Primary spontaneous pneumothorax (PSP) is a benign disease frequently found in younger and healthy-looking persons. It requires a surgical treatment in about 30-40% of cases. Video-assisted thoracoscopic surgery (VATS) has been recently introduced as a reliable alternative method to the classic thoracotomy. The aim of this paper is to establish and compare the length of surgical procedure, pain intensity, number and kind of postsurgical complications during the procedure for the patients with PNTX treated by VATS in relation to the patients with PNTX treated by thoracotomy. This is a retrospective study. The patients are divided into two groups: the first group of 50 patients treated with VATS and the second group of 50 patients treated with thoracotomy. The results obtained show a significantly shorter surgery duration in the group of the patients treated with VATS in relation to the group of patients treated by thoracotomy (p < 0.01). Video-assisted thoracoscopic surgery is characterized by a significantly low intensity of postsurgical pain in relation to thoracotomy (p < 0.001). The number and kind of postsurgical complications are similar in both target groups (p > 0.05). Only one relapse occurred in the VATS group. Video-assisted thoracoscopic surgery improves patients' life quality in relation to the thoracotomy patients. The patients return to work, or to sport activities after a very short time because of minimal sequels. That is why this method represents an obvious socio-economic interest. Today, in the era of a great video-development, VATS method is a treatment of choice for PSP.

The aim of this research is to determine: the influence of continuous opiate and intermittent non-opiate postoperative analgesia on thoracic surgical patients' acute phase response, based on acute phase response protein serum values (IL-6 and C-reactive protein) 24, 48 and 72 hours aftersurgery; to analyze the acute phase responses in those thoracic surgical patients in which the postoperative complications have developed and in those in which they haven't. The study itself has a prospective character involving 60 patients divided into two homogenous groups, 30 patients each, which are of the same age, sex, pathological substrate, and are the patients of the University Clinical Centre in Tuzla. The first group of patients were those to whom the non-opiate intermittent analgesia of methamisol natrium was applied, and the second group were the patients to whom the continuous tramadol chloride opiate analgesia was applied after the thoracic surgical procedure had been performed. According to the examined patients and applied types of analgesia, the following results were obtained: CRP values enhanced in both groups, all three measurements, with no significant statistical differences (p = 0.051; p = 0.054; p = 0.1). While the IL-6 values enhanced in all measurements in group I, in group II they remained within reference range, with a significant statistical difference (p = 0.042; p = 0.039; p = 0.035). This study suggests that CRP enhanced values in both groups are the result of the response to surgery. The enhanced IL-6 values in group I, and maintained IL-6 values within reference range in group II, are the result of continuous tramadol chloride opiate analgesia, which turned out to be more efficient and safer.

The objective of this article is to review results of one surgical team for gastric pull-up reconstruction for carcinoma of the hypopharynx and cervical esophagus after pharyngolaryngo-esophagectomy in small thoracic unit. Between July, 2004 and December 2005, four patients underwent pharyngolaryngo-esophagectomy and gastric pull-up reconstruction for carcinoma of hypopharynx and esophagus. There were three female and one male patient with average age at the time of surgery 47 years. The study analyzed complications and mortality in early postoperative period after resections of the carcinoma. Squamous cell cancer in all patients was confirmed. There was no in-hospital mortality and non-fatal complications were occurred in 3 patients. It was recorded two year survival for two patients. Pharyngolaryngo-esophagectomy and gastric pull-up reconstruction can be performed for the patients with carcinoma of the hypopharynx and cervical esophagus with an acceptable operative mortality and morbidity rate even in small thoracic unit. Long term survival despite good early postoperative results still remains poor.

The solve of tracheal stenosis is problem which occupied a big number of experts. In this article was reported a case in which the problem of tracheal stenosis was solved by balloon dilatator which was used in a treatment of esophageal stenosis. We are thinking that esophageal balloon dilatation of trachela stenosis would be a one of the first steps in the problem solving.

The objectives of the study were to identify possible associated respiratory risk factors and to assess incidence of overall postoperative complications after the lung resection. We reviewed 110 patients who underwent lung resections due to malignant neoplasms or benign lung diseases. The risk of postoperative complications was evaluated using the univariate analysis. Results confirmed that low FEV1, postoperative high PaCO2, ASA-status and advanced age were factors associated with development of postoperative complications.

The objectives of the study were to identify possible associated respiratory risk factors and to assess incidence of overall postoperative complications after lung resection. We reviewed 110 patients undergoing lung resections because of malignant neoplasms or benign lung diseases. The risk of postoperative complications was evaluated using unuvariate analysis. Results confirmed that low FEV1, postoperative high PaCO2, ASA-status and advanced age were factors associated with development of postoperative complications.