Optimization of Indications for Thoracoscopy in Chest Trauma
Background. The terms for application of video-assisted endosurgical interventions appear rather often in the surgery of chest trauma. There is a certain need for clear selection and differentiation of indications and contraindications for performing thoracoscopy and other operations.
Materials and methods. The 3-years’ 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 for 107 patients. Emergency thoracoscopy had been done in 38 cases (35.5%), urgent thoracoscopy in 27 (25.2%) and delayed thoracoscopy – in 42 patients (39.3%). The rate of thoracotomy was 14.9%.
Results and discussion. The indications for thoracoscopy at chest trauma were defined. The analysis of treatment results depending on the kind of traumatic lesion and operation method was carried out. The best results were obtained in patients with isolated blunt chest trauma and those who underwent thoracoscopy. The role of thoracoscopy in case of urgent and delayed indications for surgery was emphasized. We registered complications in 13.5% of patients with blunt chest trauma and 6.1% of patients with penetrating wounds. The general mortality was 3.8%.
Conclusion. We can conclude that the results of treatment of patients with blunt chest trauma and penetrating wounds depend on the severity of the trauma, terms and quality of special medical management and wide application of thoracoscopy.
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