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Tsotsolis N, Tsirgogianni K, Kioumis I, Pitsiou G, Baka S, Papaiwannou A, Karavergou A, Rapti A, Trakada G, Katsikogiannis N, Tsakiridis K, Karapantzos I, Karapantzou C, Barbetakis N, Zissimopoulos A, Kuhajda I, Andjelkovic D, Zarogoulidis K, Zarogoulidis P. Pneumothorax as a complication of central venous catheter insertion. Ann Transl Med 2015; 3:40. [PMID: 25815301 DOI: 10.3978/j.issn.2305-5839.2015.02.11] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 01/28/2015] [Indexed: 12/12/2022]
Abstract
The central venous catheter (CVC) is a catheter placed into a large vein in the neck [internal jugular vein (IJV)], chest (subclavian vein or axillary vein) or groin (femoral vein). There are several situations that require the insertion of a CVC mainly to administer medications or fluids, obtain blood tests (specifically the "central venous oxygen saturation"), and measure central venous pressure. CVC usually remain in place for a longer period of time than other venous access devices. There are situations according to the drug administration or length of stay of the catheter that specific systems are indicated such as; a Hickman line, a peripherally inserted central catheter (PICC) line or a Port-a-Cath may be considered because of their smaller infection risk. Sterile technique is highly important here, as a line may serve as a port of entry for pathogenic organisms, and the line itself may become infected with organisms such as Staphylococcus aureus and coagulase-negative Staphylococci. In the current review we will present the complication of pneumothorax after CVC insertion.
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Affiliation(s)
- Nikolaos Tsotsolis
- 1 Anesthesiology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 2 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 4 2nd Pulmonary Clinic of "Sotiria" Hospital, Athens, Greece ; 5 Pulmonary Laboratory of Alexandra Hospital University of Athens, Athens, Greece ; 6 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 7 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 8 Ear, Nose and Throat, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 9 Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece ; 10 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece ; 11 Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia
| | - Katerina Tsirgogianni
- 1 Anesthesiology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 2 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 4 2nd Pulmonary Clinic of "Sotiria" Hospital, Athens, Greece ; 5 Pulmonary Laboratory of Alexandra Hospital University of Athens, Athens, Greece ; 6 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 7 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 8 Ear, Nose and Throat, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 9 Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece ; 10 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece ; 11 Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia
| | - Ioannis Kioumis
- 1 Anesthesiology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 2 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 4 2nd Pulmonary Clinic of "Sotiria" Hospital, Athens, Greece ; 5 Pulmonary Laboratory of Alexandra Hospital University of Athens, Athens, Greece ; 6 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 7 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 8 Ear, Nose and Throat, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 9 Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece ; 10 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece ; 11 Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia
| | - Georgia Pitsiou
- 1 Anesthesiology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 2 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 4 2nd Pulmonary Clinic of "Sotiria" Hospital, Athens, Greece ; 5 Pulmonary Laboratory of Alexandra Hospital University of Athens, Athens, Greece ; 6 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 7 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 8 Ear, Nose and Throat, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 9 Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece ; 10 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece ; 11 Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia
| | - Sofia Baka
- 1 Anesthesiology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 2 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 4 2nd Pulmonary Clinic of "Sotiria" Hospital, Athens, Greece ; 5 Pulmonary Laboratory of Alexandra Hospital University of Athens, Athens, Greece ; 6 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 7 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 8 Ear, Nose and Throat, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 9 Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece ; 10 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece ; 11 Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia
| | - Antonis Papaiwannou
- 1 Anesthesiology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 2 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 4 2nd Pulmonary Clinic of "Sotiria" Hospital, Athens, Greece ; 5 Pulmonary Laboratory of Alexandra Hospital University of Athens, Athens, Greece ; 6 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 7 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 8 Ear, Nose and Throat, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 9 Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece ; 10 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece ; 11 Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia
| | - Anastasia Karavergou
- 1 Anesthesiology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 2 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 4 2nd Pulmonary Clinic of "Sotiria" Hospital, Athens, Greece ; 5 Pulmonary Laboratory of Alexandra Hospital University of Athens, Athens, Greece ; 6 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 7 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 8 Ear, Nose and Throat, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 9 Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece ; 10 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece ; 11 Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia
| | - Aggeliki Rapti
- 1 Anesthesiology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 2 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 4 2nd Pulmonary Clinic of "Sotiria" Hospital, Athens, Greece ; 5 Pulmonary Laboratory of Alexandra Hospital University of Athens, Athens, Greece ; 6 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 7 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 8 Ear, Nose and Throat, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 9 Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece ; 10 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece ; 11 Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia
| | - Georgia Trakada
- 1 Anesthesiology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 2 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 4 2nd Pulmonary Clinic of "Sotiria" Hospital, Athens, Greece ; 5 Pulmonary Laboratory of Alexandra Hospital University of Athens, Athens, Greece ; 6 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 7 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 8 Ear, Nose and Throat, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 9 Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece ; 10 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece ; 11 Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia
| | - Nikolaos Katsikogiannis
- 1 Anesthesiology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 2 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 4 2nd Pulmonary Clinic of "Sotiria" Hospital, Athens, Greece ; 5 Pulmonary Laboratory of Alexandra Hospital University of Athens, Athens, Greece ; 6 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 7 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 8 Ear, Nose and Throat, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 9 Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece ; 10 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece ; 11 Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia
| | - Kosmas Tsakiridis
- 1 Anesthesiology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 2 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 4 2nd Pulmonary Clinic of "Sotiria" Hospital, Athens, Greece ; 5 Pulmonary Laboratory of Alexandra Hospital University of Athens, Athens, Greece ; 6 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 7 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 8 Ear, Nose and Throat, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 9 Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece ; 10 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece ; 11 Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia
| | - Ilias Karapantzos
- 1 Anesthesiology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 2 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 4 2nd Pulmonary Clinic of "Sotiria" Hospital, Athens, Greece ; 5 Pulmonary Laboratory of Alexandra Hospital University of Athens, Athens, Greece ; 6 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 7 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 8 Ear, Nose and Throat, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 9 Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece ; 10 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece ; 11 Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia
| | - Chrysanthi Karapantzou
- 1 Anesthesiology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 2 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 4 2nd Pulmonary Clinic of "Sotiria" Hospital, Athens, Greece ; 5 Pulmonary Laboratory of Alexandra Hospital University of Athens, Athens, Greece ; 6 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 7 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 8 Ear, Nose and Throat, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 9 Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece ; 10 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece ; 11 Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia
| | - Nikos Barbetakis
- 1 Anesthesiology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 2 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 4 2nd Pulmonary Clinic of "Sotiria" Hospital, Athens, Greece ; 5 Pulmonary Laboratory of Alexandra Hospital University of Athens, Athens, Greece ; 6 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 7 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 8 Ear, Nose and Throat, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 9 Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece ; 10 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece ; 11 Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia
| | - Athanasios Zissimopoulos
- 1 Anesthesiology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 2 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 4 2nd Pulmonary Clinic of "Sotiria" Hospital, Athens, Greece ; 5 Pulmonary Laboratory of Alexandra Hospital University of Athens, Athens, Greece ; 6 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 7 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 8 Ear, Nose and Throat, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 9 Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece ; 10 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece ; 11 Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia
| | - Ivan Kuhajda
- 1 Anesthesiology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 2 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 4 2nd Pulmonary Clinic of "Sotiria" Hospital, Athens, Greece ; 5 Pulmonary Laboratory of Alexandra Hospital University of Athens, Athens, Greece ; 6 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 7 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 8 Ear, Nose and Throat, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 9 Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece ; 10 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece ; 11 Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia
| | - Dejan Andjelkovic
- 1 Anesthesiology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 2 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 4 2nd Pulmonary Clinic of "Sotiria" Hospital, Athens, Greece ; 5 Pulmonary Laboratory of Alexandra Hospital University of Athens, Athens, Greece ; 6 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 7 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 8 Ear, Nose and Throat, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 9 Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece ; 10 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece ; 11 Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia
| | - Konstantinos Zarogoulidis
- 1 Anesthesiology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 2 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 4 2nd Pulmonary Clinic of "Sotiria" Hospital, Athens, Greece ; 5 Pulmonary Laboratory of Alexandra Hospital University of Athens, Athens, Greece ; 6 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 7 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 8 Ear, Nose and Throat, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 9 Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece ; 10 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece ; 11 Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia
| | - Paul Zarogoulidis
- 1 Anesthesiology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 2 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 4 2nd Pulmonary Clinic of "Sotiria" Hospital, Athens, Greece ; 5 Pulmonary Laboratory of Alexandra Hospital University of Athens, Athens, Greece ; 6 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 7 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 8 Ear, Nose and Throat, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 9 Thoracic Surgery Department, Theagenio Cancer Hospital, Thessaloniki, Greece ; 10 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece ; 11 Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia
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