Background/Objectives: Descending necrotising mediastinitis (DNM) is a severe, life-threatening infection that originates from the oropharyngeal or odontogenic regions and spreads to the mediastinum. It poses significant challenges due to its rapid progression and high morbidity. Methods: This monocentric, retrospective study analysed the records of 22 patients treated for DNM between 2008 and 2022. Diagnosis relied on characteristic clinical, radiological, and intraoperative findings linking oropharyngeal or cervical infections to mediastinitis. Contrast-enhanced computed tomography (CT) was used in all cases for diagnosis. Data collected included demographics, comorbidities, surgical interventions, time from diagnosis to surgery, re-operations, and complications. Microbiological analyses targeted aerobic and anaerobic pathogens. Results: The study included 22 patients (mean age 60 ± 9 years, 59% male) with DNM. The primary sources of infection were oropharyngeal (77%) and odontogenic (23%). Hypertension (86%), diabetes (68%), and cardiac arrhythmias (59%) were common comorbidities. Thoracotomy with mediastinal drainage and debridement was performed in 95% of patients, while 45% underwent cervicotomy and 82% required tracheostomy. The median intensive care unit (ICU) and hospital stays were 21 and 30 days, respectively. Delayed surgery (>24 h) significantly prolonged hospital stays (median: 62 vs. 28 days, p = 0.05). Re-operations were required in 82% of patients, with longer ICU stays observed in this group (median: 25 vs. 7 days, p = 0.003). Sepsis occurred in 55% and was associated with a higher tracheostomy rate (100% vs. 60%, p = 0.029). The mortality rate was 9%. Conclusions: Early recognition and prompt aggressive surgical intervention are paramount in managing DNM to mitigate complications and improve survival.

Background: Pectus excavatum, a deformity of the chest wall, can lead to significant emotional and social challenges, adversely affecting an individual’s overall well-being. While the Nuss procedure is a well-established treatment, this study evaluates the impact of a modified, minimally invasive approach on patients’ quality of life. Methods: This retrospective study analyzed patients who underwent minimally invasive pectus excavatum repair (MIRPE) from 1 January 2010 to 31 January 2024. Collected data included demographics, operative details, and patient outcomes. Health-related quality of life (HRQoL) was assessed using the SF-36 questionnaire, administered preoperatively and at least four weeks post-surgery. Results: Two hundred thirty-four patients (195 male, mean age 20.5 ± 6 years) underwent MIRPE. Postoperative results showed statistically significant improvements in all dimensions of HRQoL (Physical Component Summary Score (PCS) p = 0.007; Mental Component Summary Score (MCS) p < 0.001). Importantly, postoperative HRQoL scores were not just improved but comparable to those of the general German population, providing reassurance and confidence in the effectiveness of MIRPE. Conclusions: This study demonstrates that MIRPE significantly enhances patients’ quality of life (HRQoL). The improvements observed post-surgery bring HRQoL to levels akin to healthy individuals in the German population. These findings underscore the profound positive impact of MIRPE on patients’ well-being, offering hope and optimism for the future of pectus excavatum treatment.

Background: Chest wall resections for malignant chest wall tumors (MCWTs), particularly those with full-thickness chest wall involvement requiring reconstruction, present a therapeutic challenge for thoracic and plastic reconstructive surgeons. The purpose of this study was to review our experience with chest wall resection for primary and metastatic MCWTs, with a focus on perioperative outcomes and postoperative overall survival (OS). Methods: All patients who underwent surgical resection for primary and secondary MCWTs at our single institution between 2000 and 2019 were retrospectively analyzed. Results: A total of 42 patients (25 male, median age 60 years) operated upon with curative (n = 37, 88.1%) or palliative (n = 5, 11.9%) intent were reviewed. Some 33 (78%) MCWTs were of secondary origin. Chest wall reconstruction was required in 40 (95%) cases. A total of 13 (31%) patients had postoperative complications and one (2.3%) died perioperatively. The 5-year postoperative overall survival rate was 51.9%. The postoperative 5-year survival rate of 42.6% in patients with secondary MCWTs was significantly lower compared to the figure of 87.5% in patients with primary MCWTs. Conclusions: In well-selected patients, chest wall resections for primary and secondary MCWTs are feasible and associated with good perioperative outcomes. For secondary MCWTs, surgery can also be performed with palliative intent.