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Fahri Kokici



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    P3.15 - Treatment in the Real World - Support, Survivorship, Systems Research (Not CME Accredited Session) (ID 981)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
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      P3.15-13 - Surgical Management of Huge Pulmonary Arteriovenous Malformations: Our Experience (ID 11125)

      12:00 - 13:30  |  Author(s): Fahri Kokici

      • Abstract
      • Slides

      Background

      Pulmonary arteriovenous malformations are rare lesions with significant clinical complications. These lesions are commonly seen in patients with hereditary hemorrhagic telangiectasia (formerly Osler-Weber-Rendu syndrome). Formerly called Osler-Weber-Rendu, HHT is an inherited disorder of the vasculature associated with AVMs and telangiectasias. The prevalence of HHT is 1 in 5,000 to 10,000 patients.) are present, the diagnosis is definite. If two criteria are present, the diagnosis of HHT is probable. If less than two criteria are present, the diagnosis is unlikely.Management of arteriovenous malformations (AVMs) remains challenging because of their unpredictable behavior and with high risk mortality. A multidisciplinary approach based on a new classification scheme and improved diagnostic techniques may improve their management.

      Objectives:The purpose of this study was to review our surgical experience with surgical to manage arteriovenous malformations (AVMs).

      a9ded1e5ce5d75814730bb4caaf49419 Method

      We diagnosed a 1 patient A. female birthday 02.09.1990 with pulmonary arteriovenous malformacion (PAVMs) .She has been admitted to the thoracic surgery clininic in QKUK Pristine in July 2015 with massive hemoptisis. Unknwn initially diagnose .She was presented to QKUK hospital urgently with such clinical signs, epistaxis ,cough, hemopstisi, weakness, sweat, fever, dyspnoea, thoracic malaiseand ,massive right hemothorax with clinical signs of hemorrhagic shock with massive hemoptisi, tachycardia, weak pulse, hypotension, severe anemia et hypovolemiv shock .She was treated with right pleural drainage (avarage 2000ml)and intensive therapy et hemotransfusion (8 flacons).She was treated initially with intensive therapy and hemotransfuzion and after that with hemodynamic parameters stable were treated with surgery.Pacient were completed with all the necessary of emergency examinations as thoracic radiography, biochemical examinations, CT scaner toracal, MRI ,Bronchoscopy, EKG ,cardiac echo and cateterisation ,gaseous exchange . The patient continued with the above-mentioned concerns with dyspnoea epistaxis from time to time. Cyanosis of the lips, fingers in the hands of drumsticks, petekie and ecimosis in the skin and mucous membranes, sleep disorders. After 1.5 years it is re-examined in the cardiology clinic "Nene Hospital Theresa "and is diagnosed with giant dexter pulmonary arteriovenous fistule by Pulmonary angiography..She was treated by surgical approach in 10.06.2016 .Right posterolateral thoracotomy ,segmentectomy IV-r and fistul artereovenosectomy ,pleural deainage.

      4c3880bb027f159e801041b1021e88e8 Result

      Arteriovenous malformation size ranged. to 10x 8 cm located in the right lung middle lobe.She was treated by anatomical 4-th segmentectomy. Operator and post operative period is good. Clinical and imaging image of ultimate control is smooth.No mortality ,no major complication.Hospital days stay was 5 days.

      8eea62084ca7e541d918e823422bd82e Conclusion

      Diagnosis and management of AVMs by surgical therapy resection was with very good results and with limited morbidity and low mortality and no recurrence during early follow-up.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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    P3.16 - Treatment of Early Stage/Localized Disease (Not CME Accredited Session) (ID 982)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
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      P3.16-23 - Soft-Tissue Sarcoma of the Chest Wall, Surgical Resection: Analysis Our Cases Period of Time Decembre 2004-July 2017 (ID 11123)

      12:00 - 13:30  |  Author(s): Fahri Kokici

      • Abstract
      • Slides

      Background

      Soft tissues include muscle, fat, blood vessels, nerves, tendons and joint linings (synovial tissue). Cancerous tumors (sarcomas) of the soft tissue are rare, but there are many types. Because soft tissue sarcomas arise from a number of different kinds of tissue, they can occur anywhere in the body. Outcomes for people with soft tissue sarcomas depend on the type, size, grade, stage and location of the tumor, as well as a person's age and general health. Clasification from grade are :low ,midle ,high diferenciations..Aim of Study: Our objective was to introduce a patient diagnosed with neglectetd giant soft tissue chest wall liposarcoma .

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Records of 32 patients admitted to our institution from January 2004 to July 2017 were treated in our clinic’ A patient with the initials K.B bored 17/06/1950 .He was admitted to our hospital in thoracal surgery at 19.09.2012 with diagnosis : soft tissue tumor left chest wall .Pacienti without other diseases . We did all necessary examinations , CT , MRI and determined the extent of tissue tumor.

      4c3880bb027f159e801041b1021e88e8 Result

      Ages ranged from 13 to 86 years (median, 38 years); the ratio of male to female patients was 3:1. The initial complaint was mass or pain in 98% of the cases. Histologic types were as follows: desmoid tumor (n = 5), 15 %; liposarcoma (n = 7), 21%; rhabdomyosarcoma (n = 6), 18%); fibrosarcoma (n =4 , 12%); malignant peripheral nerve tumor (n = 3, 9%); malignant fibrous histiocytoma (n = 1, 3%); tenosynovial sarcoma (n = 1),3 %; hemangiopericytoma (n = 2) ,6%%); alveolar soft part sarcoma (n = 2),6%); and other types(lymphoma) (n = 2),6%). Resection was the primary treatment in 28 cases (87%).All patients were treated by multimodal treatment ,chemoradition therapy and surgery. Local recurrence developed in 25%. Metastases occurred in 15 (46%) of the cases (metachronous in 12, synchronous in 3) and were more common in patients with high-grade disease than in those with low-grade disease Overall 5-year survival was 60%. Five-year survival rate for those with high-grade sarcomas was significantly lower than that for low-grade sarcomas .Tumor size and age of patient were not prognostic.

      8eea62084ca7e541d918e823422bd82e Conclusion

      Surgery is important in the treatment of most sarcomas.[Additional treatments, including chemotherapy and radiation therapy, may be administered before and/or after surgery. Thoracic wall soft-tissue sarcomas are best controlled by wide surgical resection.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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