BACKGROUND: We aimed to investigate the preoperative, operative, and postoperative factors affecting intra-aortic balloon pump (IABP) insertion in patients undergoing isolated on-pump coronary artery bypass grafting (CABG). We also investigated factors affecting morbidity, mortality, and survival in patients with IABP support. METHODS: Between January 2002 and December 2009, 1,657 patients underwent isolated CABG in Izmir Katip Celebi University Ataturk Training and Research Hospital. The number of patients requiring support with IABP was 134 (8.1%). RESULTS: In a multivariate logistic regression analysis, prolonged cardiopulmonary bypass time and prolonged operation time were independent predictive factors of IABP insertion. The postoperative mortality rate was 35.8% and 1% in patients with and without IABP support, respectively (p=0.000). Postoperative renal insufficiency, prolonged ventilatory support, and postoperative atrial fibrillation were independent predictive factors of postoperative mortality in patients with IABP support. The mean follow-up time was 38.55+/-22.70 months and 48.78+/-25.20 months in patients with and without IABP support, respectively. The follow-up mortality rate was 3% (n=4) and 5.3% (n=78) in patients with and without IABP support, respectively. CONCLUSION: The patients with IABP support had a higher postoperative mortality rate and a longer length of intensive care unit and hospital stay. The mid-term survival was good for patients surviving the early postoperative period.
Atrial Fibrillation ; Cardiopulmonary Bypass ; Coronary Artery Bypass ; Follow-Up Studies ; Humans ; Intensive Care Units ; Intra-Aortic Balloon Pumping ; Length of Stay ; Logistic Models ; Mortality ; Postoperative Period ; Renal Insufficiency ; Risk Factors

PURPOSE: The aim of study was to determine the level of the radiation exposure of surgical staff during surgical probe applications in breast cancer. METHODS: Three operations of a sentinel lymph node biopsy were randomly selected. Spaced circles (50 cm apart) were drawn surrounding the operation bed on the floor. Tc-99m nanocolloid was injected peritumorally and intradermally into a patient. The radiation dose was measured with a GeigerMueller counter placed according to the drawn circles at distances of 50-200 cm from the side of patient's head and bilateral chest while the patient lay on the operation bed. All of the surgical procedures were recorded with a video camera and were monitored. RESULTS: The whole body dose to the senior surgeon was calculated as 2.00-4.70 microSv which means that a senior surgeon can perform 212-500 procedures per year to reach the annual International Commission on Radiological Protection radiation dose limit for a member of the public. CONCLUSION: We concluded that radiation risk to the surgical staff is low from sentinel node detection with the use of radiocolloids.
Breast ; Breast Neoplasms ; Floors and Floorcoverings ; Head ; Humans ; Nitriles ; Organothiophosphorus Compounds ; Pyrethrins ; Sentinel Lymph Node Biopsy ; Thorax

PURPOSE: Alteration in oxygen saturation is a side effect of the dye used in sentinel lymph node biopsy. The object of this study was to determine the possible effects of methylene blue on the oxygen saturation in patients undergoing sentinel lymph node biopsy. METHODS: The complete peroperative records of 148 patients who underwent sentinel lymph node biopsy with intraparenchymal injection of methylene blue were reviewed. The data reviewed included the preinjection pulse oximeter saturation readings and the postinjection values until the readings returned to the preoperative levels in the postanesthesia care unit. RESULTS: The pulse oximetry values were recorded preoperatively, after intubation and, at 15, 30, 45, and 60 minutes of the operation. The results showed that methylene blue did not cause any significant changes in oxygen saturation levels. CONCLUSION: We suggest that methylene blue might be preferable for the patients with concomitant disease, and for whom close monitoring of their oxygen saturation is required.
Breast ; Breast Neoplasms ; Humans ; Intubation ; Lymph Nodes ; Methylene Blue ; Nitriles ; Oximetry ; Oxygen ; Pyrethrins ; Reading ; Sentinel Lymph Node Biopsy

OBJECTIVE: To determine factors influencing overall survival following recurrence (OSFR) in women with low-risk endometrial cancer (EC) treated with surgery alone. METHODS: A multicenter, retrospective department database review was performed to identify patients with recurrent “low-risk EC” (patients having less than 50% myometrial invasion [MMI] with grade 1 or 2 endometrioid EC) at 10 gynecologic oncology centers in Turkey. Demographic, clinicopathological, and survival data were collected. RESULTS: We identified 67 patients who developed recurrence of their EC after initially being diagnosed and treated for low-risk EC. For the entire study cohort, the median time to recurrence (TTR) was 23 months (95% confidence interval [CI]=11.5–34.5; standard error [SE]=5.8) and the median OSFR was 59 months (95% CI=12.7–105.2; SE=23.5). We observed 32 (47.8%) isolated vaginal recurrences, 6 (9%) nodal failures, 19 (28.4%) peritoneal failures, and 10 (14.9%) hematogenous disseminations. Overall, 45 relapses (67.2%) were loco-regional whereas 22 (32.8%) were extrapelvic. According to the Gynecologic Oncology Group (GOG) Trial-99, 7 (10.4%) out of 67 women with recurrent low-risk EC were qualified as high-intermediate risk (HIR). The 5-year OSFR rate was significantly higher for patients with TTR ≥36 months compared to those with TTR <36 months (74.3% compared to 33%, p=0.001). On multivariate analysis for OSFR, TTR <36 months (hazard ratio [HR]=8.46; 95% CI=1.65–43.36; p=0.010) and presence of HIR criteria (HR=4.62; 95% CI=1.69–12.58; p=0.003) were significant predictors. CONCLUSION: Low-risk EC patients recurring earlier than 36 months and those carrying HIR criteria seem more likely to succumb to their tumors after recurrence.
Cohort Studies ; Endometrial Neoplasms* ; Female ; Humans ; Multivariate Analysis ; Neoplasm Recurrence, Local ; Recurrence* ; Retrospective Studies ; Survival Analysis ; Turkey