Kardiochirurgia I Torakochirurgia Polska最新文献

Introduction: Chest tube insertion is one of the essential procedures that is performed for patients suffering from pneumothorax or pleural effusion. Choosing the best chest tube size, with maximum emptying and minimum discomfort and side effects, is one of the most important factors in patient care, while the best tube size is highly a matter of debate. In this investigation, we aimed to assess the difference between the groups with different chest tube sizes regarding the time needed for drainage, the necessity of additional invasive procedures, or pain severity.

Material and methods: In this cross-sectional study, patients with pleural effusion, were entered into the study. patients were randomly divided into two groups based on their chest tube size: size 28 and size 32. Then, the duration of complete effusion emptying and the duration of the chest tube insertion was evaluated.

Results: According to this study, 26 (65.0%) participants were male. The duration for complete evacuation of pleural effusion varied from 3 to 10 days. The average duration of chest tube retention in the group of patients with chest tube sized 28 and 32 were 5.82, and 5.91 days, respectively; The average pain intensity in the group of patients with chest tube sized 28 and 32 were 6.71 ±1.02 and 6.48 ±1.21 units, respectively.

Conclusions: There was no significant difference in how long the chest tube needed to stay in place to fully drain the pleural effusion. They also didn't differ significantly in the need for additional invasive procedures such as VATS, and secondary chest tube insertion. There was no notable difference for pain severity and the need for painkillers in the two groups of patients.

Introduction: Postpneumonectomy empyema (PPE) poses a substantial postoperative risk, even in the absence of a bronchopleural fistula, often necessitating surgical intervention for resolution.

Aim: To evaluate the efficacy of video-assisted thoracic surgery (VATS) in managing PPE, supported by a comprehensive review of pertinent literature.

Material and methods: Six studies were included in this analysis, encompassing 63 PPE cases treated with VATS. Patient ages ranged from 16 to 74 years, with prevalent bacterial strains identified within the Staphylococcus and Streptococcus genera.

Results: Hospital stays extended up to 94 days, with 4 patients requiring thoracostomy for infection management. Postoperatively, 1 patient succumbed to complications. VATS holds promise as a viable therapeutic modality for definitive PPE management.

Conclusions: In instances of bronchopleural fistula or persistent empyema, consideration should be given to open revision procedures.

Significant unprotected left main (ULM) disease is the highest-risk coronary artery lesion, carries high morbidity and mortality related to a large amount of myocardium supplied, and should undergo prompt revascularization. Among recent randomized controlled trials (RCTs), NOBLE failed to demonstrate non-inferiority of percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG). However, all the other RCTs have shown comparable outcomes. While CABG is associated with higher stroke rates at 30 days and 1 year, PCI is associated with increased spontaneous myocardial infarction (MI) events and the need for repeat revascularization. Furthermore, the benefit of CABG is more evident with the increased complexity of coronary artery disease. In current European and American guidelines, CABG is the standard of care for ULM disease. PCI is considered a reasonable alternative in selected patients (2a B-NR). There is still a great need for carefully designed RCTs with longer follow-up times to validate the role of recent technological and pharmacological regimens.

Introduction: This systematic review aims to provide a comprehensive evaluation of the literature on robotic video-assisted thoracoscopic surgery (VATS) pneumonectomy.

Aim: To evaluate its effectiveness and safety in treating various lung diseases.

Methods: A thorough search of electronic databases was conducted, and 25 studies encompassing 1,650 patients were included in the review.

Results: The review found that robotic VATS pneumonectomy surgery is a safe and effective alternative to traditional open surgery for the treatment of various lung diseases, particularly early-stage lung cancer. The surgery is associated with shorter hospitalizations, less blood loss, and less postoperative pain when compared to traditional open surgery.

Conclusions: However, long-term survival outcomes were not significantly different between robotic and open surgery. The review also highlights the need for further studies to determine the optimal use of robotic VATS pneumonectomy surgery in different clinical scenarios and to determine whether the benefits of this technique outweigh the costs. Overall, this systematic review suggests that robotic VATS pneumonectomy surgery is a safe and effective technique that can be used as an alternative to traditional open surgery.

Introduction: Despite the large amount of researches addressed the issue of the relationship between the intensity of preoperative symptoms of depression and/ or anxiety with their postoperative intensity and any complications after surgery, there have been almost unaddressed such subjects as how the patients perceive their own capabilities or physical attractiveness, and the emotions which are evoked by various aspects of their own bodies, including postoperative scars. These aspects play a significant role in assessing the quality of patients' life and have a significant impact on the overall assessment of the surgery as an event, in both the short- and long-term perspective.

Aim: To evaluate the relationship between anxiety, pain level, self-efficacy and body esteem in the pre- and postoperative periods among patients scheduled for coronary artery bypass surgery.

Material and methods: Prospective studies were carried out in a group of 50 patients scheduled for coronary artery bypass surgery, either on a planned or urgent basis. Anxiety, both as a state and as a trait, was assessed using the Polish version of the State-Trait Anxiety Inventory (STAI). The Visual Analogue Scale (VAS) was employed to evaluate pain. The Self-Efficacy Gauge measured self-efficacy, while the Body Esteem Scale assessed body esteem.

Results and conclusions: The intensity of state anxiety significantly negatively correlated with self-efficacy following CABG surgery. There was a statistically significant negative correlation between the intensity of painand self-efficacy in the postoperative period. Among female patients, the intensity of pain, both pre- and post-operatively, negatively correlated with their assessment of body esteem concerning physical condition at the respective time points. When assessing anxiety as a trait during the perioperative period, a positive correlation with pain intensification after CABG was identified.