Advancement in the Mesothelioma Diagnostics in Primorsko-Goranska County of Croatia

The purpose is to find out whether the diagnostics and registration of patients with mesothelioma in the Littoral – Mountainous County of Croatia corresponds to the world trends. Further, the intention was to show the incidence of the disease and suggest the measures of prevention in the county of 400.000 inhabitants and its center Rijeka with 140.000 people. To that purpose 43 patients with mesothelioma were monitored in two groups: 25 shipyard workers, mean age 66, and 18 workers in other occupations, mean age 62. Statistically the group did not differ significantly in the incidence of placks, left or right side effusion. The pleural puncture showed the significance (p<0.05) for incidence of rouse cells. In 20 patients out of 43 mesothelioma was confirmed by taking the material for pathohistology by means of VATS (video assisted thoracoscopy) and in 14 patients by TTB (transthoracic biopsy) with CT control. Spirometric values showed moderate restrictive difficulties. Although a considerable improvement in diagnosing mesothelioma has been achieved in the last five years an improved prevention activity by occupational medicine is required not only by periodic checkups of the exposed persons and examinations for retired workers with respiratory difficulties, but also by stimulating work case histories

Accuracy of targeted wire guided tube thoracostomy in comparison to classical surgical chest tube placement – a clinical study

BACKGROUND: Chest tube malfunction, after the tube thoracostomy, is often the result of an inappropriate chest tube tip position. The aim of this study was to analyse the precision of chest tube placement using the targeted wire guide technique (TWG technique) with curve dilator and to compare it to the classical surgical technique (CS technique). MATERIALS AND METHODS: In this clinical study 80 patients with an indication for thoracic drainage, due to pneumothorax or pleural effusion were included. Experimental group contained 39 patients whose chest tube was placed using the TWG technique. The control group contained 41 patients whose chest tube was placed using the CS technique. RESULTS: The comparison of the outcomes of the two techniques applied suggests that the TWG technique was significantly more successful in achieving adequate (precise) chest tube placement, irrespective of patient diagnosis (TWG vs. CS in all patients, 78.4% vs. 36.6%, p<0.001). In the pleural effusion group, TWG and CS had success rates of 78.2% and 37.5% (p=0.005), respectively, while in pneumothorax group, TWG and CS had success rates of 78.6% and 35.3% (p=0.029), respectively. CONCLUSIONS: Using a curved dilator and the TWG technique for the thoracic drainage procedure we found statistically significant advantage to the TWG technique in comparison to the CS technique (78% vs. 37%) regarding precise chest tube placement within the pleural cavity. Introducing the materials and technique used in this clinical trial into clinical practice may improve the quality of thoracic drainage, including residual volume of air and/or fluid, poor functioning of the chest tube, and, as a consequence of both, prolonged hospitalisation