BackgroundSolitary fibrous tumours of the pleura (SFTP) are rare tumours. They are mostly benign. Only around 12% of them are malign ant. In the initial stage they are mostly asymptomatic and by growing they cause chest pain, irritating cough and dyspnoea on account of the pressure created on the surrounding structures. Rare giant tumours have compression symptoms on the mediastinal structures. The condition requires tiered diagnostic radiology. Preoperative biopsy is not successful in most cases. The therapy of choice is radical surgical tumour removal. Malignant or non-radically removed benign solitary fibrous tumours of the pleura additionally require neoadjuvant therapy.Case reportA 68-year old patient was hospitalized for giant solitary fibrous tumour of the pleura in the right pleural cavity. With its expansive growth the tumour caused the shift of the mediastinum by compressing the lower vena cava, right cardiac auricle as well as the intermediate and lower lobe bronchus. Due to cardiac inflow obstruction and right lung collapse, the patient’s life was endangered with signs of cardio-respiratory failure. After preoperative diagnostic radiology, the tumour was surgically removed. Postoperatively, the patient’s condition improved. No disease recurrence was diagnosed after a year.ConclusionsGiant solitary fibrous tumour of the pleura may cause serious and life-threatening conditions by causing compression of the pleural cavity with its expansive growth. Early diagnosis of the condition enables less aggressive as well as video-assisted thoracic surgery in patients with significantly better state of health. Large tumour surgeries in cardio-respiratory affected patients are highly risk-associated procedures.
Pectus excavatum is the most common congenital anterior chest wall deformity, with an incidence of 1:400 to 1:1000. Surgical strategy has evolved with the revolutionary idea of Donald Nuss, who was a pioneer in the operative correction of this deformity using minimally invasive surgery. The aim of this paper is to compare the preliminary results of pectus excavatum repair in two University Centers with a moderate number of patients using the standard Nuss procedure and its modification, the extrapleural thoracoscopic approach. The statistical analysis showed no significant difference for the patient’s age (14.52 ± 3.70 vs. 14.57 ± 1.86; p = 0.95) and the CT Haller index (4.17 ± 1.58 vs. 3.78 ± 0.95; p = 0.32). A statistically significant difference was noted for the duration of a pectus bar implant (2.16 ± 0.24 vs. 2.48 ± 0.68; p = 0.03) between the Maribor and Novi Sad Center. We report 14 complications (28%), including dislocation of the pectus bar (10%), pleural effusion (8%), wound inflammation (6%), pericarditis (2%) and an allergic reaction to the pectus bar (2%). Standard and thoracoscopic extrapleural Nuss procedures are both safe and effective procedures used to correct a pectus excavatum deformity. The choice of surgical procedure should be made according to a surgeon’s reliability in performing a particular procedure. Our study found no advantages of one procedure over the other.
IntroductionThe workforce shortage in the healthcare context is a growing issue that exerts detrimental effects on employees (e.g., higher workload) and patients (e.g., suboptimal patient care). Since traditional approaches alone may not be enough to solve this problem, there is a need for complementary innovative digital health solutions, such as socially assistive robots. Hence, the proposed study aims to investigate the effects of gamified nursing education and physiotherapy delivered by a socially assistive robot on patient- (engagement, perceived quality of care) and employee-related outcomes (perceived self-efficacy, workload).Methods and analysisApproximately 90 vascular and thoracic surgery patients will receive either standard care or standard care with additional robot interactions over the course of 3–5 days. Additionally, approximately 34 nursing and physiotherapeutic employees will fill out self-report questionnaires after weeks of not using a social robot and weeks of using a social robot. The main hypotheses will be tested with mixed-design analyses of variance and paired-samples t-tests.DiscussionWhile the proposed study has some limitations, the results will provide high-quality and comprehensive evidence on the effectiveness of socially assistive robots in healthcare.Ethics and disseminationThe study was approved by the Medical Ethics Commission of the University Medical Center and registered in the ISRCTN registry (ISRCTN96689284). The study findings will be summarized in international peer-reviewed scientific journals and meetings and communicated to relevant stakeholders.
Purpose: We present a case report of successful surgical treatment of a 58-year- old severely immunocompromised male patient with invasive fungal infection. Case presentation: A 58-year-old male with a smoking history of 30 years was admitted to hospital because of sudden shortness of breath. Radiographic imaging showed an extensive pneumothorax. The patient had a history of T-cell lymphoma, B-cell MALT lymphoma, and chronic obstructive pulmonary disease. He had also previously undergone chemotherapy. During hospitalization, his health state started to deteriorate. On the basis of imaging and microbiological culture results, he was diagnosed to have a fungal infection with Aspergillus fumigatus. After careful preoperative care, preparations, and several consultations, we performed video-assisted thoracic surgery. Because of poor visibility, inaccessibility, and rupture of an intercostal artery, we performed thoracotomy with excision of the right lung apex. Histopathology and microbiology results confirmed the initial diagnosis. Postoperatively, a 1-year treatment regimen with voriconazole was introduced. The follow-up CT scan showed no signs of fungal infection progression. The patient was given further instructions and discharged from the hospital in a cardiorespiratory compensated state. Conclusion: Despite poor prognostic factors, the surgical procedure was successful and the patient’s health state considerably improved.
Purpose: This paper discusses the diagnostic approach, treatment and certain complications in the treatment of patients with hydatid lung disease. The objective of surgical treatment is removal of the cyst and preservation of the healthy lung parenchyma. In cases of overgrowth of the pulmonary artery, which are rare, it is sometimes necessary to remove the lung;this is linked with the possibility of serious postoperative complications. Case report: We present the case of a 27–year–old patient with a hydatid cyst overgrowing the pulmonary artery and requiring removal of the left lung. After the surgery, acute respiratory distress syndrome (ARDS) developed in the remaining right lung. Extracorporeal membrane oxidation (ECMO) was required. Despite a serious complication of the extensive surgical resection, the patient left the hospital after four weeks without major health problems. Conclusion: In patients with giant pulmonary hydatidcysts it is possible to perform surgery, preserve the lung and continue treatment with the addition of albendazole therapy. The removal of the lung, on account of overgrowth of the pulmonary artery, can significantly affect the course of postoperative treatment. When planning the surgical procedure, a precise image of the pulmonary hilar structures is essential.
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