Background/Objectives: Lung cancer remains the leading cause of cancer-related mortality worldwide, and surgical resection is the primary curative treatment for patients with early-stage non-small cell lung cancer (NSCLC). Patients undergoing lung cancer surgery are frequently affected by malnutrition, systemic inflammation, sarcopenia, and cancer-related cachexia, which may adversely affect postoperative recovery and clinical outcomes. Perioperative immunonutrition has been proposed as a strategy to support immune and metabolic responses associated with surgical stress. This narrative review summarizes current evidence regarding the role of perioperative immunonutrition in patients undergoing lung cancer surgery. Methods: This narrative review summarizes current evidence regarding perioperative immunonutrition in patients undergoing lung cancer surgery. Relevant studies evaluating perioperative immunonutrition, including formulations enriched with arginine, omega-3 fatty acids, glutamine, and nucleotides, were analyzed. Particular attention was given to clinical studies in thoracic surgical oncology, perioperative outcomes, inflammatory response, and current nutritional guideline recommendations. Results: Available evidence suggests that perioperative immunonutrition may improve nutritional and immunological status in patients undergoing lung cancer surgery. Clinical studies have reported reductions in postoperative complications, shorter chest drainage duration, improved nutritional indices, and decreased inflammatory markers in patients receiving immunonutritional support. Experimental and translational studies also indicate potential beneficial effects on immune cell function and inflammatory regulation. However, current thoracic-specific evidence remains limited because of small study populations, heterogeneity of nutritional protocols, and variability in study design. Conclusions: Perioperative immunonutrition appears to be a promising adjunct to comprehensive perioperative care in patients undergoing lung cancer surgery. Although preliminary evidence suggests potential benefits in postoperative recovery and nutritional optimization, its implementation should be individualized according to the patient's nutritional status, disease stage, and overall treatment strategy. As immunonutrition modulates metabolic and immune pathways that may also influence tumor biology, nutritional interventions should be evidence-based, carefully monitored, and integrated within multidisciplinary perioperative care to maximize clinical benefits while minimizing potential unintended effects. Further large, well-designed randomized clinical trials are needed to establish standardized protocols and clarify the role of immunonutrition in thoracic surgical oncology.

Background:Preoperative characterization of solitary pulmonary nodules is critical yet challenging, as distinguishing early-stage neoplasms from benign lesions is essential to prevent unwarranted anatomical resections. The study aimed to analyze the impact of preoperative positron emission tomography-computed tomography (PET-CT) on the incidence of video-assisted thoracoscopic surgery (VATS) lobectomy for unsuspected benign disease, in patients without preoperative diagnosis. Methods:The study included 864 patients, after VATS lobectomy, without the preoperative diagnosis, between January 1, 2014 and December 31, 2020, with 654 receiving preoperative PET-CT and 210 without it. The propensity score matching analysis was done, calculating the predicted probability using: age, sex, cardiovascular comorbidities, previous malignancy, chronic obstructive pulmonary disease (COPD), diabetes, and T category, obtaining equal groups of 210 patients with preoperative PET-CT (PET group) and without preoperative PET-CT (non-PET group). Univariate and multivariate analyses assessed the impact of the various factors on the incidence of benign postoperative diagnosis. Results:No significant difference was found in benign postoperative diagnosis between the PET and non-PET groups [n=6 (2.9%) vs. n=10 (4.8%), P=0.31; risk difference (RD): -0.019, 95% confidence interval (CI): -0.060 to 0.022] In the univariate analysis, younger age [60.75 vs. 65.5 years, P=0.02] and absence of COPD (4.6% vs. 0%, P=0.046), significantly influenced the risk of the postoperative unsuspected benign diagnosis. The younger age emerged as the sole significant risk factor for VATS lobectomy for benign lesions [P=0.042, odds ratio (OR) =1.062; 95% CI: 1.002-1.127]. Conclusions:The use of preoperative PET-CT did not decrease the risk of performing VATS lobectomy on unsuspected benign tumors. That risk should be considered when qualifying for VATS lobectomy, especially in younger patients.

Background:The paradigm of adjuvant treatment for patients in pathological stages II and III of non-small-cell lung cancer has changed toward the adjuvant combination of chemotherapy and immune checkpoint inhibitors, neoadjuvant chemoimmunotherapy, or ultimately periadjuvant chemoimmunotherapy. The introduction of a new standard requires significant changes in preoperative assessment. A real description of its current state in Poland is required, which can form the basis for systemic changes. Objectives:The aim of our study was to analyze the current standards for preoperative assessment in Poland. Design:Observational study. Methods:A comprehensive survey was conducted across seven thoracic surgery centers in Poland, focusing on preoperative pathological examination techniques, imaging methodologies, multidisciplinary team consultations, and the interval between imaging and surgical resection. Results:The survey analyzed data from 459 patients who were operated between January 2024 and October 2024. The most common pathological diagnostic methods were intraoperative frozen section, and preoperative core biopsy. Almost all patients in stages pIA-IIIB had contrast-enhanced computerized tomography (CT) of the chest, positron emission tomography (PET/CT), and bronchoscopy before surgery. In Poland, brain imaging is not a standard part of the preoperative assessment, and brain scans are obtained only exceptionally (pooled median 0% of patients in stages IA-IIIB). The median time between the CT and surgery was 61 days (range 30-90 days), and between PET/CT and surgery 35 days (range 10-66 days). The median time between the surgery and pathological report was 17 days (range 5-30 days). Multidisciplinary tumor boards are organized in the postoperative period for all patients comparing to pooled median 50% in preoperative period. In the vast majority of cases, the expression status of Programmed Death Ligand-1 and next-generation sequencing were carried out only in postoperative samples. Conclusion:Current compliance with perioperative assessment standards in Poland is inadequate. The consequence of this situation may be low availability of perioperative treatment protocols.

This article presents recommendations aimed at reducing the risk of bleeding during bronchoscopy. The document was developed by a working group convened by the Polish Respiratory Society, which included pulmonologists experienced in bronchoscopic procedures, an anesthesiologist, a thoracic surgeon, a cardiologist, a hematologist, a nurse, and methodologists. Clinical questions were formulated according to the PICO (Population, Intervention, Comparison, Outcome) framework, followed by a systematic literature search and critical appraisal of the selected studies. Based on these data, 13 recommendations/good clinical practice points were developed addressing bronchoscopy in patients with thrombocytopenia, abnormal activated partial thromboplastin time or international normalized ratio results, and in those receiving antiplatelet agents, oral anticoagulants, or low-molecular-weight heparin.

Background/Objectives: Recent advancements in immunotherapy have significantly reduced recurrence rates and improved distant outcomes of patients with non-small cell lung cancer. This review synthesizes literature from 2020 to 2025, concentrating on preoperative immunotherapy outcomes. Methods: We analyzed treatment regimens, focusing on primary endpoints, the percentage of patients who underwent initial surgery, type of surgery, R0 rate, immune-related adverse events and chemotherapy-related toxicities as well as the rate of surgery delays and cancelations. Results: Our findings emphasize the importance of optimizing patient selection, effectively managing adverse events, and implementing strategies to minimize surgical delays and cancelations. Conclusions: We defined areas for improvement, such as increasing the implementation of minimally invasive surgeries and avoiding pneumonectomies. These priorities are essential for increasing the efficacy of immunotherapy in surgical settings for NSCLC, and improving patient outcomes.

OBJECTIVES:Postoperative air leak is among the most common complications in thoracic surgery. Current management strategies are often suboptimal. Intrapleural administration of a glucose solution has emerged as a novel therapeutic approach; however, its clinical value has not been thoroughly investigated. This study aimed to compare the effectiveness of intrapleural 40% glucose solution vs autologous blood patch pleurodesis in managing postoperative air leak. METHODS:This prospective, randomized, controlled study enrolled patients who underwent anatomical lung resections (segmentectomy, lobectomy, or bilobectomy) at the Department of Thoracic Surgery, Poznan University of Medical Sciences, between November 2023 and December 2024. Patients with postoperative air leak were randomized to receive either 40% glucose (study group) or autologous blood (control group). The primary end-point was cessation of postoperative air leak. Secondary end-points included incidence of residual air space, chest pain, and reoperation. RESULTS:A total of 110 patients were included: 47 in the glucose group and 63 in the blood group. Glucose administration resulted in a higher rate of postoperative air leak resolution (95.7% vs 82.5%, P = .033; 95% CI: 2.2% to 24.2%). The glucose group had a shorter postoperative hospital stay (7 vs 9 days, P = .036). Chest pain occurred more frequently in the glucose group, but the difference was not statistically significant (10.6% vs 4.8%, P = .24). No major infectious complications were observed. Residual air space occurrence and reoperation rates were comparable. CONCLUSIONS:Intrapleural 40% glucose solution achieved a higher resolution rate of postoperative air leak compared to autologous blood patch pleurodesis, with a comparable safety profile. CLINICAL REGISTRATION NUMBER:NCT06936969 (ClinicalTrials.gov).

Background:Surgery remains the most effective treatment for patients with non-small cell lung cancer (NSCLC). However, pneumonectomy is usually associated with high mortality and morbidity rates. Defining post-operative death after such extensive procedures remains controversial. This study aimed to assess the 30- and 90-day post-pneumonectomy mortality rates. The secondary aim was to identify the most critical factors determining early post-pneumonectomy mortality. Methods:This retrospective, single-institution cohort study was conducted at a high-volume center and included a large group of 514 patients who underwent pneumonectomy for NSCLC from 2006 to 2020. Our analysis considered patient comorbidities, staging, surgical techniques, neoadjuvant chemotherapy, and major complications, and examined their associations with 30- and 90-day mortality rates. We initially performed a univariable Cox regression analysis, followed by multivariable analyses, including variables with P<0.1. Results:The 30- and 90-day mortality was equal to 4.3% and 9.1%, respectively. For 30-day mortality, statistically significant factors included the occurrence of a bronchopleural fistula (BPF) [hazard ratio (HR) =5.128; 95% confidence interval (CI): 2.009-13.087; P<0.001], positive bronchial resection margin (HR =7.917; 95% CI: 2.61-24.01; P<0.001) and the prolonged intubation (>48 hours) (HR =3.822; 95% CI: 1.06-13.785; P=0.041). For the 90-day mortality, the presence of the BPF (HR =5.284; 95% CI: 2.706-10.318; P<0.001), positive bronchial resection margin (HR =3.528; 95% CI: 1.370-9.083; P=0.009), chest wall infiltration (HR =3.770; 95% CI: 1.121-12.676; P=0.03), and prolonged intubation (>48 hours) (HR =2.912; 95% CI: 1.102-7.649; P=0.03) were the statistically significant risk factors. Conclusions:A 90-day follow-up period should be considered when assessing short-term mortality rates after major pulmonary resections. Monitoring long-term mortality is important, as the mortality rate in our group doubled after 3 months. BPF, prolonged intubation, chest wall infiltration, and positive bronchial resection margin significantly increase the risk of 30- and 90-day mortality rates.

Lung cancer remains a major health challenge despite recent advances in diagnostics and treatment. Surgical resection, particularly in early stages, offers the best chance for cure. Enhanced Recovery After Surgery (ERAS) programs have been shown to improve outcomes in various surgical areas. This narrative review summarizes current evidence on the role of prehabilitation within ERAS for lung cancer surgery and presents the organizational model from a high-volume academic thoracic surgery center. Key elements of prehabilitation include smoking cessation, nutritional optimization, physical activity enhancement, and patient education, all delivered by a multidisciplinary team. Despite organizational challenges, preoperative ERAS programs demonstrate benefits for patients and hospitals, supporting their broader implementation in thoracic surgery.

Background: Malnutrition is a prevalent yet often overlooked issue in lung cancer patients, significantly affecting surgical outcomes. This review examines the impact of nutritional status on lung cancer surgery and explores the role of nutritional assessment and intervention strategies. Methods: A comprehensive literature search was conducted using databases such as PubMed, Scopus, and Web of Science. Key studies on nutritional status assessment, preoperative nutritional support, and their impact on surgical outcomes were analyzed. Results: Malnutrition in lung cancer patients is associated with increased postoperative complications, prolonged hospital stays, and reduced survival rates. Various assessment tools, including dietary interviews, physical examinations, laboratory tests, and body composition analyses, can help identify malnourished patients. Nutritional support strategies such as high-protein diets, oral supplements, enteral and parenteral nutrition, and perioperative immunomodulation improve clinical outcomes. Conclusions: Implementing standardized nutritional assessment and support protocols is crucial for optimizing surgical outcomes in lung cancer patients. Integrating these strategies into the Enhanced Recovery After Surgery (ERAS) protocol may further enhance recovery and long-term prognosis.

Introduction: The outcomes of lung cancer surgery depend on the patients' nutritional status. Body fat percentage (BF%) is one of the indicators of body composition and nutritional status. Direct measurement of BF% is complicated, requires significant resources and is rarely performed. The CUN-BAE (Cl & iacute;nica Universidad de Navarra - Body Adiposity Estimator) index has been shown to accurately predict BF% is several clinical settings, but its relation to the outcomes of lung surgery has not been reported so far. Aim: To determine the relation of the BF% to the outcomes of thoracoscopic lobectomy. Material and methods: This retrospective study included 1,183 patients who underwent thoracoscopic lobectomy for non -small cell lung cancer between June 1999, and September 2019 at one department. BF% was calculated according to the Cl & iacute;nica Universidad de Navarra - Body Adiposity Estimator equation. The primary endpoints were postoperative complications and long-term survival. Results: Univariate analysis showed that higher BF% was related to lower incidence of complications (p = 0.001), including prolonged air leak (p < 0.001), atelectasis (p < 0.05), psychosis (p < 0.001), reoperations (p < 0.05), and shorter chest drainage (p = 0.001) and hospitalization duration (p < 0.001). Multivariate analysis showed that higher BF% was correlated with lower risk of complications (p = 0.005; OR = 0.964; 95% CI: 0.940 to 0.989), including prolonged air leak (p < 0.001; OR = 0.923; 95% CI: 0.886 to 0.962), and shorter duration of chest drainage (p < 0.001; B = -0.046; 95% CI: -0.069 to -0.023) and hospitalization (p < 0.001; B = -0.112; 95% CI: -0.176 to -0.048). Cox proportional hazards regression analysis showed that BF% was not related to long-term survival. Conclusions: Body fat percentage is a valuable tool that can help predict the short-term outcomes of minimally lobectomy for lung cancer.

Background: Sleeve resection is currently the gold standard procedure for centrally located non-small cell lung cancer (NSCLC). Extended sleeve lobectomy (ESL) consists of an atypical bronchoplasty with resection of >1 lobe and carries several technical difficulties compared with simple sleeve lobectomy (SSL). Our study compared the outcomes of ESL and SSL for NSCLC. Methods: This multicenter, retrospective, cohort study included 1314 patients who underwent ESL (155 patients) or SSL (1159 patients) between 2000 and 2018. The primary end points were 30-day and 90-day mortality, overall survival (OS), disease-free survival (DFS), and complications. Results: No differences were found between the 2 groups in general characteristics and surgical and survival outcomes. In particular, there were no differences in early and late complication frequency, 30- and 90-day mortality, R status, recurrence, OS (54.26 +/- 33.72 months vs 56.42 +/- 32.85 months, P = .444), and DFS (46.05 +/- 36.14 months vs 47.20 +/- 35.78 months, P = .710). Mean tumor size was larger in the ESL group (4.72 +/- 2.30 cm vs 3.81 +/- 1.78 cm, P < .001). Stage IIIA was the most prevalent stage in ESL group (34.8%), whereas stage IIB was the most prevalent in SSL group (34.3%; P < .001). The multivariate analyses found nodal status was the only independent predictive factor for OS. Conclusions: ESL gives comparable short- and long-term outcomes to SSL. Appropriate preoperative staging and exclusion of metastases to mediastinal lymph nodes, as well as complete (R0) resection, are essential for good long-term outcomes.

Lymphadenectomy is an essential part of complete surgical operation for non-small cell lung cancer (NSCLC). This retrospective, multicenter cohort study aimed to identify factors that influence the lymphadenectomy quality. Data were obtained from the Polish Lung Cancer Study Group Database. The primary endpoint was lobe-specific mediastinal lymph node dissection (L-SMLND). The study included 4271 patients who underwent VATS lobectomy for stage IA NSCLC, operated between 2007 and 2022. L-SMLND was performed in 1190 patients (27.9%). The remaining 3081 patients (72.1%) did not meet the L-SMLND criteria. Multivariate logistic regression analysis showed that patients with PET-CT (OR 3.238, 95% CI: 2.315 to 4.529; p < 0.001), with larger tumors (pT1a vs. pT1b vs. pT1c) (OR 1.292; 95% CI: 1.009 to 1.653; p = 0.042), and those operated on by experienced surgeons (OR 1.959, 95% CI: 1.432 to 2.679; p < 0.001) had a higher probability of undergoing L-SMLND. The quality of lymphadenectomy decreased over time (OR 0.647, 95% CI: 0.474 to 0.884; p = 0.006). An analysis of propensity-matched groups showed that more extensive lymph node dissection was not related to in-hospital mortality, complication rates, and hospitalization duration. Actions are needed to improve the quality of lymphadenectomy for NSCLC.

The Nuss procedure is the most common corrective surgery for pectus excavatum. We analyzed treatment outcomes and complication rates in 1238 patients treated with the Nuss procedure from 2002 to 2021, focusing on the number of corrective bars used. Using Propensity Score Matching based on age, sex, BMI, pre-operative FEV1, and the Haller index, we created two groups: 546 patients with a single bar and 546 with two bars. Both groups achieved similar correction effects (Haller index: single bar = 2.58 vs. two bars = 2.56; p = 0.65). In the univariate analysis, in the two-bar group, the postoperative complications were observed more often (28.6% vs. 15.4%, p < 0.001), including pneumothorax (11.2% vs. 6.2%, p < 0.001), hemothorax (3.7% vs. 0.7%, p < 0.001), additional drainage (13.7% vs. 5.3%, p < 0.001), the need for thoracentesis (8.6% vs. 2.9%, p < 0.001), bar displacement (3.8% vs. 0.7%, p < 0.001), pleural effusion (10.6% vs. 3.1%, p < 0.001), and fever (6.6% vs. 3.8%, p < 0.041). In the logistic regression, two bars significantly increased the risk of postoperative complications (p = 0.019), including hematoma (p = 0.036), pleural effusion (p = 0.002), and the need for thoracentesis (p = 0.013). Using two corrective bars during the Nuss procedure is associated with a higher rate of postoperative complications but similar corrective results.

&lt;b&gt;Introduction:&lt;/b&gt; The bronchopleural fistula (BPF) remains one of the most severe complications after pneumonectomy. Several surgical methods may enhance bronchial stump healing and reduce the occurrence of BPF. Usually, surgeons use tissue buttressing, such as intercostal muscle flap (IMF), parietal pleura, pericardium fat pad, or mediastinal fat, to reinforce the bronchial stump. This paper reviews the literature describing the impact of different buttressing tissues on the occurrence of early post-pneumonectomy BPF.&lt;b&gt;Material and methods:&lt;/b&gt; We included all studies that described the use of bronchial stump buttressing in patients after pneumonectomy. Studies written in languages other than English were excluded. The search was performed using PubMed, Google Scholar, Embase, COCHRANE databases, and the clinical trial registry on December 1, 2023. We used the following search input: &quot;lung cancer&quot; AND &quot;pneumonectomy&quot; AND (&quot;bronchopleural fistula&quot; OR &quot;BPF&quot;) AND (&quot;tissue buttressing&quot; OR &quot;intercostal muscle flap&quot; OR &quot;mediastinal fat pad&quot;). We analysed the types of studies, the numbers of patients, and the most important conclusions. We performed descriptive statistics.&lt;b&gt;Results:&lt;/b&gt; Twenty-seven articles on the use of bronchial tissue buttressing were identified. Nine papers were rejected due to small sample size (&lt; 20 patients), surgical operation other than pneumonectomy or lobectomy, or papers older than 30 years. Ultimately, 16 articles were included in the analysis. Among them, three papers highlighted the statistically significant influence of bronchial stump buttressing in reducing the risk of BPF formation. Descriptive statistics were reported in nine studies, and two papers included the assessment of the blood perfusion in the buttressing tissue. Only one study was a randomized trial featuring a control group for comparison.&lt;b&gt;Discussion:&lt;/b&gt; Buttressing the bronchial stump remains a controversial issue in thoracic surgery. It could be beneficial for high-risk patients. Among different tissues, the ideal one has still not been identified. Future research should incorporate control groups and intraoperative assessments of the blood supply to the tissue employed for bronchial buttressing.

Background: Division of the pulmonary ligament is standard in lower lobectomies, but its application in upper lobectomies remains controversial due to potential complications like atelectasis and bronchial kinking. This retrospective matched cohort study aimed to evaluate the efficacy and safety of ligament resection in upper lobectomies for oncological purposes. Methods: From January 2015 to December 2020, 988 patients who underwent minimally invasive upper lobectomies across multiple centers were identified. They were categorized into ligament resection and no ligament resection groups, with propensity score matching (PSM) to minimize confounding factors. Endpoints included operative time, pleural effusion, complications (frequency and Clavien-Dindo scores), chest drainage removal, length of stay, pleural space, collapse rate, and bronchial kinking. Results: Following PSM, 276 patients were included in each group, with no significant differences in baseline characteristics. Ligament resection correlated with longer operative times, increased lymphadenectomy sampling at station #9 (p < 0.001), and a bigger change in the bronchial angle (p < 0.001). No statistically significant differences were observed for the other endpoints. Conclusions: Ligament resection during upper lobectomy may impact the bronchial angle without immediate postoperative outcome changes. Further research is necessary to comprehensively assess the risks and benefits of ligament resection in upper lobectomies for neoplastic disease.

Biobanks are vital for high-throughput translational research, but the rapid development of novel molecular techniques, especially in omics assays, poses challenges to traditional practices and recommendations. In our study, we used biospecimens from oncological patients in Polish clinics and collaborated with the Indivumed Group. For serum/plasma samples, we monitored hemolysis, controlled RNA extraction, assessed cDNA library quality and quantity, and verified NGS raw data. Tissue samples underwent pathologic evaluation to confirm histology and determine tumor content. Molecular quality control measures included evaluating the RNA integrity number, assessing cDNA library quality and quantity, and analyzing NGS raw data. Our study yielded the creation of distinct workflows for conducting preanalytical quality control of serum/plasma and fresh-frozen tissue samples. These workflows offer customization options to suit the capabilities of different biobanking entities. In order to ensure the appropriateness of biospecimens for advanced research applications, we introduced molecular-based quality control methods that align with the demands of high-throughput assays. The novelty of proposed workflows, rooted in innovative molecular techniques, lies in the integration of these QC methods into a comprehensive schema specifically designed for high-throughput research applications.

Non-small cell lung cancer (NSCLC) encompasses distinct histopathological subtypes, namely adenocarcinoma (AC) and squamous cell lung carcinoma (SCC), which require precise differentiation for effective treatment strategies. In this study, we present a novel molecular diagnostic model that integrates tissue-specific expression profiles of microRNAs (miRNAs) obtained through next-generation sequencing (NGS) to discriminate between AC and SCC subtypes of NSCLC. This approach offers a more comprehensive and precise molecular characterization compared to conventional methods such as histopathology or immunohistochemistry. Firstly, we identified 31 miRNAs with significant differential expression between AC and SCC cases. Subsequently, we constructed a 17-miRNA signature through rigorous multistep analyses, including LASSO/elastic net regression. The signature includes both upregulated miRNAs (hsa-miR-326, hsa-miR-450a-5p, hsa-miR-1287-5p, hsa-miR-556-5p, hsa-miR-542-3p, hsa-miR-30b-5p, hsa-miR-4728-3p, hsa-miR-450a-1-3p, hsa-miR-375, hsa-miR-147b, hsa-miR-7705, and hsa-miR-653-3p) and downregulated miRNAs (hsa-miR-944, hsa-miR-205-5p, hsa-miR-205-3p, hsa-miR-149-5p, and hsa-miR-6510-3p). To assess the discriminative capability of the 17-miRNA signature, we performed receiver operating characteristic (ROC) curve analysis, which demonstrated an impressive area under the curve (AUC) value of 0.994. Our findings highlight the exceptional diagnostic performance of the miRNA signature as a stratifying biomarker for distinguishing between AC and SCC subtypes in lung cancer. The developed molecular diagnostic model holds promise for providing a more accurate and comprehensive molecular characterization of NSCLC, thereby guiding personalized treatment decisions and improving clinical management and prognosis for patients.

AMA Kwiatkowska N, Kaminska A, Sielewicz M, Kasprzyk M, Piwkowski C. Boerhaave syndrome complicated by subsequent esophageal stenosis and esophageal fistula. Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery. 2023;20(4):274-276. doi:10.5114/kitp.2023.134167. APA Kwiatkowska, N., Kaminska, A., Sielewicz, M., Kasprzyk, M., & Piwkowski, C. (2023). Boerhaave syndrome complicated by subsequent esophageal stenosis and esophageal fistula. Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery, 20(4), 274-276. https://doi.org/10.5114/kitp.2023.134167 Chicago Kwiatkowska, Natalia Maria, Alicja Kaminska, Magdalena Sielewicz, Mariusz Kasprzyk, and Cezary Piwkowski. 2023. "Boerhaave syndrome complicated by subsequent esophageal stenosis and esophageal fistula". Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery 20 (4): 274-276. doi:10.5114/kitp.2023.134167. Harvard Kwiatkowska, N., Kaminska, A., Sielewicz, M., Kasprzyk, M., and Piwkowski, C. (2023). Boerhaave syndrome complicated by subsequent esophageal stenosis and esophageal fistula. Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery, 20(4), pp.274-276. https://doi.org/10.5114/kitp.2023.134167 MLA Kwiatkowska, Natalia Maria et al. "Boerhaave syndrome complicated by subsequent esophageal stenosis and esophageal fistula." Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery, vol. 20, no. 4, 2023, pp. 274-276. doi:10.5114/kitp.2023.134167. Vancouver Kwiatkowska N, Kaminska A, Sielewicz M, Kasprzyk M, Piwkowski C. Boerhaave syndrome complicated by subsequent esophageal stenosis and esophageal fistula. Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery. 2023;20(4):274-276. doi:10.5114/kitp.2023.134167.

Objectives Coronavirus disease 2019 (COVID-19) can irreversibly damage the lungs and could possibly increase the risk of surgical treatment of lung cancer. The study aimed to assess the relationship between preoperative COVID-19 and complications and early outcomes of lung cancer surgery. Methods This single-center cohort study included 444 patients who underwent lobectomy or segmentectomy for primary lung cancer from January 1, 2019 to December 31, 2021. The exclusion criteria were pneumonectomy, extended resection, and wedge resection. The groups of patients with ( n = 72) and without ( n = 372) the history of COVID-19 prior to surgery were compared. The groups were similar in terms of distribution of baseline, surgical and histopathological characteristics. The primary endpoint was the incidence of postoperative complications. Secondary endpoints were outcomes at discharge and at 90 days. Results The incidence of postoperative complications did not differ between the groups of patients with and without COVID-19 history (30.6% vs 29.3%, p = 0.831). Outcomes at discharge and at 90 days after surgery did not differ between the groups. Among the patients with and without prior COVID-19, 97.2 and 99.5% were alive at discharge ( p = 0.125), and 97.2% and 98.1% ninety days after surgery ( p = 0.644), respectively. Patients with COVID-19 history more often required re-drainage (6.9% v 2.2%, p = 0.044) and reoperation (5.6 v 1.3%, p = 0.042). Conclusions COVID-19 history is not related to the general incidence of complications, outcomes at discharge from the hospital, and at 90-days after surgery.