Scientists from all over the world have been intensively working to discover different aspects of Coronavirus disease 2019 (COVID-19) since the first cluster of cases was reported in China. Herein, we aimed to investigate unclear issues related to transmission and pathogenesis of disease as well as accuracy of diagnostic tests and treatment modalities. A literature search on PubMed, Ovid, and EMBASE databases was conducted, and articles pertinent to identified search terms were extracted. A snow-ball search strategy was followed in order to retrieve additional relevant articles. It was reported that viral spread may occur during the asymptomatic phase of infection, and viral load was suggested to be a useful marker to assess disease severity. In contrast to immune response against viral infections, cytotoxic T lymphocytes decline in SARS-CoV-2 infection, which can be partially explained by direct invasion of T lymphocytes or apoptosis activated by SARS-CoV-2. Dysregulation of the urokinase pathway, cleavage of the SARS-CoV-2 Spike protein by FXa and FIIa, and consumption coagulopathy were the proposed mechanisms of the coagulation dysfunction in COVID-19. False-negative rates of reverse transcriptase polymerase chain reaction varied between 3% and 41% across studies. The probability of the positive test was proposed to decrease with the number of days past from symptom onset. Safety issues related to infection spread limit the use of high flow nasal oxygen (HFNO) and continuous positive airway pressure (CPAP) in hypoxic patients. Further studies are required to elucidate the challenging issues, thus enhancing the management of COVID-19 patients.

We present the use of a bi-level, bilateral ultrasound-guided (US-guided) superficial parasternal intercostal plane block (S-PIP) for main anesthetic method in a 71-year-old patient with a C2 vertebral fracture undergoing repair of a sternal fracture. Conscious sedation was provided using midazolam and a remifentanil infusion. The patient had an uneventful recovery and was discharged from the hospital on the first postoperative day without complications. An US-guided S-PIP should be considered when patients are deemed at high risk for general anesthesia, especially in trauma patients with a cervical spine fracture.

Background: The aim of this study was to evaluate the effects of preoperative three-dimensional (3D) modeling on the performance of uniportal video-assisted thoracoscopic bronchial sleeve resection and early postoperative outcomes. Methods: A total of 10 patients (5 males, 5 females; mean age: 53.8±16.9 years; range, 18 to 75 years) who underwent uniportal video-assisted thoracoscopic bronchial sleeve resection with preoperative 3D modeling between April 2021 and November 2023 were retrospectively analyzed. Preoperative 3D modeling was prepared using computed tomography with an open-source 3D software program. Demographic, clinical, intraoperative, and postoperative data of the patients were recorded. Anatomical landmarks identified by preoperative 3D modeling were compared with intraoperative findings. Results: The anatomical landmarks created with the 3D model were in 100% agreement with the intraoperative findings. The procedures performed were three left lower lobes, three right upper lobes, one middle lobe, one right lower lobe, and one parenchyma-sparing intermediate bronchial sleeve resection. Bronchial sleeve resection was completed using uniportal video-assisted thoracoscopic technique in 90% of patients, with only one patient requiring conversion to open thoracotomy. The mean resection time was 264.2±40.5 min, and the mean anastomosis time was 86.0±20.3 min. Anastomosis times decreased with increasing experience (p=0.008). Postoperative atelectasis was observed in two patients, and there was no mortality. The mean follow-up duration was 12.2±11.8 months. Conclusion: Preoperative 3D modeling significantly contributed to the successful implementation of uniportal video-assisted thoracoscopic bronchial sleeve resection surgery. In the future, with advancements in simulation programs, patient-specific 3D modeling is expected to benefit the identification of anatomical landmarks for bronchial sleeve resections.

Evolving diagnostic and therapeutic methods in corrosive esophagitis: Evaluation of a diagnostic and therapeutic algorithm based on 26 years of experience - Turkish Journal of Thoracic and Cardiovascular Surgery

Scapulothoracic bursitis, a rare lesion of the thoracic wall, usually presents as a cystic mass growing at the scapulothoracic interface. Histopathologically, it is characterized by the presence of synovial cells lining the interior of the thickened fibrotic cystic wall and capillary proliferation. A 48-year-old male patient was admitted to our clinic with a complaint of swelling in the back. The magnetic resonance imaging of the lung and mediastinum showed a 43 mm × 130 mm axial lesion in the left infrascapular area between the external muscles and the serratus anterior muscle, hyperintense on T2 sequence, not suppressed on fat-suppressed sequences, with a peripheral minimally contrasted septated collection area. The patient underwent surgical total excision and was discharged on the second postoperative day with no morbidity. Histopathology of the tissue was reported as soft tissue compatible with an inflamed cyst wall with prominent fibroblastic proliferation. Scapulothoracic bursitis lesions can be treated with non-invasive or minimally invasive methods. However, when it becomes a giant lesion occupying space on the thoracic wall and has hemorrhagic content, surgical excision is the treatment of choice.