The decrease in Oxygen Reserve Index (ORI) provides a prediction for the development of hypoxemia and hyperoxia. Our aim is to determine the effect of ORI-guided oxygen titration on hyperoxemia-mediated morbidity. Consecutive 120 ASA I-III patients, 18-70 years of age, without severe obstruction or restriction, undergoing one lung ventilation (OLV), were included. Patients were divided into 4 groups. Oxygen titration without ORI monitoring with low-flow anesthesia (n=25) and high-flow anesthesia (n=28). Oxygen titration by ORI monitoring with low flow anesthesia (n=25) and high flow anesthesia (n=25). OLV time, duration of surgery and anesthesia, oxygen application time over 60%, vital signs, hospital and ICU stay time and complications were recorded. There was a significant difference in terms of FiO2 used during OLV (p< 0.05). There was no difference in ORI values (p <0.05). In Group 3, both PaO2 and SpO2 were significantly lower than the others both before and during OLV. There was no significant difference in ORI parameters between low and high flow anesthesia groups. There was a strong, positive correlation between the duration of hospital stay and FiO2 used above 80% during OLV. We concluded that ORI-guided thoracic anesthesia may reduce hospital stay and increase patient safety.

Background: This study aims to examine the factors influencing prognosis and long-term survival outcomes in pathological single-station N2 (pN2a) patients undergoing surgical treatment for non-small cell lung cancer. Methods: Between January 2012 and June 2021, a total of 144 patients (125 males, 19 females; mean age: 60.5±8.4 years; range, 48 to 78 years) who underwent anatomical resection for non-small cell lung cancer and were identified with pN2a disease were retrospectively analyzed. Factors influencing prognosis were analyzed. Survival analysis was performed. Results: Forty-nine (34%) patients received neoadjuvant therapy and 87 (60.4%) patients underwent lobectomy. In terms of staging, 95 (66%) patients were classified as Stage 3A, while 49 (34%) patients were categorized as Stage 3B. Analysis of N2 subtypes revealed that 77 (53.5%) patients were classified as known N2, whereas 67 (46.5%) patients were identified as incidental. Histopathological evaluation revealed that 58 (40.3%) patients had adenocarcinoma, while 86 (59.7%) patients had non-adenocarcinoma histology. N2 disease was categorized as skip metastasis (pN0N2a) in 61 (42.4%) patients and non-skip metastasis (pN1N2a) in 83 (57.6%) patients. Adjuvant therapy was administered to 126 (87.5%) patients, with treatment modalities determined by the oncology clinics and patient characteristics. Among these, 46 (31.9%) patients received chemotherapy, 15 (10.4%) patients underwent radiotherapy, and 65 (45.1%) patients were treated with chemoradiotherapy. The five-year overall survival rate was 33.9% with a median duration of 37.1±5.0 months. The disease-free survival rate was 24.9% with a median duration of 18.2±2.3 months. Adenocarcinoma histology, non-skip N2 disease, lack of adjuvant therapy, and advanced age (>65 years) were found to be significant factors affecting the prognosis of pN2a disease. Conclusion: The findings of this study indicate that adenocarcinoma histology, advanced age, absence of adjuvant therapy, and the presence of pN1N2a are significant prognostic factors in pN2a patients undergoing curative resection for non-small cell lung cancer.

The effects of preoperative anaemia on postoperative complications in patients undergoing thoracic surgery: A prospective descriptive study - Turkish Journal of Surgery

Background: This study aimed to review the management and treatment approaches for patients who underwent surgery for bilateral pulmonary hydatid cysts in our clinic. Methods: A total of 175 patients who underwent surgery for pulmonary hydatid cysts between January 2008 and February 2023 were retrospectively analyzed. Bilateral pulmonary hydatid cysts were detected in 16 patients (9.14%), and 12 patients who underwent bilateral surgical treatment were included in the study. Results: The average age of the patients was 36.7 ± 18.0 years (ranging from 15 to 65 years), with an equal number of males and females. One patient underwent simultaneous bilateral thoracotomy, while the others received sequential thoracotomy for surgical treatment. A total of 36 pulmonary hydatid cysts were removed across 23 surgical sessions involving 12 patients. The cysts had an average diameter of 4.7±1.42 cm and were predominantly located in the lower lobes (56%). The contralateral side was operated on an average of 3.81 months after the intervention on one hemithorax. After the second operation, albendazole treatment at a dosage of 10 mg/kg/day was initiated. No operative mortality was recorded, and the average follow-up duration was 26.6 months. Conclusion: This study emphasizes the importance of reviewing the necessary criteria for successful surgical planning in cases of hydatid cysts in bilateral lungs. According to the data obtained, prioritizing numerous, larger, and intact cysts can help minimize the risk of potential operative complications.