Operative Management of Pulmonary Injuries: Lung-Sparing and Formal Resections

Asensio, Juan A.; García-Núñez, Luis Manuel; Petrone, Patrizio; King, David R.; Castrellon, Ricardo; Duran, Dominic; Vara, Alexander D.; Weston, John S.; Robinson, Donald W.; Pizano, Louis R.

doi:10.1016/b978-0-323-04418-9.50042-4

Cited by 3 publications

(10 citation statements)

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“…The same is done for small bronchi. The edges of the wound are then approximated with a running locked suture [ 45 , 46 ].…”

Section: Surgical Techniques Of Repair and Resectionmentioning

confidence: 99%

“…The orifices of entry and exit are left open for the egress of air and/or blood. The integrity of the suture line is tested by having the anesthesiologist inflate the lung, and the air leaks are then detected and repaired [ 11 , 46 ].…”

Section: Surgical Techniques Of Repair and Resectionmentioning

confidence: 99%

“…Resectional procedures include formal lobectomy and formal pneumonectomy. These procedures are indicated for control of hemorrhage, resection of devitalized or destroyed pulmonary tissue, control of major air leaks not amenable to repair, and control of life-threatening hemorrhage [ 45 , 46 ].…”

Section: Resectional Proceduresmentioning

confidence: 99%

“…In the left lung the oblique fissure divides the left upper from the left lower lobe. The lingula of the left upper lobe corresponds to the middle lobe on the right, but it is fused with the upper lobe in most cases [ 45 , 46 ].…”

Section: Resectional Proceduresmentioning

confidence: 99%

“…All pulmonary vessels whether they be the main lobar vessels or segmental vessels can be ligated in continuity and transfixed with non-absorbable sutures. Alternatively, they may be stapled or may also be over sewn [ 45 , 46 ].…”

Section: Resectional Proceduresmentioning

confidence: 99%

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Surgical management of penetrating pulmonary injuries

Petrone

Asensio

2009

Scand J Trauma Resusc Emerg Med

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Chest injuries were reported as early as 3000 BC in the Edwin Smith Surgical Papyrus. Ancient Greek chronicles reveal that they had anatomic knowledge of the thoracic structures. Even in the ancient world, most of the therapeutic modalities for chest wounds and traumatic pulmonary injuries were developed during wartime.The majority of lung injuries can be managed non-operatively, but pulmonary injuries that require operative surgical intervention can be quite challenging. Recent progress in treating severe pulmonary injuries has relied on finding shorter and simpler lung-sparing techniques. The applicability of stapled pulmonary tractotomy was confirmed as a safe and valuable procedure. Advancement in technology have revolutionized thoracic surgery and ushered in the era of videoassisted thoracoscopic surgery (VATS), providing an alternative method for accurate and direct evaluation of the lung parenchyma, mediastinum, and diaphragmatic injuries.The aim of this article is to describe the incidence of the penetrating pulmonary injuries, the ultimate techniques used in its operative management, as well as the diagnosis, complications, and morbidity and mortality.

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“…The same is done for small bronchi. The edges of the wound are then approximated with a running locked suture [ 45 , 46 ].…”

Section: Surgical Techniques Of Repair and Resectionmentioning

confidence: 99%

Section: Surgical Techniques Of Repair and Resectionmentioning

confidence: 99%

Section: Resectional Proceduresmentioning

confidence: 99%

Section: Resectional Proceduresmentioning

confidence: 99%

Section: Resectional Proceduresmentioning

confidence: 99%

See 3 more Smart Citations

Surgical management of penetrating pulmonary injuries

Petrone

Asensio

2009

Scand J Trauma Resusc Emerg Med

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Operative Management of Thoracic Gunshot Wounds: More Aggressive Treatment Has Been Required over Time

Miller

Benns

Bozeman

et al. 2019

The American Surgeon™

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Our department has a database of thoracic gunshot wounds (GSWs), which has cataloged these injury patterns over the past five decades. Prevailing wisdom on the management of these injuries suggested operative treatment beyond tube thoracostomy is not commonly required. It was our clinical impression that the operative treatment required beyond chest tube placement has greatly increased over the past several decades, whereas the operative management of cardiac GSWs seemed to be increasingly infrequent events. To test these observations, we analyzed the treatment of GSWs to the chest and heart in four distinct time periods, categorized as “historical” (1973–1975 and 1988–1990) and “modern” (2005–2007 and 2015–2017). There was a significant increase in emergent thoracotomy, delayed thoracic operations, overall operative interventions, and pulmonary resections from the historical period to the modern era. There was a decline in cardiac injuries treated, whereas the number of injuries remained constant. Mortality was unchanged between the early and later periods. Operative treatment beyond tube thoracostomy was much more prevalent for noncardiac thoracic GSWs in the past two decades than in the prior decades, whereas the number of cardiac wounds treated decreased by half.

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