Optimization of Indications for Thoracoscopy in Chest Trauma

Аннотация

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.

Ключевые слова

Список литературы

1. Korotkov NI, Kutyrev EA, Kukushkin AV. Videothoracoscopic interventions: diagnostic and medical possibilities. Endoskopicheskaya  khirurgia. 2006(2):62. (In Russ.).

2. Yuan Z-Y, Cheng G-Y, Sun K-L, Mao Y-S. et al. Comparative study of video-assisted thoracic surgery versus open thymectomy in one single center. J Thorac Dis. 2014;6(6):726-733.

3. Rutenburg GM, Puzanov SYu, Bogdanov DYu, Alishikhov AM. Diagnostic and therapeutic thoracoscopy in treatment of chest injury. Endoskopicheskaya  khirurgia. 2012(3):57-63. (In Russ.).

4. Gonzalez-Rivas D. Single incision video-assisted thoracoscopic anatomic segmentectomy. Ann Cardiothorac Surg. 2014;3(2):204-207.

5. Ben-Nun A, Orlovsky M, Best LA. Video-assisted thoracoscopic surgery in the treatment of chest trauma: long-term benefit. Ann Thorac Surg. 2007;(83):383-387.

6. Villavicencio RT, Aucar JA, Wall MJ. Analysis of thoracoscopy in trauma. Surg Endosc. 1999;13(1):3-9.

7. Voskresenskiy OV, Abakumov MM, Radchenko YuA. The importance of Algover`s index in the choice of surgical tactics at penetrating chest wounds. Khirurgia. Zhurnal im.N.I.Pirogova. 2009;(12):43-48. (in Russ.).

8.  Smith JW, Franklin GA, Harbrecht BG, Richardson JD. Early VATS for blunt chest trauma: a management technique underutilized by acute care surgeons. J Trauma. 2011;71(1):102-105.

9. 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. Surg Endosc. 2008;22(5):1227-1231.

10. Goodman M, Lewis J, Guitron J, Reed M et al. Video-assisted thoracoscopic surgery for acute thoracic trauma. J Emerg Trauma Shock. 2013;6(2):106-109.

11. Bisenkov LN. Torakal'naya khirurgiya. SPb.: Gippokrat. 2004. (In Russ.).

12. Sigal EI, Zhestkov KG, Burmistrov MV, Pikin OV. Torakoskopicheskaya khirurgiya. M.: IPK “Dom knigi”, 2012. (In Russ.).

Для цитирования

Korymasov EА, Benyan AS. Optimization of Indications for Thoracoscopy in Chest Trauma. Science & Innovations in Medicine. 2017;1(5):65-72.

Request

Send an online application form to the publication

Send