Postoperative hiatal hernia after esophagectomy occurs with a frequency of 0.4–6%, and the local conditions following esophagectomy promote its occurrence. In the material presented here, hiatal hernia in the form of displacement of the colon to the mediastinum was established in 0.78% (2/256) of all performed esophagectomies. Both cases were reoperated successfully.

Objective The aim of this study was to compare pressure resistance of the most common methods of vessel occlusion during thoracic surgical procedures: ligations, clips, and vascular endostaplers. Methods Pulmonary vessels were obtained during routine thoracic surgeries. A ball-tipped cannula was inserted through an opening in the side wall and secured with a linen ligature from slipping out. Subsequently, saline was infused into the vessel. We recorded the pressure on which a leakage occurred. Results A total of 65 vessels, divided between 3 groups, were enrolled in the study. In the endostaplers group, median bursting pressures were 262.5 mmHg and 300 mmHg for arteries and veins, respectively. In the case of clips, it was over 750 mmHg in both types of the vessels. The same results were observed in the ligation group. Minimal bursting pressures in endostapler occlusion were 187.5 mmHg and 225 mmHg in arteries and veins, respectively. In the case of clips, it was 600 mmHg for arteries and 675 mmHg for veins. A total of 525 mmHg (arteries) and 750 mmHg (veins) were the minimal leaking values observed in vessels occluded with ligations. Comparative analysis showed statistically significant differences in endostapler-clips and endostapler-ligations pairs (p < 0.001). There were no differences between clips and ligations. Conclusions The examined methods are capable of occluding pulmonary vessels under physiological conditions. Furthermore, ligations and clips are resistant to pressures highly exceeding physiological values.

In this study, the cases of a patient with Goodpasture syndrome (also referred to as anti-glomerular basement membrane disease) and a patient with the morphological features of Goodpasture syndrome or Goodpasture-like syndrome found in a histopathological examination are described. In both cases the course of the disease was atypical, with a massive respiratory tract hemorrhage being the most significant symptom. Accordingly, the presented patients were treated surgically. Furthermore, the paper described diagnostic difficulties in identifying the cause of the hemorrhage. Finally, the importance of histopathological examination in the diagnosis of Goodpasture syndrome and the Goodpasture-like syndrome with atypical course is emphasized.

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