Insertion of two chest tubes is not more effective than the insertion of a single chest tube after pulmonary lobectomy. Moreover, using a single tube is in fact more effective than using two tubes in that it causes less postoperative pain and less pleural fluid loss.

This study confirms the competency of single-port procedure in first-line surgical treatment of primary spontaneous pneumothorax.

Purpose: Massive hemoptysis is a life threatening situation with high mortality rates. Surgery is effective, however generally an avoided treatment. We report our experience with patients undergoing lung resection for life-threatening hemoptysis. Methods: Records of all surgically treated patients for hemoptysis between June 2009 and June 2012 were reviewed and analyzed retrospectively. Results: Anatomical resection was performed on 31 (15.3%) patients out of 203 patients referred to our intensive care unit for life-threatening hemoptysis. 25 (80.6%) were male and six (19.4%) were female; with mean age of 46.4 ± 13.7 (21-77). Pneumonectomy was performed in four (12.9%), lobectomy in 24 (77.4%), segmentectomy in two (6.5%) and bilobectomy in one case. Postoperative complications developed in eight (25.8%), and mortality was observed in two (6.5%) patients. Etiology was bronchiectasis in 13 (42.0%), tuberculosis in eight (25.8%), carcinoma in four (12.9%), aspergilloma in four (12.9%), hydatid cyst in one (3.2%) and lung abscess in one (3.2%) of the cases. Conclusions: Although lung resection in the treatment of massive hemoptysis is accompanied with high morbidity and mortality rates, surgery is the only permanent curative modality. Acceptable results can be achived in the company of a multidisciplinary approach, through avoidance of pneumonectomy and urgent surgery.

Effective palliative treatment in malignant pleural effusion can only be carried out when the lung is fully expanded after drainage of effusion. We investigated the efficacy of intrapleural fibrinolytics for lysing fibrin deposits and improving lung reexpansion in patients with malignant pleural effusion. We randomly allocated 47 patients with malignant pleural effusion into 2 groups: a fibrinolytic group of 24 were given 3 cycles of 250,000 U intrapleural streptokinase; the control group of 23 received pleural drainage only. Pleurodesis with 5 mg of talc slurry was performed in all patients who had lung reexpansion after drainage. Patient characteristics, pleural drainage, lung expansion assessed by chest radiography, and pleurodesis outcomes were compared between the 2 groups. Patient characteristics were similar in both groups. Lung reexpansion was adequate for performing talc pleurodesis in 96% of patients in the fibrinolytic group and 74% in the control group. In the fibrinolytic group, the mean volume of daily pleural drainage before streptokinase administration was 425 mL, and it increased significantly to 737 mL after streptokinase infusion. Intrapleural administration of streptokinase is advisable for patients with malignant pleural effusion.

Objectives We aimed to evaluate the characteristics and management outcomes of patients who developed tracheal stenosis after invasive mechanical ventilation (IMV) due to COVID-19 in this study. Design, settings and participants The data of 7 patients with tracheal stenosis and 201 patients without tracheal stenosis after IMV due to COVID-19 between March 2020 and October 2021 were retrospectively analyzed. Interventions Flexible bronchoscopy was performed for the diagnosis of tracheal stenosis and the evaluation of the treatment's effectiveness and rigid bronchoscopy was applied for the dilatation of tracheal stenosis. Measurements and Main Results In the follow-up period, tracheal stenosis was observed in 7 of 208 patients (2 women, 5 men, 3.3%). The patients were divided into two groups as patients with tracheal stenosis (n=7) and patients without tracheal stenosis (n=201). There was no statistically significant difference between the two groups in terms of age, gender, body mass index (BMI) and comorbidities (p > 0.05). The mean duration of IMV of the patients with tracheal stenosis was longer than patients without tracheal stenosis (27.9 ± 13 vs 11.2 ± 9 days, p < 0.0001, respectively). Three (43%) of the stenoses were web-like and four (57%) of them were complex type stenosis. The mean length of the stenoses was 1.81 ± 0.82 cm. Three of the patients were successfully treated with bronchoscopic dilatation and four of them were treated with tracheal resection. Conclusions Tracheal stenosis developed in 7 (3.3%) of 208 patients with COVID-19 who were treated with IMV. The most important characteristics of patients with tracheal stenosis was prolonged IMV support.