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A greater number of medically complex patients with multiple comorbidities are now more readily considered for total knee arthroplasty (TKA). Therefore, the purpose of this study was to determine whether comorbidity burden, measured with the Elixhauser Comorbidity Index (ECI), correlated with 90-day medical complications and longer in-hospital lengths-of-stay (LOS) in TKA patients. The PearlDiver supercomputer was queried for all primary TKA patients in the Medicare Standard Analytic Files from 2005 to 2014 using International Classification of Disease, 9th edition codes. Patients were included based on ECI scores, ranging from 1 to 5. ECI 1 patients served as the control cohort, while ECI 2, 3, 4, and 5 patients were considered study cohorts. Each study cohort was matched based on age and gender to the control cohort, resulting in a total of 715,398 patients included for analysis (ECI 1, n = 144,072; ECI 2, n = 144,072; ECI 3, n = 144,072; ECI 4, n = 144,072; ECI 5, n = 139,110). Logistic regression analysesand outcomes after TKA procedures can guide providers on how to modify their pre- and postoperative care. SN-38 These results demonstrate that higher ECI scores are associated with a greater likelihood of 90-day medical complications and longer in-hospital LOS. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.OBJECTIVES  The aim of this study was to observe outcomes of early decortication in a treatment of pleural empyema using video-assisted thoracoscopic surgery (VATS). METHODS  The case records of 21 pediatric patients who underwent VATS for empyema between 2009 and 2019 were retrospectively reviewed. Patients were observed based on demographic, laboratory, and clinical data, as well as treatment outcomes. RESULTS  Out of a total of 59 patients treated for pleural empyema, 21 (10 male and 11 female) children with a median age of 5 years (interquartile range [IQR] 2.8; 6.0) received VATS. The empyema was classified as stage I in 2 patients (9.5%), stage II in 4 patients (19%), and stage III in 15 patients (71.5%). Median surgical time was 60 minutes (IQR 50; 90). There were 2 (9.5%) postoperative complications and 1 recurrence (4.8%). Children treated in stages I and II showed significantly better postoperative results compared with the children treated in stage III. Length of hospital stay (8 vs. 10 days; p = 0.01), length of intensive care unit stay (1 vs. 5 days; p  less then  0.001), duration of chest tube drainage (4 vs. 6 days; p = 0.043), duration of postoperative fever (1.5 vs. 4 days; p = 0.001), and surgical time (40 vs. 70 minutes; p  less then  0.001) were significantly shorter in children operated in stages I and II than in stage III. CONCLUSION  Early decortication using a VATS is a successful, effective, and easily performed surgical method in the treatment of pediatric pleural empyema, as well as a method that significantly improves recovery time and shortens the hospital stay. Georg Thieme Verlag KG Stuttgart · New York.BACKGROUND  In thoracic surgery, utilization of extracorporeal membrane oxygenation (ECMO) is mainly established for patients undergoing lung transplantation. The aim of our study was to summarize our single-center experience with intraoperative use of veno-venous- or veno-arterial-ECMO in patients undergoing complex lung surgery involving the main carina, or the left atrium or the descending aorta. METHODS  A total of 24 patients underwent combined complex lung, carinal, aortal, or left atrial resections. In cases of carinal resection, percutaneous veno-venous, jugular-femoral cannulation was considered suitable. For combined resection of lung and descending aorta, a percutaneous femoral veno-arterial cannulation was used. In cases of extended left atrial resection, a percutaneous jugular-femoral veno-venous-arterial cannulation was favored. RESULTS  Procedures were divided into three groups carinal resections and reconstruction (n = 8), resections of the descending aorta and left lung (n = 7), resections of lung and left atrium (n = 9). No intraoperative complications occurred. Overall 30-day mortality was 25%. A complete resection was achieved in 18 patients. Median survival was 12 months. One- and 5-year survival were 48.1 and 22.7%, respectively. CONCLUSION  The present study shows that intraoperative use of ECMO for extended carinal, aortic, or atrial resections is feasible with minimal intraoperative complications allowing surgeons increased operating-field safety. Perioperative mortality is high, but this is rather an attribute of local extended disease and patient comorbidities. Georg Thieme Verlag KG Stuttgart · New York.in English, German HINTERGRUND  Die atypischen Mykobakterien stellen eine inhomogene Gruppe dar. Obwohl mehr als 140 Spezies identifiziert wurden, stehen nur 25 mit der atypischen Mykobakteriose beim Menschen in Beziehung. Die häufigste Manifestation bei immunkompetenten Kindern ist die zervikale Lymphadenitis. Das Ziel der vorliegenden Arbeit ist die Korrelation des Lebensraums mit den Patientendaten und dem Krankheitsbild, die Auswertung der sonografischen Befunde und der operativen Therapiemethoden und die Erstellung eines Diagnose- und Therapiealgorithmus. MATERIAL UND METHODEN  Die Patienten wurden nach einer systematischen Suche in der klinischen, mikrobiologischen und pathologischen Datenbank der HNO-Klinik identifiziert. Eine statistische Analyse der Ergebnisse wurde durchgeführt. ERGEBNISSE  32 Patienten wurden ausgewertet. Eine signifikante Korrelation zwischen dem Wohnort und der Manifestation oder dem Verlauf der Erkrankung konnte nicht nachgewiesen werden. Echoarme Lymphknoten mit intraglandulärer Nekrose und niedriger Durchblutung wurden bei der Mehrheit der Patienten beobachtet. Die verwendeten operativen Methoden schlossen die Abszessinzision mit Biopsie, die diagnostische Lymphadenektomie, die selektive Neck-Dissection und die laterale Parotidektomie ein. Die Rezidivrate war signifikant höher nach Abszessinzision als nach Lymphadenektomie oder selektiver Neck-Dissection. SCHLUSSFOLGERUNGEN  Um den Einfluss des Wohnsitzes auf das Krankheitsbild deutlich zu definieren, sind größere prospektive Studien notwendig. Die sonografischen Befunde sind diagnostisch wegweisend. Eine vollständige Resektion trägt zur Diagnose und Therapie bei und stellt eine risikoarme Therapieoption dar.