing bony and chondroid areas are called osteochondrolipomas. Osteochondrolipomas are extremely rare and their treatment is not known exactly. In this article, we report a 41-year-old male patient who had a 45 mm long subcutaneous mass in the chest wall which was detected 15 years before. When the mass started to grow recently, the patient was admitted to our hospital. Total excision was performed to the mass of the chest wall. According to the histopathological examination of the material, the lesion was an osteochondrolipoma. It might be challenging to diagnose such rare osteochondrolipomas in the tru-cut or small biopsy specimens. Differential diagnosis may be challenging clinically, radiologically, and histopathologically. To our knowledge, this is the fifth case of a totally excised osteochondrolipoma of the chest wall which was reported in the literature.