TEA (thoracic epidural analgesia) is considered a basic method of analgesia used in thoracic surgeries. PVB (paravertebral block) is an alternative method. The thesis compares effectiveness of both methods in postoperative analgesia with particular focus on assessment of the postoperative pain management quality. The study involved 2 groups of patients, each consisting of 30 patients undergoing posterolateral thoracotomy. The study group involved patients anesthetized applying PVB method, while the control group involved patients anesthetized with TEA. Hemodynamic and respiratory parameters as well as severity of pain assessed using NRS (numeric rating scale) during the first 3 days after the surgery, number of days of hospitalization, and the need to use additional pain relievers were taken into account in both groups. Evaluation of postoperative pain management quality was performed applying Clinical Quality Indicators in Postoperative Pain Management. No statistical significance was demonstrated between the groups in respect of hemodynamic and respiratory parameters values, the need to use additional pain relievers and the number of days of hospitalization. There was no statistically significant difference between the groups in respect of general assessment of pain management quality, except for the assessment of the lowest level of pain within the last 24 h of measurement. This result in TEA group was statistically significantly lower than the one in PVB group (p = 0.019). In the assessment of postoperative pain management quality both analyzed methods are statistically significantly different only in the category of “lowest level of pain within the last 24 hours of measurement”, to the benefit of TEA group. No statistically significant difference has been observed between the two study groups with respect to the remaining parameters. KB-0012/71/15. Date of registration 22 June 2015.

Uterine leiomyomas may occasionally spread to the lungs forming nodular lesions detectable on chest X-ray. This condition known as benign metastasizing leiomyoma (BML) usually occurs in females with a history of hysterectomy or myomectomy. We present three cases of BML demonstrating the diagnostic process and treatment approaches. Two patients presented with the more common multiple-nodule variant while the other had a single mass, but all were symptom-free. The age of presented patients at diagnosis of BML ranged from 46–53. The first patient was diagnosed with BML at the age of 50, and 12 years prior to the diagnosis, underwent a supracervical hysterectomy. The second patient had a myomectomy at 36, and BML was diagnosed 17 years later at the age of 53. The third patient had a hysterectomy with bilateral salpingo-oophorectomy at the age of 46, with lung lesions present before the hysterectomy. Immunohistochemical studies of postoperative materials showed positive staining of spindle cells with antibodies against desmin and smooth muscle actin, as well as estrogen and progesterone receptors. The final histopathological diagnoses were pulmonary BML. All patients are stable and symptom-free: two at two years follow-up and one at six months follow-up

Basal cell carcinoma (BCC) is the most frequent human skin cancer, but metastasizing BCC (MBCC) is extremely rare, developing in approximately 0.0028% to 0.55% of BCC patients. Herein, we report two cases of pulmonary MBCC. The first one developed in a 72-year-old male who underwent surgical resection due to multiple recurrences and adjuvant radiotherapy. Immunohistochemistry showed that neoplastic cells expressed Ber-EP4, CK5/6, p63, EMA (focally), BCL-2, and CD10, but were negative for CK7, CK20, S100, estrogen and progesterone receptors, and TTF-1. The second case is a 64-year-old female treated with vismodegib. Clinicopathological features and differential diagnoses are described.

Background: Lung cancer is the leading cause of cancer-related death worldwide. Screening with low-dose computed tomography (LDCT) enables early detection of low-stage non-small cell lung cancer (NSCLC), increasing the chances of curative surgery. The aim of the present study was to analyze selected surgical aspects of treatment among patients diagnosed with NSCLC through LDCT-based screening in Szczecin, the first program of this kind in Poland. Methods: A group of 52 patients who were screened and operated on was compared with patients diagnosed and operated on outside the screening program during the same time period and a group of patients diagnosed and operated on prior to the screening program being implemented. Results: The screened population demonstrated a significantly higher frequency of stage IA cancer diagnosis, smaller tumor volume, more lobectomies, and fewer pneumonectomies compared with the other two groups. In addition, the waiting time for surgery was shorter, the duration of the procedure longer, and the length of hospitalization was reduced among the screened patients. No significant differences were observed in postoperative mortality or perioperative complications. Adenocarcinoma occurred significantly more often in the screened population than in the other groups, and tumors were more frequently classified as grade G2. A significant correlation was found between the need for blood transfusion and the occurrence of perioperative complications. Conclusions: The implementation of an LDCT-based screening program for lung cancer has a significant impact on the workload and case profile of thoracic surgery departments. Several aspects of surgical treatment differ significantly between patients diagnosed through screening and patients diagnosed outside of the program.