Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery最新文献

{"title":"Surgical outcomes and risk factors for complications after tracheal resection in benign tracheal stenosis: A 15-year single-center experience.","authors":"Elgün Valiyev, İsmail Tombul, Bengisu Artıran, Mahir Fattahov, Ayşegül Kurtoğlu Turan, İsmail Cüneyt Kurul, Muhammet Sayan, Ali Çelik","doi":"10.4274/tjtcs.2026.2026-4-1","DOIUrl":"10.4274/tjtcs.2026.2026-4-1","url":null,"abstract":"<p><strong>Background: </strong>Surgical resection is an established treatment for benign tracheal stenosis with favorable outcomes in selected patients. This study aimed to evaluate postoperative outcomes in patients undergoing tracheal resection and reconstruction.</p><p><strong>Methods: </strong>A retrospective analysis was performed on patients who underwent surgical treatment for tracheal stenosis between January 2010 and December 2024. Of 110 patients, those with tracheoesophageal fistula (n=25), malignancy (n=18), or incomplete follow-up (n=5) were excluded. A total of 62 patients with benign tracheal stenosis were included. Demographic characteristics, surgical details, airway management strategies, perioperative interventions, comorbidities, and postoperative outcomes were analyzed.</p><p><strong>Results: </strong>Among the 62 patients, 24 (38.7%) were female and 38 (61.3%) were male, with a median age of 37 years (range: 4-83). The primary etiology was post-intubation stenosis in 50 patients (80.7%) and post-tracheostomy stenosis in 12 (19.3%). No cases of idiopathic laryngotracheal stenosis were identified in our surgical cohort. The mean resection length was 2.76±0.9 cm. Surgical access was achieved via collar incision in 87.1% of patients. Ventilation was managed using a laryngeal mask airway in 59.6% and an endotracheal tube in 40.4%. Postoperative complications occurred in 13 patients (20.9%), including wound infection, restenosis, and vocal cord edema. Although complications were more frequent in patients with comorbidities, the difference was not statistically significant (p>0.05). No mortality was observed.</p><p><strong>Conclusion: </strong>Tracheal resection and reconstruction is a safe and effective treatment for benign tracheal stenosis, with low morbidity and no mortality in this series. Increased complication rates were associated with extended resections and proximal airway involvement. Careful patient selection and meticulous surgical planning are essential to optimize outcomes.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":"446-451"},"PeriodicalIF":0.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148266765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical frailty or acute illness burden? Methodological concerns regarding interpretation of the CFS in surgical infective endocarditis.","authors":"Ünsal Vural","doi":"10.4274/tjtcs.2026.2026-7-39","DOIUrl":"10.4274/tjtcs.2026.2026-7-39","url":null,"abstract":"","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":"376-378"},"PeriodicalIF":0.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrograde pedal access to facilitate intraluminal recanalization in complex infrainguinal chronic total occlusions.","authors":"Selim Aydın, Yakup Tire, İbrahim Gökçe, Bahar Temur, Emre Özker, Ersin Erek","doi":"10.4274/tjtcs.2026.2026-4-22","DOIUrl":"10.4274/tjtcs.2026.2026-4-22","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to assess the feasibility, safety, and clinical performance of retrograde pedal access to facilitate intraluminal crossing in complex infrainguinal chronic total occlusions in patients with advanced peripheral artery disease.</p><p><strong>Methods: </strong>In this retrospective, single-centre analysis, 33 patients undergoing endovascular revascularization for complex peripheral arterial chronic total occlusions between August 2021 and October 2024 were evaluated. Retrograde pedal access was performed when intraluminal crossing could not be achieved using antegrade or contralateral femoral approaches. The primary endpoint was technical success, defined as successful intraluminal crossing. Secondary endpoints included procedural complications, freedom from clinically driven target lesion revascularisation, longitudinal changes in Rutherford classification, wound healing, limb salvage and all-cause mortality.</p><p><strong>Results: </strong>Successful intraluminal crossing via retrograde pedal access was achieved in 30 patients (90.9%). The posterior tibial artery (39.4%) and anterior tibial artery (36.4%) were the most commonly utilized access sites. Among the 30 patients who underwent definitive endovascular treatment after successful intraluminal crossing, the most frequent complication was flow-limiting dissection, occurring in five patients (16.7%); no cases of perforation, distal embolization, pseudoaneurysm, arteriovenous fistula, or procedure-related death were recorded. Kaplan-Meier estimated freedom from clinically driven target lesion revascularization was 96.7% at 12 months and 75.5% at 24 months. No major amputations occurred, and all patients presenting with tissue loss achieved complete wound healing, with or without minor amputation.</p><p><strong>Conclusion: </strong>Retrograde pedal access represents a safe and effective approach for achieving intraluminal crossing in complex peripheral chronic total occlusions, particularly among patients with chronic limb-threatening ischemia. The high rate of technical success and favorable limb-related outcomes support its role as an integral component of modern endovascular revascularization strategies.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":"409-420"},"PeriodicalIF":0.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fenestrated and branched technologies in complex aortic aneurysm care.","authors":"Edwaldo Edner Joviliano","doi":"10.4274/tjtcs.2026.2026-9-20","DOIUrl":"10.4274/tjtcs.2026.2026-9-20","url":null,"abstract":"","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":"336-339"},"PeriodicalIF":0.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic determinants in occult N1 non-small cell lung cancer after anatomical resection.","authors":"Arda Sarıgül, Salih Duman, Berna Karataş, Doğu Vurallı Bakkaloğlu, Adalet Demir, Murat Kara, S Alper Toker, Berker Özkan","doi":"10.4274/tjtcs.2026.2026-7-12","DOIUrl":"https://doi.org/10.4274/tjtcs.2026.2026-7-12","url":null,"abstract":"<p><strong>Background: </strong>Clinically occult pN1 disease in non-small cell lung cancer (NSCLC) represents postoperative nodal upstaging, but prognostic factors within this subgroup remain incompletely defined. This study evaluated clinicopathological factors associated with disease-free survival (DFS) and overall survival (OS) in clinically node-negative NSCLC patients found to have pathological N1 disease after anatomical resection.</p><p><strong>Methods: </strong>Between January 2008 and November 2024, 94 patients with primary NSCLC who had been classified as clinically node-negative before surgery were retrospectively identified. All underwent anatomical lung resection and were subsequently found to have pathological N1 disease on definitive histopathological examination. DFS and OS were evaluated according to N1 nodal burden, final pathological stage, pleural invasion, nodal location, and other clinicopathological variables.</p><p><strong>Results: </strong>Of the 94 patients, 75 (79.8%) had metastatic involvement limited to a single N1 station, whereas 19 (20.2%) had multistation N1 disease. Multistation N1 was associated with poorer 5-year DFS (17.8% vs. 52.3%) and OS (27.9% vs. 59.7%). In the adjusted analysis, involvement of multiple N1 stations remained an independent adverse factor for DFS (hazard ratio [HR]: 2.84; 95% confidence interval [CI]: 1.53-5.26; p=0.001) and OS (HR: 2.41; 95% CI: 1.23-4.74; p=0.011), after accounting for pathological stage and pleural invasion. Increasing pathological stage was also associated with worse DFS (HR: 2.49, 95% CI: 1.55-4.01, p<0.001) and OS (HR: 2.36, 95% CI: 1.46-3.81, p<0.001).</p><p><strong>Conclusion: </strong>In clinically occult pN1 NSCLC, multistation N1 involvement and higher pathological stage were independently associated with worse DFS and OS. Detailed pathological assessment of N1 nodal burden may improve postoperative risk stratification.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic significance of the glucose-to-lymphocyte ratio in acute pulmonary embolism.","authors":"Erhan Saraçoğlu, Yunus Emre Özbebek, Derya Doğan, Rıfat Bozkuş, İbrahim Halil Uygun, Serap Akçalı Duru","doi":"10.4274/tjtcs.2026.2026-9-32","DOIUrl":"https://doi.org/10.4274/tjtcs.2026.2026-9-32","url":null,"abstract":"<p><strong>Background: </strong>Acute pulmonary embolism has a heterogeneous clinical course, and simple laboratory markers reflecting metabolic and inflammatory stress may provide additional prognostic information. We investigated the association between the glucose-to-lymphocyte ratio (GLR) and in-hospital mortality in acute pulmonary embolism.</p><p><strong>Methods: </strong>This retrospective observational study included 631 consecutive patients diagnosed between January 2023 and June 2025. GLR was calculated as admission blood glucose divided by absolute lymphocyte count. Receiver operating characteristic (ROC) analysis assessed the discriminatory ability of GLR for in-hospital mortality and identified a ROC-derived exploratory threshold for subsequent analyses. Clinical characteristics and in-hospital outcomes were compared between GLR groups, and logistic regression analyses identified factors associated with mortality.</p><p><strong>Results: </strong>The median age was 69 years, 52.6% were female, and in-hospital mortality occurred in 41 patients (6.5%). GLR showed modest discrimination for mortality (area under the curve 0.626, 95% confidence interval [CI] 0.548-0.705; p=0.007), with a ROC-derived exploratory threshold of 80.06. Mortality was higher in patients with GLR ≥80.06 than in those with GLR <80.06 (9.5% vs. 3.3%; p=0.001). Elevated GLR was also associated with right ventricular dysfunction, vasopressor requirement, intensive care unit admission, hemodynamic deterioration, active infection, and longer hospital stay. GLR ≥80.06 remained associated with mortality in the primary multivariable model (adjusted odds ratio [OR] 2.43, 95% CI 1.15-5.15; p=0.020), but this association was attenuated after additional adjustment for active infection (adjusted OR 1.85, 95% CI 0.86-3.97; p=0.118).</p><p><strong>Conclusion: </strong>Higher admission GLR was associated with in-hospital mortality in the primary multivariable analysis. Although its discriminatory performance was modest, GLR may provide complementary prognostic information; however, the attenuation of the association after adjustment for active infection warrants cautious interpretation.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple saccular outpouchings of the thoracoabdominal aorta: An unusual manifestation of suspected tuberculous aortitis in a young adult.","authors":"Vidushi Dhiman, Resham Singh Thakur, Varun Bansal, Lokesh Rana, Narvir Singh Chauhan, Raman Sharma","doi":"10.4274/tjtcs.2025.2026-7-41","DOIUrl":"https://doi.org/10.4274/tjtcs.2025.2026-7-41","url":null,"abstract":"","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-flow nasal cannula in a patient with prolonged air leak following cardiothoracic surgery: A case-based observation.","authors":"Lokman Yalçın, Bedih Balkan","doi":"10.4274/tjtcs.2026.2026-3-21","DOIUrl":"https://doi.org/10.4274/tjtcs.2026.2026-3-21","url":null,"abstract":"<p><p>Prolonged air leak (PAL) following cardiothoracic surgery severely limits available ventilatory strategies. We report a 68-year-old male who developed bilateral PAL after coronary artery bypass grafting and mitral valve replacement. Despite maximal ventilatory support, critical hypoxaemia persisted. Following early extubation at hour 72, high-flow nasal cannula (HFNC) was initiated, achieving rapid oxygenation recovery (ΔPaO₂ +22 mmHg, ΔPaCO₂ -15 mmHg within 24 hours). Combined with awake physiotherapy and intermittent noninvasive ventilation, HFNC facilitated clinical recovery without re-intubation. This case illustrates HFNC as a feasible respiratory support alternative when positive-pressure strategies are limited by PAL.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bronchial stump re-resection for carcinoid tumor recurrence after left pneumonectomy: Case report.","authors":"Mehmet Oğuz Köksel, Murat Özeren, Mustafa Kazar, Fatma Bağrıaçık Ekinci","doi":"10.4274/tjtcs.2026.2025-12-33","DOIUrl":"https://doi.org/10.4274/tjtcs.2026.2025-12-33","url":null,"abstract":"<p><p>Carcinoid tumors of the lung are rare, low-grade neoplasms within the neuroendocrine tumor spectrum. They are classified as typical and atypical carcinoids. Typical carcinoids are predominantly centrally located and rarely metastasize, whereas atypical carcinoids more commonly occur in peripheral locations and have a higher propensity for distant metastasis. Most patients benefit from curative surgical treatment. In this case report, we describe a patient who previously underwent left pneumonectomy for a typical carcinoid tumor and subsequently developed a local recurrence requiring re-resection of the bronchial stump. We discuss the surgical approach and potential challenges in light of current literature.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary human epithelium on nitinol stents to improve mucociliary function.","authors":"Ebru Sağlam, Ahmet Ferudun Işık, Demet Taşdemir, Ömer Eronat, Tarık Öztuzcu, Zeynep Sav Tunca, Esra Bozgeyik","doi":"10.4274/tjtcs.2026.2026-6-5","DOIUrl":"https://doi.org/10.4274/tjtcs.2026.2026-6-5","url":null,"abstract":"<p><strong>Background: </strong>Current airway stents treat tracheobronchial stenosis effectively but lack native respiratory epithelium. This deficiency impairs mucociliary clearance, leading to complications such as mucus accumulation, infection, and granulation tissue formation. The objective of this study was to evaluate if the direct explant culture of human bronchial tissue on silicone-coated nitinol stents supports epithelial adhesion and preserves functional ciliary activity.</p><p><strong>Methods: </strong>Primary bronchial epithelial tissues from lung cancer patients (n=4) were cultured directly on silicone-coated nitinol stents using an explant technique, with conventional dishes as controls. Cellular viability and density were evaluated, and ciliary differentiation and function were quantified by measuring ciliary beating frequency (CBF) on days 5, 10, and 15 via high-speed video analysis. Cell density and phenotype were verified immunohistochemically on day 20.</p><p><strong>Results: </strong>Human bronchial epithelial cells successfully adhered and proliferated on nitinol stents, forming a differentiated ciliated architecture. Functional ciliary activity was detected in both groups at all time points. On stents, mean CBF increased from 7.38±0.67 Hz (day 5) to 8.60±1.78 Hz (day 10). Immunohistochemistry confirmed the presence of ciliated structures. CBF values on stents were comparable to control groups (p>0.05), indicating physiological functional equivalence and excellent biocompatibility on the biomaterial surface.</p><p><strong>Conclusion: </strong>These findings demonstrate the feasibility of engineering a biologically active airway stent by culturing patient-derived bronchial epithelium on nitinol surfaces. Epithelialized stents may support mucociliary function and improve biological performance. Further preclinical validation is warranted to evaluate the therapeutic benefit of this approach.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}