Background: Video-Assisted Thoracoscopic Surgery (VATS) has recently occupied a significant place in the surgical treatment of primary pleural empyema (PPE). Patients with anamnesis shorter than 4 weeks have a good chance of being cured only by VATS. As it is not easy to define precisely the beginning of the disease, it is difficult to say strictly to which period VATS method will be successful in PPE treatment. Objective: The aim of this study was to determine the efficacy of the VATS method in the surgical treatment of primary pleural empyema. Methods: The study included 50 patients with findings appropriate for PPE over a period of three years, in whom the VATS method was applied in the surgical treatment of pleural empyema. Results: The established total length of treatment was 13.56 ± 7.98 days and the length of hospital treatment after surgery was 9.90 ± 3.315. The duration of thoracic drainage was 8.06 ± 3.005. Treatment was completed by the primary procedure without additional interventions in 94% of patients. Based on the final outcome, all patients from the clinic were discharged as cured Conclusion: The best time to indicate surgical treatment by using VATS method is history of disease in duration of four weeks Debridement or VATS decortication method is safe and efficient surgical procedure, especially in the first two stages. It is recommended to use this method as the first surgical option for patients in early stages of the disease.

Patients with penetrating explosive lung injuries without metallic foreign bodies shown by a radiogram, with complications as hemoptisis, lung abscess, bronchiectasis, obstruction of the bronchus, chronic pneumonia should be subjected to thoracotomy for removing suspected foreign bodies without resecting the lung.

No abstract

Descending necrotizing mediastinitis (DNM) is a rare, life-threatening form of mediastinitis caused by odontogenic, pharyngeal, or cervical infections. The retropharyngeal space is the most common primary site of infection. Given the fulminant course and high mortality rate, early diagnosis and prompt treatment are important predictors of survival in patients with DNM. Appropriate empirical antibiotic treatment, prompt surgical intervention, and proper management of patients in the intensive care unit can be of vital importance. We present the case of a previously healthy 20-year-old male patient who was successfully cured and discharged from the Clinical Center University of Sarajevo after suffering from a severe form of mediastinitis as a complication of the retropharyngeal abscess caused by anaerobes.