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Aim:Completion pneumonectomy is a compelling procedure that is associated with high rates of mortality and morbidity. The aim of the present study was to investigate long-term surgical and oncologic outcomes of completion pneumonectomy.Methods:A retrospective review was conducted of 66 patients who underwent completion pneumonectomy in our clinic between 2006 and 2016. The patients were divided into two groups. The patients undergoing classical completion pneumonectomy (n=58), 56 had a malignant disease (non-small-cell lung carcinoma) and two patients had a benign disease. Eight patients had undergone rescue completion pneumonectomy; bronchopleural fistula in five patients, pulmonary venous occlusion in two patients, and upper lobe torsion in one patient.Results:The median follow-up period was 37.6 months. The overall mortality rate was 7.6%. The amount of intraoperative bleeding and the percentage decrease in hemoglobin levels (p=0.003) were prognostic factors affecting mortality. The postoperative complication rate was 41.4% in classical completion pneumonectomy and 50% in rescue completion pneumonectomy (p=0.64), and it was significantly higher in patients older than 65 years (p=0.04). The 5-year survival rate was 58% in malignant disease.Conclusion:Completion pneumonectomy procedure has satisfactory oncological and surgical results when performed in experienced centers on selected patients. The morbidity and mortality rates of classical completion pneumonectomy and rescue completion pneumonectomy are similar.

ABSTRACT Objective: In this study, we aimed to determine whether plasma calcium level and C-reactive protein albumin ratio (CAR) as well as other demographic and hematological markers are related in predicting severe bleeding after coronary artery bypass grafting (CABG). Methods: A total of 227 adult patients who underwent CABG at our hospital between December 2021 and June 2022 were prospectively studied. Total amount of chest tube drainage was evaluated within the first 24 hours postoperatively or until the patient was re-explored for bleeding. The patients were divided into two groups - Group 1, patients with low amount of bleeding (n=174), and Group 2, patients with severe bleeding (n=53). Univariate and multivariate regression analyzes were performed to determine independent parameters related to severe bleeding within the first 24 hours after surgery. Results: When the groups were compared in terms of demographic, clinical, and preoperative blood parameters; cardiopulmonary bypass time and serum C-reactive protein (CRP) levels were found to be significantly higher in Group 2 compared to the low bleeding group. In addition, lymphocytes, hemoglobin, calcium, albumin, and CAR were found to be significantly lower in Group 2. In multivariate analysis, calcium, albumin, CRP, and CAR were found to be independent predictors of significant association with excessive bleeding. A cut-off value of 8.7 (94.3% sensitivity and 94.8% specificity) for calcium and 0.155 (75.4% sensitivity and 80.4% specificity) for CAR predicted excessive bleeding. Conclusion: Plasma calcium level, CRP, albumin, and CAR can be used to predict severe bleeding after CABG.

Purpose: Bronchopleural fistula (BPF) is a complication that can occur after pulmonary resections onset may be early or late. This study aims to present our results using omentoplasty in the treatment of BPF. Materials and Methods: We retrospectively evaluated the data of patients who developed BPF after pulmonary resection between 2010 and 2020. The results of the patients who underwent omentoplasty during surgical revision for BPF were analyzed in terms of surgical methods used, timing of the procedure, and surgical success. Results: BPF formed in 52 (2.1%) of 2486 patients who underwent anatomical lung resection. Fourteen (26.9%) of the patients with BPF were treated with omentoplasty. All of the patients were men and the median age was 58 years (range, 27-75 years). Among the patients who underwent omentoplasty, the median time from pulmonary resection to BPF development was 22 days (range, 4-221 days). The median time from BPF development to omentoplasty was 9.5 days (range, 4-485 days). Seven (50%) of the patients developed BPF after pneumonectomy and the other 7 (50%) after lobectomy. Most post-pneumonectomy BPFs occurred after right pneumonectomy (n=6, 85.7%). BPF developing after right pneumonectomy constituted 43% of all BPFs (n=6). Surgical success was achieved in 13 (92.9%) of the 14 patients who underwent BPF closure with omentoplasty. Conclusion: Omentoplasty has low complication and high success rates and can be used safely for the treatment of BPF.