Email this article 
To Whom and When Is Thoracoscopy Indicated at Chest Trauma?
- Authors: 1, 2
-
Affiliations:
- Samara State Medical University, 89 Chapaevskaia Str., Samara, 443099, Russian Federation
- M.I. Kalinin Samara Regional Clinical Hospital, 159 Tashkentskaia Str., Samara, 443095, Russian Federation
- Issue: Vol 7, No 3 (2014)
- Pages: 237-345
- Section: Original articles
- URL: https://vestnik-surgery.com/journal/article/view/575
- DOI: https://doi.org/10.18499/2070-478X-2014-7-3-237-345
- ID: 575
Cite item
Full Text
Abstract
Relevance The terms for application of endosurgical interventions appeared rather often in the surgery of chest trauma. There is need for clear selection and differentiation of indications and contraindications for performing of thoracoscopy and other operations.
Materials and methods The 3-year experience of treatment of patients with blunt chest trauma and penetrating wounds is described in the article. There was prevalence of patients with isolated blunt chest trauma (35,1%) and penetrating thoracic wounds (29,0%). We have performed thoracoscopy at 107 patients. Emergency thoracoscopy had been done 38 (35,5%), urgent thoracoscopy at 27 (25,2%) and late thoracoscopy – at 42 patients (39,3%). The rate of thoracotomy was 14,9%.
Results and their discussion The indications to thoracoscopy at chest trauma had been defined. The analysis of treatment`s results in depend of kind of traumatic lesion and operation method was carried out. The best results were at patients with isolated blunt chest trauma and those who underwent thoracoscopy. The role of thoracoscopy at urgent indications and delayed sequelae had been underlined. We have registered complications at 13,5% patients with blunt chest trauma and 6,1% patients with penetrating wounds. The general mortality is 3,8%.
Conclusion Is that results of treatment of patients with blunt chest trauma and penetrating wounds depend of severity of trauma, terms and quality of special medical management and wide application of thoracoscopy.
Materials and methods The 3-year experience of treatment of patients with blunt chest trauma and penetrating wounds is described in the article. There was prevalence of patients with isolated blunt chest trauma (35,1%) and penetrating thoracic wounds (29,0%). We have performed thoracoscopy at 107 patients. Emergency thoracoscopy had been done 38 (35,5%), urgent thoracoscopy at 27 (25,2%) and late thoracoscopy – at 42 patients (39,3%). The rate of thoracotomy was 14,9%.
Results and their discussion The indications to thoracoscopy at chest trauma had been defined. The analysis of treatment`s results in depend of kind of traumatic lesion and operation method was carried out. The best results were at patients with isolated blunt chest trauma and those who underwent thoracoscopy. The role of thoracoscopy at urgent indications and delayed sequelae had been underlined. We have registered complications at 13,5% patients with blunt chest trauma and 6,1% patients with penetrating wounds. The general mortality is 3,8%.
Conclusion Is that results of treatment of patients with blunt chest trauma and penetrating wounds depend of severity of trauma, terms and quality of special medical management and wide application of thoracoscopy.
Keywords
About the authors
Samara State Medical University, 89 Chapaevskaia Str., Samara, 443099, Russian Federation
Author for correspondence.
Email: korymasov@mail.ru
MD, Prof., head of chair of surgery in Samara state medical university
M.I. Kalinin Samara Regional Clinical Hospital, 159 Tashkentskaia Str., Samara, 443095, Russian Federation
Email: armenbenyan@yandex.ru
Ph.D., head of thoracic department in Samara regional clinical hospital
References
- Ben-Nun A., Orlovsky M., Best L.A. Video-Assisted Thoracoscopic Surgery in the Treatment of Chest Trauma: Long-Term Benefit [Video-pomoshch' torakoskopicheskoy khirurgii v lechenii travmy grudnoy kletki]. Ann. Thorac. Surg., 2007; 83: 383-387.
- Fabbrucci P., Nocentini L., Secci S., Manzoli D. et al. Video-assisted thoracoscopy in the early diagnosis and management of post-traumatic pneumothorax and hemothorax [Video-pomoshch' torakoskopiya v ranney diagnostike i lecheniyu posttravmaticheskogo pnevmotoraksa i gemotoraksom]. Surg. Endosc., 2008; 22(5): 1227-1231.
- Gonzalez-Rivas D.Single incision video-assisted thoracoscopic anatomic segmentectomy [Razrez videoassistirovannykh torakoskopicheskoye anatomicheskoye segmentektomiya] . Ann. Cardiothorac. Surg., 2014; 3(2): 204-207.
- Goodman M., Lewis J., Guitron J., Reed M. et al. Video-assisted thoracoscopic surgery for acute thoracic trauma [Video-pomoshch' torakoskopicheskoy operatsii po povodu ostrogo torakal'noy travmy]. J. Emerg. Trauma Shock., 2013; 6(2): 106-109.
- Smith J.W., Franklin G.A., Harbrecht B.G., Richardson J.D Early VATS for blunt chest trauma: a management technique underutilized by acute care surgeons [Rannie chanakh tupoi travmy grudi: tekhnika upravleniia nedostatochno ostrymi khirurgov po ukhodu]. J. Trauma., 2011; 71(1): 102-105.
- Villavicencio R.T., Aucar J.A., Wall M.J Analysis of thoracoscopy in trauma [Analiz torakoskopii pri travme]. Surg. Endosc., 1999; 13(1): 3-9.
- Yuan Z.-Y., Cheng G.-Y., Sun K.-L., Mao Y.-S. et al Sravnitel'noye issledovaniye videoassistirovannykh torakal'noy khirurgii po sravneniyu s otkrytoy timektomirovannykh v odnom tsentre. J. Thorac. Dis., 2014; 6(6): 726-733.
Supplementary files
