Video-assisted thoracoscopic surgery for retained hemothorax in blunt chest trauma

Chou, Yi-Pin; Lin, Hsing‐Lin; Wu, Tzu‐Chin

doi:10.1097/mcp.0000000000000173

Cited by 43 publications

(50 citation statements)

References 47 publications

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“…VATS as a procedure for pleural space management in the non-critical, non-massive-transfusion patients can be of great assistance (23). Its value in persistent nonmajor-vessel-bleeding haemothorax in terms of pleural space debridement is undisputable (24). In some cases VATS is considered to be related to lower ARDS-rates in comparison to open thoracotomy patients, whereby an obvious bias for the non-massive-injury-patients exist (25).…”

Section: Surgical Trauma Life Supportmentioning

confidence: 99%

Management of chest trauma

Ludwig¹,

Koryllos²

2017

J. Thorac. Dis.

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Trauma is the leading cause of death worldwide. Approximately 2/3 of the patients have a chest trauma with varying severity from a simple rib fracture to penetrating injury of the heart or tracheobronchial disruption. Blunt chest trauma is most common with 90% incidence, of which less than 10% require surgical intervention of any kind. Mortality is second highest after head injury, which underlines the importance of initial management. Many of these deaths can be prevented by prompt diagnosis and treatment. What is the role of the thoracic surgeon in the management of chest trauma in severely injured patients? When should the thoracic surgeon be involved? Is there a place for minimal invasive surgery in the management of severely injured patients? With two case reports we would like to demonstrate how the very specific knowledge of thoracic surgeons could help in the care of trauma patients.

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Section: Surgical Trauma Life Supportmentioning

confidence: 99%

Management of chest trauma

Ludwig¹,

Koryllos²

2017

J. Thorac. Dis.

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“…All surgical procedures were performed in operating rooms, and patients were under general anesthesia. As per our other studies [14,15], in the VATS-only group, VATS was applied for the evacuation of residual blood clots and the resection of pulmonary lacerations under endoscopic visions. In patients who received rib fixation, VATS was also first used to treat the pleural and lung parenchyma lesions.…”

Section: Vats and Surgical Fixation Of Fractured Ribsmentioning

confidence: 90%

Facilitating ventilator weaning through rib fixation combined with video-assisted thoracoscopic surgery in severe blunt chest injury with acute respiratory failure

Lin

Chou

et al. 2020

Crit Care

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Background: Severe blunt chest injury sometimes induces acute respiratory failure (ARF), requiring ventilator use. We aimed to evaluate the effect of performing rib fixation with the addition of video-assisted thoracoscopic surgery (VATS) on patients with ARF caused by blunt thoracic injury with ventilator dependence.Methods: This observational study prospectively enrolled patients with multiple bicortical rib fractures with hemothorax caused by severe blunt chest trauma. All patients received positive pressure mechanical ventilation within 24 h after trauma because of ARF. Some patients who received rib fixation with VATS were enrolled as group 1, and the others who received only VATS were designated as group 2. The length of ventilator use was the primary clinical outcome. Rates of pneumonia and length of hospital stay constituted secondary outcomes.Results: A total of 61 patients were included in this study. The basic demographic characteristics between the two groups exhibited no statistical differences. All patients received operations within 6 days after trauma. The length of ventilator use was shorter in group 1 (3.19 ± 3.37 days vs. 8.05 ± 8.23, P = 0.002). The rate of pneumonia was higher in group 2 (38.1% vs. 75.0%, P = 0.005). The length of hospital stay was much shorter in group 1 (17.76 ± 8.38 days vs. 24.13 ± 9.80, P = 0.011). Conclusion: Rib fixation combined with VATS could shorten the length of ventilator use and reduce the pneumonia rate in patients with severe chest blunt injury with ARF. Therefore, this operation could shorten the overall length of hospital stay.

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“…Subsequently, the lung was reexpanded. Finally, 2 drainage tubes were fixed into the pleural cavity, and the patient was transferred to the trauma ICU for further postoperative care [ 17 , 18 ]. Following either procedure, the thoracostomy tubes were removed at the discretion of the thoracic surgeon when the drainage was <100 mL/24 h and no air leak was present.…”

Section: Methodsmentioning

confidence: 99%

Efficiency Analysis of Direct Video-Assisted Thoracoscopic Surgery in Elderly Patients with Blunt Traumatic Hemothorax without an Initial Thoracostomy

Huang

Yang

et al. 2016

BioMed Research International

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Hemothorax is common in elderly patients following blunt chest trauma. Traditionally, tube thoracostomy is the first choice for managing this complication. The goal of this study was to determine the benefits of this approach in elderly patients with and without an initial tube thoracostomy. Seventy-eight patients aged >65 years with blunt chest trauma and stable vital signs were included. All of them had more than 300 mL of hemothorax, indicating that a tube thoracostomy was necessary. The basic demographic data and clinical outcomes of patients with hemothorax who underwent direct video-assisted thoracoscopic surgery without a tube thoracostomy were compared with those who received an initial tube thoracostomy. Patients who did not receive a thoracostomy had lower posttrauma infection rates (28.6% versus 56.3%, P = 0.061) and a significantly shorter length of stay in the intensive care unit (3.13 versus 8.27, P = 0.029) and in the hospital (15.93 versus 23.17, P = 0.01) compared with those who received a thoracostomy. The clinical outcomes in the patients who received direct VATS were more favorable compared with those of the patients who did not receive direct VATS.

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Video-assisted thoracoscopic surgery for retained hemothorax in blunt chest trauma

Cited by 43 publications

References 47 publications

Management of chest trauma

Management of chest trauma

Facilitating ventilator weaning through rib fixation combined with video-assisted thoracoscopic surgery in severe blunt chest injury with acute respiratory failure

Efficiency Analysis of Direct Video-Assisted Thoracoscopic Surgery in Elderly Patients with Blunt Traumatic Hemothorax without an Initial Thoracostomy

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