Neo-carina after carina resection and right upper lobectomy in a patient with adenoid cystic carcinoma: Alternative technique.

Surgical treatment of carinal tumors that extend into the lobar bronchus is a procedure that challenges thoracic surgeons. There is no consensus on the suitable technique for a safe anastomosis in lobar lung resection with carina. The preferred Barclay technique has a high rate of anastomosis-related complications. Although a lobe-sparing end-to-end anastomosis technique has been previously described, the double-barrel method can be applied as an alternative technique. We present a case where we performed double-barrel anastomosis and neo-carina formation after tracheal sleeve right upper lobectomy.

A rare lung tumor: Primary pulmonary synovial sarcoma.

ABSTRACT: Synovial sarcoma is one of the rare soft tissue sarcomas occurring in the periarticular region originating from synovia. Synovial sarcomas occur less frequently in the neck, tongue, larynx, mediastinum, heart, lung, abdominal wall, small intestine, mesentery, and retroperitoneum. Primary pulmonary synovial sarcoma is a poor pathological condition without extrapulmonary involvement. In these rapidly progressing tumors, making quick decisions is important and performing complete resection is the best treatment that contributes to survival. Herein, we present a case of primary pulmonary synovial sarcoma in which we were able to achieve long-term survival with the multimodal approach after complete resection.

Evaluation of diaphragm thickness to predict intubation requirement and mortality in critical COVID-19 patients.

OBJECTIVES: To investigate the value of measuring the diaphragm thickness (DT) on thorax computed tomography (CT) at intensive care unit (ICU) admission for predicting intubation requirement and mortality among COVID-19 patients. METHODS: This study was carried out in Ankara City Hospital, Ankara, Turkey, from September 2020 to January 2021, with 94 critical COVID-19 patients. The patients' demographic characteristics, laboratory parameters, DT measurements, mechanical ventilation (MV) requirements, and mortality statuses were retrospectively screened. The relationships between DT on initial CT, MV requirement, and mortality were investigated. RESULTS: Diaphragm thickness was lower in patients who required intubation after ICU admission than in non-intubated patients (p=0.006); it was also lower in non-survivors (p=0.009). The threshold values for MV need was 3.35 mm (p=0.004) and 3.275 mm for mortality (p=0.006), according to the receiver operating characteristic analysis used to assess the predictive potential of DT. The non-survivor group had a greater neutrophil-to-lymphocyte ratio (p=0.026). Absolute neutrophil count (p=0.017), neutrophil-to-lymphocyte ratio (p=0.010), and interleukin-6 levels (p=0.027) were higher among patients requiring MV than among non-intubated patients. CONCLUSION: Mortality and MV requirements can be predicted from DT measurements. Diaphragm thickness can facilitate the identification of high-risk patients on CT evaluation at ICU admission.