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Intrathoracic Pleural Lipomas

Aim: Lipomas are benign tumors composed of adipose tissue. They are usually located in the subcutaneous region, particularly in the upper back, neck, and shoulder. However, they rarely seen in the intrathoracic cavity. The objective of this study is to analyze intrathoracic pleural lipomas. Material and Method: We analyzed a retrospective review of the clinicopathological records of 8 patients who had undergone surgical resection for intrathoracic lipomas between 1990 to 2012. The clinical records of all patient was examined with regard to age, sex, body mass index, presenting symptoms, lesion locations and sizes, diagnostic methods, operative procedures, histopathological features, and prognosis. Results: There were 5 men and 3 female with a mean age 60,1 (range, 29-75 years). Symptoms noticed were chest pain in three, dyspnea in one, neck swelling in one. Five patients had no symptoms, and lesions were found incidentally on chest radiography. Radiographically, the tumors showed well-defined, homogenous, and fatty density lesions. Tumor excision was carried out, 4 right sided and 4 left; video-assisted thoracoscopy in one case, thoracotomy in 7 cases. All lesions were intrathoracic lipomas sourced from parietal pleura. The size of the lesions ranged between 3-12cm, the average was 7.6 cm. Complete resection was achieved in all patients except one. There were no recurrences in postoperative follow-up of patients and mean follow-up was 7.4 years. Discussion: Intrathoracic lipomas are rare benign lesions. Our series is the largest in the literature. Because lipomas cannot be differentiated from malignant lesions, and they have invasive growth capability, surgery should be performed for the purpose of diagnosis and treatment.

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Intraluminal Cervical Esophageal Perforations in Rats (Experimental Study)

Aim: Esophageal perforation has high morbidity and mortality rate. Morbidity and mortality rates have been decreased slightly by the progress in surgical technics and intensive care conditions. We here aimed to search the effect of both (a) cervical esophageal perforation from anterior and lateral locations and (b) safe time interval for repair on mortality and morbidity. Material and Method: In our study,we have used 40 rats. The rats were first grouped into anterior and lateral perforation groups, afterwards these two groups were divided into two subgroups as early (12 h) and late (24 h) repair groups. Perforation was made with 22 gauge angiocath and repaired in early or late time periods. Before the perforation and treatment, blood samples were collected from tail vein in order to measure leucocyte levels. Blood sampled before the perforation and while sacrifying the rats-by cardiak puncture- were used to measure IL-10 levels. Contamination status were analysed and radiological studies were made. Histopathologic examination of the esophageus was made after the sacrification. In order to evaluate the rupture status in treated rats, contrast esophagograms were studied before the sacrification. Results: The groups were evaluated according to the perforation localisation, time interval for treatment, white blood cell values revealing the infection, contamination status, IL-10 and fibrosis. We have found significant difference in white blood cell count and contamination between the rats that were perforated anteriorly, repaired early and perforated laterally, repaired in late time period. Also we have found significant difference in contamination between anterior perforation early repair group and lateral perforation early and late repair group. No statistical differences was found within the groups for IL-10, fibrosis, location of the perforation and the time of the treatment. Discussion: As a result, we think that our findings show us anterior perforation of the cervical esophageus is better tolarated and has a wider safe time interval for treatment.

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