Surgical resection and reconstruction are considered the most appropriate approaches to treat post-intubation tracheal stenosis (PITS). Bronchoscopic methods can be utilized as palliative therapy in patients who are ineligible for surgical treatment or who develop post-surgical re-stenosis. We investigated treatment outcomes in patients with benign tracheal stenosis. A retrospective review was performed in patients who were diagnosed with PITS. Tracheal resection was performed for operable cases, whereas endoscopic interventions were preferred for inoperable cases with a complex or simple stenosis. In total, 42 patients (23 treated by bronchoscopic methods, 19 treated by surgery) took part in this study. No significant differences were observed in segment length, the proportion of obstructed airways, or vocal cord distance between the two groups. In all, 15 patients in the bronchoscopic treatment group received a stent. Following the intervention, the cure rates in the bronchoscopic and surgical treatment groups were 43.47% and 94.7%, respectively. A multidisciplinary approach resulted in a cure or satisfactory outcome in 90.5% of the patients while failure was noted in 9.5% of the patients. Bronchoscopic methods are associated with a lower cure rate compared to surgery. A multidisciplinary approach was helpful for treatment planning in patients with PITS.

Objective Video-assisted thoracoscopic surgery (VATS) has become the standard treatment method for primary spontaneous pneumothorax. Concerns about lesser pain and better cosmesis led to the evolution of uniportal access. This study prospectively compared the results of the uniportal, two-port, and three-port thoracoscopic surgery. Material and Methods One hundred and thirty-five patients were randomized into three groups according to the port numbers. The groups were compared regarding the operation time, hospital stay, amount of drainage, area of pleurectomy, complications, recurrences, and pain scores. Results Except for the amount of drainage (p = 0.03), no factors were found to be statistically significant. The overall recurrence rate was 5%. Although the first and second week pain scores were not statistically significant, the single-incision group patients had significantly less pain at 4, 24, and 72 hours (p < 0.05). Conclusion The study indicated that uniportal VATS approach is less painful and has better cosmetic results, besides it is as efficient as two- or three-port VATS approach.

Transcutaneous electrical nerve stimulation has been used to control post-thoracotomy pain, with conflicting results. We aimed to assess its efficacy on post-thoracotomy pain and early complications. Between January 2012 and December 2014, 87 patients underwent a standard posterolateral thoracotomy and were randomized in 2 groups: group T was 43 patients who had transcutaneous electrical nerve stimulation and group C was 44 patients who had placebo stimulation with an inoperative device. Pain score was measured using a visual analogue scale ranging from 0 to 10. The frequency of the device was set at 100 Hz and pulse width at 100 ms. There were no statistically significant differences in the demographic characteristics of the 2 groups, and there was no difference in the duration of hospitalization (4.74 ± 1.6 vs. 5.23 ± 1.5 days; p = 0.06). Postoperative pain scores of the two groups showed that on postoperative day 0, 1, and 2, the mean pain scores of group T were significantly lower (p = 0.001, p < 0.001, and p = 0.003). There were no significant differences in early complications or surgical technique. We concluded that electrical stimulation is a safe and effective adjunctive therapy for acute post-thoracotomy pain control. However, it does not affect the duration of hospitalization or early pulmonary complications.

Background Carinal resections for non-small cell lung cancer (NSCLC) invading the carina are challenging cases that require a therapeutic strategy. The aim of this study was to compare the oncologic outcomes and complications of patients who underwent carinal resection. Methods Sixty-four patients who underwent carinal resection between 2005 and 2016 were evaluated. Data were retrospectively reviewed for indications, complications, and factors influencing long-term survival. Results The study included 51 patients (79.7%) who underwent sleeve pneumonectomy (sP) and 13 patients who underwent carinal sleeve lobectomy (csL) as a curative therapy. Nine patients (14.1%) received induction chemotherapy. Complications were observed in 31 patients (48.8%), including 24 patients (47.1%) in the sP group and 7 patients (53.8%) in the csL group (p = 0.662). Six patients (9.4%) developed bronchopleural fistula. The 30-day mortality rate was 10.9% (n = 7). The 5- and 10-year survival rates were 42.2 and 23.1%, respectively. N2 and R1 were identified as factors affecting survival (p = 0.029 and p = 0.047). Conclusion Carinal resections have acceptable morbidity, mortality, and long-term survival outcomes in central NSCLC. The main factors affecting survival are complete resection and nodal status. The results of csL were similar to those of sP. Therefore, we believe that csL should be performed in all eligible patients.