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    Composing an Adhesion Barrier Using Hyaluronic Acid and Carboxymethylcellulose to Prevent Mediastinal Adhesion
    (2023) Akçıl, Ali Murat; Demirkaya, Ahmet; Erşen, Ezel; Ceviz, Fatma Şimşek; Ramazanoglu, Sultan Rana; Öz, Buge; Kaynak, Mehmet Kamil
    Objective: Remediastinal intervention is an indispensable procedure to assess mediastinal lymph node metastasis after induction chemotherapy in patients with non-small cell lung cancer. Remediastinal interventions can be a difficult procedure because adhesions from a prior mediastinoscopy may reduce the surgeon’s field of view and may cause difficulty in diagnosing a lymph node, which causes suspicion about invasion. There are several adhesion barrier procedures, which were used to prevent postoperative adhesions, but none of them provided remarkable results. There are studies including abdominal, gynecologic, and neurochirurgic surgery; however, there is no sufficient study regarding mediastinum. In this study, we have explored the role of hyaluronic acid and carboxymethylcellulose in preventing mediastinal adhesion. Methods: In our study, 21 New Zealand-type male and female rabbits—each with a weight of 2500-3500 g—were used. Three groups, each including 7 rabbits, were set up using randomized sampling method. Mediastinal dissection was performed in the first group and Seprafilm® was used to build adhesion inhibition. Mediastinal dissection was performed in the second group, and 0.9% NaCl was used to build adhesion inhibition. In the control group, all layers were sutured primarily after mediastinal dissection. The rabbits were sacrificed after 30 days and each group was compared with the control group, using macroscopic and microscopic adhesion criteria. Results: According to the results of our study, Seprafilm® was found to be statistically efficient in preventing and decreasing adhesion in mediastinum (P < .01 in macroscopic criteria, P < .05 in inflammation, and vascular proliferation criteria). Conclusion: Seprafilm® can be used as an adhesion barrier in prevention of adhesions that develop as a result of surgery.
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    Minimally Invasive Surgery Using Abramson Method Is Safe and Successful in Pectus Carinatum Deformity
    (2023) Demirkaya, Ahmet; Güler, Gökberk; Sarbay, İsmail; Ersen, Ezel; Kaynak, Mehmet Kamil; Khoraki, Yaman; Kılıç, Burcu
    Objective: Pectus carinatum is the second most common congenital deformity after pectus excavatum. While pectus carinatum deformity has been corrected with open surgery (Ravitch) for nearly 50 years, a minimally invasive correction procedure was defined by Abramson in 2005. Methods: The Abramson procedure, which has been adopted by many centers, was applied to 68 patients with pectus carinatum deformity between 2010 and 2021 in our clinic. All patients who underwent surgery during this period were evaluated for clinical features, postoperative complications, patient satisfaction, and long-term results. Results: All patients in this study were male. There was no female patient who applied to the polyclinic and did not undergo surgery. The mean age of the patients was 16.7 years and 28.5% of the patients had a family history of pectus deformity. The mean follow-up period of the patients whose bar was removed was calculated at 27 months. No complications were observed. No patient had recurrence after bar removal. Considering the mid-long term complications, intense pain required the use of painkillers for 3 months in 7 (10.2%) patients and a break in the wire suture was detected after the second year in 4 (5.8%) patients. Conclusion: Abramson technique should be preferred to open surgery in suitable patients. It can be used safely in cases where brace application is not sufficient or in deformities that do not have a brace indication.