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Video-assisted thoracoscopic surgery in the management of penetrating and blunt thoracic trauma.

Milanchi S, Makey I, McKenna R, Margulies DR - J Minim Access Surg (2009 Jul-Sep)

Bottom Line: Thoracotomy was avoided in 21 patients.There was no mortality.VATS can be performed safely for the management of thoracic traumas.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Thoracic Surgery and Trauma, Surgical Director, Women's Guild Lung Institute, Program Director, General Thoracic Surgery Fellowship, Cedars-Sinai Medical Center, Los Angeles, California, USA.

ABSTRACT

Background: The role of video-assisted Thoracoscopic Surgery (VATS) is still being defined in the management of thoracic trauma. We report our trauma cases managed by VATS and review the role of VATS in the management of thoracic trauma.

Materials and methods: All the trauma patients who underwent VATS from 2000 to 2007 at Cedars-Sinai Medical Center were retrospectively studied.

Results: Twenty-three trauma patients underwent 25 cases of VATS. The most common indication for VATS was retained haemothorax. Thoracotomy was avoided in 21 patients. VATS failed in two cases. On an average VATS was performed on trauma day seven (range 1-26) and the length of hospital stay was 20 days (range 3-58). There was no mortality. VATS was performed in an emergency (day 1-2), or in the early (day 2-7) or late (after day 7) phases of trauma.

Conclusion: VATS can be performed safely for the management of thoracic traumas. VATS can be performed before or after thoracotomy and at any stage of trauma. The use of VATS in trauma has a trimodal distribution (emergent, early, late), each with different indications.

No MeSH data available.


Related in: MedlinePlus

Distribution of video-assisted thoracoscopic surgery cases after trauma. Note the tri-modal distribution of the cases: Emergency, early and late
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Figure 0002: Distribution of video-assisted thoracoscopic surgery cases after trauma. Note the tri-modal distribution of the cases: Emergency, early and late

Mentions: Based on the timing of performing VATS, we can divide our cases into three types: Emergency, early and late. Emergency cases were performed on arrival to the Emergency Room and on trauma day one or two, for diagnostic purposes, evacuation of retained haemothorax (after placement of chest tube), control of bleeding from intercostal arteries, or removal of foreign bodies from the chest. Early cases were performed from trauma day two to day seven for evacuation of retained haemothorax, control of bleeding (e.g., from the intercostal arteries), repair of bronchial injuries and ligation of injured thoracic duct. Late cases were performed after trauma day seven for retained haemothorax, empyema, pleural effusion, or pericardial effusion [Figure 2].


Video-assisted thoracoscopic surgery in the management of penetrating and blunt thoracic trauma.

Milanchi S, Makey I, McKenna R, Margulies DR - J Minim Access Surg (2009 Jul-Sep)

Distribution of video-assisted thoracoscopic surgery cases after trauma. Note the tri-modal distribution of the cases: Emergency, early and late
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2822172&req=5

Figure 0002: Distribution of video-assisted thoracoscopic surgery cases after trauma. Note the tri-modal distribution of the cases: Emergency, early and late
Mentions: Based on the timing of performing VATS, we can divide our cases into three types: Emergency, early and late. Emergency cases were performed on arrival to the Emergency Room and on trauma day one or two, for diagnostic purposes, evacuation of retained haemothorax (after placement of chest tube), control of bleeding from intercostal arteries, or removal of foreign bodies from the chest. Early cases were performed from trauma day two to day seven for evacuation of retained haemothorax, control of bleeding (e.g., from the intercostal arteries), repair of bronchial injuries and ligation of injured thoracic duct. Late cases were performed after trauma day seven for retained haemothorax, empyema, pleural effusion, or pericardial effusion [Figure 2].

Bottom Line: Thoracotomy was avoided in 21 patients.There was no mortality.VATS can be performed safely for the management of thoracic traumas.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Thoracic Surgery and Trauma, Surgical Director, Women's Guild Lung Institute, Program Director, General Thoracic Surgery Fellowship, Cedars-Sinai Medical Center, Los Angeles, California, USA.

ABSTRACT

Background: The role of video-assisted Thoracoscopic Surgery (VATS) is still being defined in the management of thoracic trauma. We report our trauma cases managed by VATS and review the role of VATS in the management of thoracic trauma.

Materials and methods: All the trauma patients who underwent VATS from 2000 to 2007 at Cedars-Sinai Medical Center were retrospectively studied.

Results: Twenty-three trauma patients underwent 25 cases of VATS. The most common indication for VATS was retained haemothorax. Thoracotomy was avoided in 21 patients. VATS failed in two cases. On an average VATS was performed on trauma day seven (range 1-26) and the length of hospital stay was 20 days (range 3-58). There was no mortality. VATS was performed in an emergency (day 1-2), or in the early (day 2-7) or late (after day 7) phases of trauma.

Conclusion: VATS can be performed safely for the management of thoracic traumas. VATS can be performed before or after thoracotomy and at any stage of trauma. The use of VATS in trauma has a trimodal distribution (emergent, early, late), each with different indications.

No MeSH data available.


Related in: MedlinePlus