Background: Pulmonary circulation typically shows flow divided between the right and left lungs, with a marked predominance of the right lung. Pneumonectomy reduces pulmonary circulation by ~50%, irreversibly changing the pulmonary perfusion characteristics. Here we assessed pulmonary flow after pneumonectomy and investigated how selected factors influenced pulmonary perfusion in this patient group. Methods: This study included 31 patients who underwent pneumonectomy complicated by postpneumonectomy pleural empyema, which was successfully treated, with long-term survival. Testing was conducted at a median of 1100 days after pneumonectomy, after flow stabilization. The control group comprised 31 subjects without pulmonary pathology. Pulmonary flow was assessed by scintigraphy using Technetium (99m-Tc). Results: The average single lung perfusion after pneumonectomy corresponded to the total perfusion in both lungs in the control group without statistic difference between comparable parameters (upper field, 21.35 vs. 22.129, p = 0.4; middle field, 47.15 vs. 49.62, p = 0.099; lower field 30.71 vs. 28.29, p = 0.14). Compared to those with left-sided pneumonectomy, patients with right-sided pneumonectomy exhibited increased upper field perfusion (22.61 vs. 19.82, p = 0.049) and decreased perfusion in the lower field (30.81 vs. 26.22, p = 0.049) and the combined middle and lower field (79.63 vs. 76.49, p = 0.046). Pulmonary flow was not significantly related to age, side of surgery, or empyema duration. Conclusions: Flow rate in the remaining lung after pneumonectomy corresponded to the total flow in both lungs in healthy controls. The perfusion ratio differed after right-sided versus left-sided pneumonectomy, which may be related to the initial anatomical differences of the right and left lung.

Human echinococcosis is a zoonotic disease caused by accidental ingestion of tapeworm eggs of the genus Echinococcus, shed in the feces of animal definitive host. In the human duodenum, these eggs release oncospheres, which penetrate the intestinal wall and via the bloodstream reach the liver—the most common site for development of cysts. However, it is important to remember that any other organ can be affected via the bloodstream, due to larvae size. In Europe, the most diagnostically relevant species are Echinococcus granulosus, with a median incidence of 0.6 cases per 100,000 inhabitants, and Echinococcus multilocularis, with 0.1 cases per 100,000 inhabitants. This article aims to describe an exceptionally unusual location of human cystic echinococcosis in the anterior mediastinum. We describe the role of multidisciplinary diagnostics in establishing the definitive diagnosis. The pathomorphological examination, radiological imaging and serological testing for diagnosing cystic echinococcosis are hereby described. It is particularly important to avoid reporting unspecified Echinococcus (NOS) if possible, as the management and treatment of patients with echinococcosis varies depending on the species.

Refractory thoracic infections require targeted antimicrobial combinations, repeated drainage interventions and often staged surgical procedures of varying complexity grades. In necrotizing pneumonia cases, successful treatment is complete removal of destroyed non-functional parenchyma, pleural cavity debridement, and complete pathogen eradication based on culture-based sensitivity-driven antimicrobials. The latter proves challenging in pan-resistant microbial strains where both medical and surgical treatments demonstrate limited effectiveness. We describe a case of persistent thoracic sepsis due to pan-resistant Pseudomonas receiving sequentially thoracoscopic decortication, thoracotomy for lobectomy, and open thoracostomy as the last treatment option to prevent fatal sepsis in view of non-available antibiotics. The immediate source-control effect raised the question of the ideal timing for selecting an aggressive thoracoplastic procedure despite its deforming nature over any other treatment approach.

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.