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Regional nerve blocks (NBs) mitigate the occurrence of postoperative cognitive dysfunction (POCD) and postoperative delirium (POD) in adult patients undergoing thoracic surgery. This study aimed to determine the exact effect of NBs on POCD and POD. Electronic databases, including PubMed, EMBASE, CINAHL, Scopus, and Web of Science, were searched for studies. The primary outcome was the incidence of POD or POCD. The secondary outcome was pain scores assessed 24 and 48 h postoperatively. We calculated the log odds ratio (LOR) and standardized mean difference (SMD) with 95% confidence intervals (CIs). The LOR was converted to an odds ratio (OR). In the analysis of 1010 patients from seven randomized controlled trials, POD and POCD rates were 14.1% and 16.7%, respectively, in the NB group, and higher, at 27.3% and 35.2%, in the control group. NBs reduced the incidence of POD (OR, 0.44; 95%CI 0.30 to 0.64; < 0.001; I = 0.00%) and POCD (OR, 0.43; 95%CI 0.24 to 0.76; < 0.001; I = 0.00%). NBs reduced pain scores at 24 h (SMD, -2.60; 95%CI -3.90 to -1.30, < 0.001; I = 97.68%) and 48 h (SMD, -1.80; 95%CI -3.18 to -0.41, = 0.01; I = 98.14%) postoperatively. NBs mitigated the occurrence of POD and POCD in adult patients after thoracic surgery.
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http://dx.doi.org/10.3390/jcm12247576 | DOI Listing |
Gen Thorac Cardiovasc Surg
September 2025
Department of General Thoracic Surgery, Seirei Hamamatsu General Hospital, 2-12-12, Hamamatsu, Shizuoka, 430-8558, Japan.
Thoracoscopic surgery for stage III acute empyema is often limited by poor visualization and anatomical complexity. We developed a standardized, minimally invasive approach using a variable-view rigid endoscope and fixed port placement, regardless of disease extent or patient physique. The variable-view endoscope enabled a wide, adjustable field of view without moving the camera shaft, allowing safe access even in the confined thoracic space.
View Article and Find Full Text PDFMinerva Anestesiol
September 2025
Department of Cardiac, Thoracic and Vascular Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Background: Postoperative cognitive dysfunction (POCD) occurs in 20% to 80% of patients following cardiac surgical interventions. The incidence of delirium is from 20% to 50%. Impaired cerebral autoregulation (CA) during cardiopulmonary bypass (CPB) contributes to these issues.
View Article and Find Full Text PDFInt J Surg
September 2025
Department of Respiratory and Critical Care Medicine, Hubei Province Clinical Research Center for Major Respiratory Diseases, Key Laboratory of Pulmonary Diseases of National Health Commission, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
Background: Precise preoperative discrimination of invasive lung adenocarcinoma (IA) from preinvasive lesions (adenocarcinoma in situ [AIS]/minimally invasive adenocarcinoma [MIA]) and prediction of high-risk histopathological features are critical for optimizing resection strategies in early-stage lung adenocarcinoma (LUAD).
Methods: In this multicenter study, 813 LUAD patients (tumors ≤3 cm) formed the training cohort. A total of 1,709 radiomic features were extracted from the PET/CT images.
Int J Surg
September 2025
Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China.
Background: Phrenic nerve injury during mediastinal tumor resection can lead to significant postoperative diaphragmatic dysfunction. Current intraoperative protection techniques are imprecise and lack real-time feedback. We aimed to develop and validate a quantifiable, multimodal neuroprotective strategy.
View Article and Find Full Text PDFInt J Surg
September 2025
Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
Background: Percutaneous transthoracic lung biopsy (PTNB) guided by Computed Tomography (CT) greatly depends on the operators' skill for accuracy. This study aimed to evaluate whether three-dimensionally(3D) printed navigational templates for percutaneous transthoracic lung biopsy achieve diagnostic yield comparable to conventional computed tomography guidance.
Materials And Methods: Conducted from 1 November 2020, to 27 July 2023, this noninferiority randomized clinical trial included 159 patients with peripheral lung masses (≥30 mm).