In this retrospective study we analyzed the age-related mortality and the long-term survival of a total of 2021 subjects (male: n=1509; female: n=512) who underwent major pulmonary resections (lobectomy, pneumonectomy) in curative intention for primary non-small cell lung cancer (NSCLC). As controls, patients were divided into three groups of age: subjects >75 years of age (n=119), subjects 65-75 years of age (n=587) and subjects <65 years of age (n=1315). Overall mortality after lobectomy was 1.4% (21/1505 patients); age-related mortality was 0.9% (n=8/919) in subjects aged <65 years, 1.9% (n=9/486) in subjects aged 65-75 years, and 4.0% (n=4/100) in subjects aged >75 years. Overall mortality after pneumonectomy was 4.3% (22/516 patients); age-related mortality was 3.0% (n=12/396) in subjects aged <65 years, 7.9% (n=8/101) in subjects aged 65-75 years, 10.5% (n=2/19) in subjects aged >75 years. The overall 5-year survival rates were 52.5% (age: <65 years), 45.8% (age: 65-75 years), and 50% (age: >75 years). There was no significant difference in overall survival between age groups. However, an impaired performance status (ECOG status grades 1-3) had a significant negative impact on survival in subjects >65 years (p=0.017), and in subjects >75 years (p=0.002). We conclude, medically fit elderly patients should not be denied surgery of resectable non-small cell lung cancer based on their chronologic age alone. Curative pulmonary resections due to lung cancer can be performed safely in those elderly patients that are fulfilling the common criteria of operability.

Background: The purpose of this trial was to compare the feasibility of adjunctive intrapleural instillation of antimicrobial or antibiotic solutions in parapneumonic empyema.Patients and Methods: Patients receiving video-assisted thoracic surgery for parapneumonic empyema stage II were prospectively randomized to either of the following groups: group I (8 patients), postoperative irrigation treatment with Ringer solution; group II (8 patients), instillation of 200 ml Taurolidin 2%: group III (8 patients), instillation of Neomycin/Bacitracin twice a day.Results: Treatment could be given as planned in 8 patients in group I, 6 patients in group II, and 5 patients in group III. No statistically significant differences were obtained when comparing the two groups II and III with Ringer group I. The median chest tube drainage time in group I: 12.5 days, in group II: 13.5 days, and group III: 25 days. The median irrigation duration was 9.5 days in group I, 12.5 days in group II, and 20 days in group III.Conclusions: Postoperative instillation and irrigation of antimicrobial or antibiotic solutions is a feasible method to achieve local cleansing in patients with parapneumonic empyema thoracis. Chest tube drainage time, irrigation duration, and hospitalization time were not improved under Taurolidin or Neomycin/Bacitracin compared with Ringer solution.

Die Therapieziele der Defektdeckung nach Resektion von Thoraxwandmalignomen umfassen neben einer adäquaten Weichteildeckung die Wiederherstellung von Funktion, Integrität, Stabilität und Ästhetik der Thoraxwand. Ziel dieser Arbeit war die retrospektive Analyse von Fällen, welche interdisziplinär nach onkoplastischen Konzepten operiert wurden.

Iatrogene tracheobronchial Verletzungen (TBV) sind im Verhältnis zu der Anzahl vorgenommener Intubationen und endoskopischer Untersuchungen des Tracheobronchialystems seltene Ereignisse. Daher sind die meisten Institutionen mit dem Management dieser potentiell lebensbe-drohlichen Komplikation wenig vertraut. Die Erfahrungen mit der Versorgung der bisher größten, durch eine einzelne Institution versorgten Zahl an Verletzten werden dargestellt.