Role of Videothoracoscopy in Chest Trauma

Lang-Lazdunski, Loı̈c; Mouroux, Jérôme; Pons, François; Grosdidier, G.; Martinod, Emmanuel; Elkaïm, Dan; Azorin, J.; Jancovici, R

doi:10.1016/s0003-4975(96)00960-5

Cited by 102 publications

(67 citation statements)

References 15 publications

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“…(11) If done thereafter, failure rates were reported to be high. (12) Conversion to open thoracotomy rates have been found to be from 13.8 to 31%. (13) Our conversion rate was 3.2% (1 patient).…”

Section: Discussionmentioning

confidence: 99%

Thoracoscopy in Management of Chest Trauma: Our Three-year Jeju Experience

Lee

Yie

Lee

et al. 2017

Journal of Trauma and Injury

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Purpose:The role for minimally invasive surgery in chest trauma is vague, one that recently is more frequently performed, and one attractive option to be considered. Thoracoscopic surgery may improve morbidity, mortality, hasten recovery and shorten hospital stay.Methods: A total of 31 patients underwent video assisted thoracoscopic surgery for the treatment of blunt and penetrating chest trauma from June 9th, 2013 to March 21st, 2016 in Jeju, South Korea.Results: Twenty-three patients were males and eight patients were females. Their ages ranged from 23 to 81 years. The cause of injury was due to traffic accident in 17 patients, fall down in 5 patients, bicycle accident in 2 patients, battery in 2 patients, crushing injury in 2 patients, and slip down, kicked by horse, and stab wound in one patient each. Video assisted thoracoscopic exploration was performed in the 18 patients with flail chest or greater than 3 displaced ribs. The thoracoscopic procedures done were hematoma evacuation in 13 patients, partial rib fragment excision in 9 patients, lung suture in 5 patients, bleeding control (ligation or electrocautery) in 3 patients with massive hemothorax, diaphragmatic repair in two patients, wedge resection in two patients and decortication in 1 patient. There was only one patient with conversion to open thoracotomy.Conclusion: There is a broad range of procedures that can be done by thoracoscopic surgery and a painful thoracotomy incision can be avoided. Thoracoscopic surgery can be done safely and swiftly in the trauma patient. [ J Trauma Inj 2017; 30: 33-40 ]

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Section: Discussionmentioning

confidence: 99%

Thoracoscopy in Management of Chest Trauma: Our Three-year Jeju Experience

Lee

Yie

Lee

et al. 2017

Journal of Trauma and Injury

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“…[24] Manlulu ve arkadaşları [25] ile diğer araştırmacıların [7][8][9]19,23,24] göğüs travmaların-daki VATS prosedürlerini akut fazda yapmadıkları ve travmadan birkaç gün sonra gerçekleştirdikleri görül-mektedir.…”

Section: Discussionunclassified

Should videothorascopic surgery be the first choice in isolated traumatic hemothorax ? Prospective randomised controlled study

Çobanoğlu¹,

Sayır²,

Mergan³

2011

Ulus Travma Acil Cerrahi Derg

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“…The topic of time between diagnosis of the hemothorax and thoracoscopic drainage, probably affecting lowest complications rate and better outcomes, has not been fully clarified in the literature. Various studies showed that early evacuation results in less complications: but, while some authors (17,18) recommend the surgical procedure performed within 3 days following the diagnosis, others report successful outcomes in trauma patients when this is accomplished after 7 or more days (19,20). Villegas et al in their series of 139 patients showed that the longer the time span between the moment of the trauma and the procedure, the higher the risk of complications and the conversion rate (21).…”

Section: Multiportal Vats Strategy: Basic Conceptsmentioning

confidence: 99%

Uniportal video-assisted thoracoscopic surgery in hemothorax

et al. 2017

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The management of hemothorax (spontaneous or, more often, due to thoracic trauma lesions), follows basic tenets well-respected by cardiothoracic surgeons. In most, a non-operative approach is adequate and safe, with a defined group of patients requiring only tube thoracostomy. Only a minority of patients need a surgical intervention due to retained hemothorax, persistent bleeding or incoming complications, as pleural empyema or entrapped lung. In the early 1990s, the rapid technological developments determined an increase of diagnostic and therapeutical indications for multiport video-assisted thoracoscopic surgery (VATS) as the gold standard therapy for retained and persistent hemothorax, allowing an earlier diagnosis, total clots removal and better tubes placement with less morbidity, reduced post-operative pain and shorter hospital stay. There is no consensus in the literature regarding the timing for draining hemothorax, but best results are obtained when the drainage is performed within the first 5 days after the onset. The traditional multiport approach has evolved in the last years into an uniportal approach that mimics open surgical vantage points utilizing a non-rib-spreading single small incision. Currently, in experienced hands, this technique is used for diagnostic and therapeutic interventions as hemothorax evacuation as like as the more complex procedures, such as lobectomies or bronchial sleeve and vascular reconstructions. visualization, a higher yield of detecting small injuries, less post-operative pain, improved lung function, shorter hospital stay and earlier recovery (2,5,7,8). KeywordsMore recently, the uniportal VATS approach has gained popularity in thoracic surgery, initially for minor procedures (9,10) and then also for major lung resection (11,12). This paper summarised recent advances available in the medical literature focusing especially on the VATS treatment of hemothorax, in particular considering the advantages of uniportal versus multiportal approach. Multiportal VATS strategy: basic conceptsThoracoscopy in the last years has been suggested as the first-line treatment in non-complicated hemothorax, leaving thoracotomy as the rescue option in case of failure or major trauma with bleeding (7). Truly, Joao Martins Castello Branco in 1946 was the first to describe the use of thoracoscopy in thoracic trauma, managing persistent bleeding with electrocoagulation. Since then, many authors described the use of this technique for diagnostic (diaphragmatic lesions) and therapeutic (hemothorax in penetrating chest trauma) options (13,14). However, only in the late 1990s, due to technical advances, its use became worldwide popular and VATS gained a primary position in the care of thoracic trauma patients (7,15). Villavicencio et al. (16) demonstrated that thoracoscopy may be used safely and successfully in assessment of clotted or persistent hemothorax and in empyema drainage; according to their data, 90-95% of patients with posttraumatic hemothorax are treated conservatively o...

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Role of Videothoracoscopy in Chest Trauma

Cited by 102 publications

References 15 publications

Thoracoscopy in Management of Chest Trauma: Our Three-year Jeju Experience

Thoracoscopy in Management of Chest Trauma: Our Three-year Jeju Experience

Should videothorascopic surgery be the first choice in isolated traumatic hemothorax ? Prospective randomised controlled study

Uniportal video-assisted thoracoscopic surgery in hemothorax

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