Kardiochirurgia I Torakochirurgia Polska最新文献

{"title":"Current trends in hybrid coronary revascularization.","authors":"Magdalena Synak, Mateusz Hulbój, Witold Gerber, Paweł Kaźimierczak, Piotr P Buszman, Krzysztof Sanetra","doi":"10.5114/kitp.2025.154849","DOIUrl":"10.5114/kitp.2025.154849","url":null,"abstract":"<p><strong>Introduction: </strong>Hybrid coronary revascularization (HCR) is a combined approach for multivessel coronary artery disease (MVD), integrating surgical grafting of the left internal mammary artery (LIMA) to the left anterior descending artery (LAD) with percutaneous coronary intervention (PCI) for non-LAD lesions. It aims to reduce invasiveness while maintaining effectiveness.</p><p><strong>Aim: </strong>To summarize current evidence on the safety, effectiveness, and clinical outcomes of HCR compared to coronary artery bypass grafting (CABG), PCI, and off-pump coronary artery bypass (OPCAB).</p><p><strong>Methods: </strong>A review of current literature including clinical trials, meta-analyses, and observational studies was conducted. Focus was placed on procedural techniques, patient selection, and outcomes.</p><p><strong>Results: </strong>HCR is associated with shorter hospital stays, reduced bleeding, and faster recovery compared to CABG. Compared to PCI, it shows improved LAD patency and fewer repeat interventions. Outcomes are similar to OPCAB, with lower myocardial injury. Despite its benefits, HCR remains underused due to technical demands and limited availability of hybrid facilities.</p><p><strong>Conclusions: </strong>Further randomized trials are needed to confirm its long-term safety, effectiveness, and cost-efficiency.</p>","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":"22 3","pages":"190-198"},"PeriodicalIF":1.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12670225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ChatGPT-3.5 and the Polish thoracic surgery specialty examination: a performance evaluation.","authors":"Adam Mitręga, Dominika Kaczyńska, Mikołaj Magiera, Natalia Denisiewicz, Michał Bielówka, Anna Kożuch, Miłosz Korbaś, Aleksandra Gaweł, Jakub Kufel","doi":"10.5114/kitp.2025.154986","DOIUrl":"10.5114/kitp.2025.154986","url":null,"abstract":"<p><strong>Introduction: </strong>The incredibly rapid development of artificial intelligence (AI) in recent years has created new opportunities for its application in medical advancements. This raises questions about the reliability and limitations of AI.</p><p><strong>Aim: </strong>The aim of the present study was to evaluate the effectiveness of the ChatGPT-3.5 language model in solving the test component of the National Specialist Examination (PES) in the field of thoracic surgery.</p><p><strong>Material and methods: </strong>A total of 120 test questions from 2015 PES examination were analyzed. They were grouped according to subject matter, clinical character, and cognitive requirements. In independent sessions, each question was submitted five times. The following statistical tests were applied: χ², Kruskal-Wallis, Mann-Whitney and Spearman's rank correlation. The consistency of the answers was assessed using Fleiss' k coefficient.</p><p><strong>Results: </strong>The AI tool achieved a score of 42.2% correct answers, with the passing threshold set at 60%. A statistically significant difference was found between clinical and non-clinical questions (<i>p</i> = 0.041). Correct answers were characterized by a higher confidence coefficient (<i>p</i> < 0.001). No correlation was observed between confidence and psychometric indicators. The response consistency was assessed as moderate (k = 0.341).</p><p><strong>Conclusions: </strong>The result obtained by ChatGPT-3.5 is equivalent to a failing score on the examination. The confidence of responses correlated with their correctness, whereas limitations in clinical knowledge and consistency indicate the need for caution when using this model to assess specialized knowledge.</p>","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":"22 3","pages":"169-173"},"PeriodicalIF":1.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12670230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can artificial intelligence models predict hospital stays following non-small cell lung carcinoma surgery?","authors":"Gizem Özçıbık Işık, Onur S Özçıbık, Tülay Yıldırım, Burcu Kılıç, Ezel Erşen, Mehmet K Kaynak, Akif Turna, Hasan V Kara","doi":"10.5114/kitp.2025.155014","DOIUrl":"10.5114/kitp.2025.155014","url":null,"abstract":"<p><strong>Introduction: </strong>The hospitalization day after non-small cell lung carcinoma surgery is important in terms of medical, financial, and social aspects.</p><p><strong>Aim: </strong>Our study aimed to accurately and successfully predict the rate of postoperative hospitalization shorter than 9 days versus longer than 9 days using artificial intelligence algorithms.</p><p><strong>Material and methods: </strong>The study included 953 patients who underwent surgery for non-small-cell lung carcinoma between 2001 and 2023. The patients' input data consisted of clinical data, laboratory data, respiratory parameters, and radiological and pathological data. The output data included the hospitalization date. We used a fully connected neural network and the k-layer validation method.</p><p><strong>Results: </strong>The algorithm's training data had a sensitivity value of 90.3%, a positive predictive value of 87.8%, and an accuracy value of 82.6%. The algorithm's F1 1 score was 89.0%, the F1 0 value was 58.3%, and the F1 mean score was 73.6% for the training data. For the test data, the algorithm's sensitivity value was 83.8%, the positive predictive value was 88.6%, and the accuracy value was 78.7%. The F1 1 score was 86.1%, the test F1 0 score was 54.5%, and the F1 average score was 70.3%. The algorithm for the test data created a ROC curve with an area under the curve of 0.82 (AUC = 0.82).</p><p><strong>Conclusions: </strong>Artificial intelligence algorithms determined the length of hospital stay after non-small cell lung carcinoma surgery with high accuracy and confidence. During the preoperative period, the estimation of hospital stay length will contribute to personalized patient care.</p>","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":"22 3","pages":"163-168"},"PeriodicalIF":1.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12670233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comments on \"The diagnostic value of thoracic ultrasound in thoracic surgery consultations: a new tool in pleural effusion decision-making\".","authors":"Çağrı Zorlu","doi":"10.5114/kitp.2025.154834","DOIUrl":"10.5114/kitp.2025.154834","url":null,"abstract":"","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":"22 3","pages":"239"},"PeriodicalIF":1.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12670223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimodal treatment strategies in generalized lymphatic anomaly with pleural effusion: a case study and literature review.","authors":"Szymon W Tobor, Dariusz Basek, Lidia Hyla-Klekot, Zbigniew Olczak, Tomasz Koszutski","doi":"10.5114/kitp.2025.154976","DOIUrl":"10.5114/kitp.2025.154976","url":null,"abstract":"","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":"22 3","pages":"216-221"},"PeriodicalIF":1.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12670232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidisciplinary management of acute type A aortic dissection in a pregnant woman with Marfan syndrome.","authors":"Mikołaj Jodłowski, Adam R Kowalówka, Konrad Mendrala, Anna Bednarek, Tomasz Darocha, Ryszard Bachowski, Radoslaw Gocol","doi":"10.5114/kitp.2025.154805","DOIUrl":"10.5114/kitp.2025.154805","url":null,"abstract":"","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":"22 3","pages":"236-238"},"PeriodicalIF":1.3,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12670228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breast implant rupture during coronary artery bypass grafting in a transgender woman.","authors":"Osman Fehmi Beyazal, Percin Karakol, Serap Bas, Selman Sadi Cıtak, Yasin Canbaz","doi":"10.5114/kitp.2025.154795","DOIUrl":"10.5114/kitp.2025.154795","url":null,"abstract":"","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":"22 3","pages":"232-235"},"PeriodicalIF":1.3,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12670227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative outcomes of laparoscopic versus robotic esophagectomy: a systematic review and meta-analysis.","authors":"Danilo Coco, Silvana Leanza","doi":"10.5114/kitp.2025.152501","DOIUrl":"10.5114/kitp.2025.152501","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Esophagectomy is a complex surgical procedure primarily used for the treatment of esophageal malignancies and other esophageal disorders. In recent years, minimally invasive techniques, such as laparoscopic and robotic-assisted esophagectomy, have gained popularity due to their potential to reduce postoperative morbidity and enhance recovery. However, the comparative effectiveness, safety, and long-term outcomes of laparoscopic versus robotic esophagectomy remain unclear.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;This study aims to conduct a systematic review and meta-analysis comparing the perioperative and long-term outcomes of laparoscopic and robotic esophagectomy, with a focus on operative time, estimated blood loss, postoperative complications, length of hospital stay, lymph node yield, R0 resection rate, and oncological outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A comprehensive literature search was conducted across PubMed, Embase, and the Cochrane Library from inception to January 2023. Randomized controlled trials (RCTs) and observational studies comparing laparoscopic and robotic esophagectomy were included. The primary outcomes were operative time, estimated blood loss, and postoperative complications. Secondary outcomes included length of hospital stay, lymph node yield, R0 resection rate, and long-term oncological outcomes. Meta-analyses were performed using random-effects models. Risk of bias was assessed using the Cochrane Risk of Bias tool for RCTs and the Newcastle-Ottawa Scale (NOS) for observational studies. Publication bias was evaluated using Egger's test. Statistical analyses were conducted using Stata version 16.0, with a &lt;i&gt;p&lt;/i&gt;-value &lt; 0.05 considered statistically significant.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 24 studies (6 RCTs and 18 observational studies) involving 6,972 patients (3,433 robotic and 3,539 laparoscopic esophagectomy cases) were included. Robotic esophagectomy was associated with a longer operative time (mean difference [MD] = 55.52 minutes, 95% CI: 27.55 to 83.49, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) but lower estimated blood loss (MD = -103.67 ml, 95% CI: -162.78 to -44.57, &lt;i&gt;p&lt;/i&gt; = 0.001) compared to laparoscopic esophagectomy. Postoperative complications (odds ratio [OR] = 0.78, 95% CI: 0.59 to 1.04, &lt;i&gt;p&lt;/i&gt; = 0.091) and length of hospital stay (MD = -0.74 days, 95% CI: -1.82 to 0.34, &lt;i&gt;p&lt;/i&gt; = 0.181) were comparable between the two techniques. Robotic esophagectomy demonstrated a higher lymph node yield (MD = 2.38, 95% CI: 0.89 to 3.87, &lt;i&gt;p&lt;/i&gt; = 0.002) and a higher R0 resection rate (OR = 1.70, 95% CI: 1.26 to 2.30, &lt;i&gt;p&lt;/i&gt; &lt; 0.001). Long-term oncological outcomes, including overall survival and disease-free survival, were similar between the two approaches. Egger's test indicated no significant publication bias.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This meta-analysis demonstrates that robotic esophagectomy, despite longer operative times, offers advantages in terms of reduced blood ","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":"22 3","pages":"199-205"},"PeriodicalIF":1.3,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12670222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of red cell distribution width-to-platelet ratio and other laboratory markers in staging Fontan-associated liver disease.","authors":"Paweł Skorek, Beata Róg, Natalia Bajorek, Tadeusz Wilkosz, Lidia Tomkiewicz-Pająk","doi":"10.5114/kitp.2025.152440","DOIUrl":"10.5114/kitp.2025.152440","url":null,"abstract":"<p><strong>Introduction: </strong>Fontan-associated liver disease (FALD) is a common complication in patients with Fontan circulation.</p><p><strong>Aim: </strong>We aimed to evaluate the red blood cell distribution width-to-platelet ratio (RPR) index as a non-invasive marker for assessing FALD severity, given its reported usefulness in in conditions such as hepatitis.</p><p><strong>Material and methods: </strong>This retrospective, cross-sectional study included adult Fontan patients. Laboratory tests, liver elastography, and hemodynamic parameters were analyzed.</p><p><strong>Results: </strong>Fifty-six patients (24 females, 43%; median age 24 years, interquartile range [22-28]) were enrolled. Patients were grouped by liver stiffness (LS) stage: METAVIR ≤ F2 (22 patients, 39%) and > F2 (34 patients, 61%). The RPR index was significantly higher in the > F2 group (0.08 vs. 0.12, <i>p</i> = 0.02), along with FIB-4 (0.68 vs. 1.06) and APRI (0.36 vs. 0.57). RPR correlated positively with liver stiffness (<i>r</i> = 0.27), total bilirubin (<i>r</i> = 0.43), cystatin C (<i>r</i> = 0.36), and creatinine (<i>r</i> = 0.38) but not with NT-proBNP, pulmonary artery pressure, or maximal oxygen consumption. The ROC curve analysis for predicting LS > F2 showed an AUC of 0.74 (95% CI: 0.61-0.87), comparable to FIB-4. Moreover, in the logistic regression model that accounted for age, gender, height, body weight, and systemic chamber morphology, RPR showed a significant association with LS > F2, with an odds ratio indicating a 1.4-fold (95% CI: 1.1-1.7) increase for every 0.01-unit increase in RPR.</p><p><strong>Conclusions: </strong>The RPR index is a simple, helpful tool for evaluating FALD severity in Fontan patients.</p>","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":"22 2","pages":"88-93"},"PeriodicalIF":1.3,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12288488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144734917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Giant pseudoaneurysm of the inferior wall of the left ventricle presenting as a pulsatile epigastric mass.","authors":"Ermal Likaj, Laureta Dibra, Saimir Kuci, Marsela Goga, Fjorba Mana, Altin Veshti","doi":"10.5114/kitp.2025.152325","DOIUrl":"10.5114/kitp.2025.152325","url":null,"abstract":"","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":"22 2","pages":"139-141"},"PeriodicalIF":1.3,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12288485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144734918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}