SummaryTracheal neoplasms occur infrequently, the majority of primary tracheal tumours in adults are malignant, and in 40% of cases it is adenoid cystic carcinoma, which can be asymptomatic for a long period of time. Surgical treatment can be justified even in advanced disease, because progression of tracheal tumour usually causes obstruction of airways. Improved long-term outcome seems to follow combined surgical resection and full-dose radiotherapy. Patients after resection of adenoid cystic carcinoma need careful and long-term observations to detect a relapse
Resection of the First Rib for Fibrous Dysplasia by Transmanubrial Approach
Primary tumours of the first rib remains a rarity, but the diagnosis and the surgical approach are quite challenging because of the anatomical difficulties in approaching it and the closeness of subclavian vessels. The anterior transmanubrial approach gives an excellent exposure, especially when approaching the anterior part of the first rib. Diagnosis quite often can be approved just by the histo-pathological examination of the resected specimen. We describe the management of such a case, when diagnosis of fibrous dysplasia was confirmed postoperatively.
Introduction. There is still ongoing discussion about superiority of video-assisted thoracoscopic surgery or VATS approach for performing lobectomy over conventional pulmonary lobectomy performed by open thoracotomy for the treatment of non-small cell lung cancer at an early stage.
Aim of the study. This encouraged us to conduct a prospective study for evaluation and comparison of the systemic inflammatory response by using these two approaches.
Materials and methods. We have conducted a prospective study for evaluation of C-reactive protein and Fibrinogen as indicators of systemic inflammatory response during early postoperative course. Surgery was prospectively randomised in two groups: 15 patients underwent VATS lobectomy and 15 patients underwent conventional open lobectomy. Blood samples were taken preoperatively, 24 and 72 hours after operation, on the day of drain removal, and 1 and 9 days after the drain removal.
Results. Surgery caused systemic inflammatory response in both groups. The increase in CRP was notably higher in OL group in all measurements except preoperative (p<0,05). The increase in Fibrinogen concentrations was also higher in OL group but statistical significance (p<0,05) was reached only in day of drain removal.
Conclusions. VATS approach caused reduced systemic inflammatory response compared with conventional open thoracotomy approach and was also associated with lesser postoperative pain as duration of chest drains and total amount of drained effusion is significantly smaller.
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