Video-Assisted Thoracic Surgery for Hemothorax following Coronary Artery Bypass

Samra, Shivpreet Singh; Samra, Navdeep S.; Jain, Ajeet; Mehta, Vipin

doi:10.1177/021849230601400225

Cited by 3 publications

(4 citation statements)

References 4 publications

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“…The pleural cavity has to be well cleaned up, as well as for non-transplanted patients. The lower impact on respiratory parameters of thoracoscopy compared to thoracotomy must be considered [ 25 – 28 ].…”

Section: Discussionmentioning

confidence: 99%

Morbidity and mortality of iatrogenic hemothorax occurring in a cohort of liver transplantation recipients: a multicenter observational study

et al. 2021

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Hemothorax (HT) is a life-threatening condition, mainly iatrogenic and poorly explored in Liver Transplantation (LT) recipients. The aim of this study is to report and analyze for the first time incidence and outcomes of HT in LT recipients, as well as to suggest a management strategy. Data concerning 7130 consecutive adult liver and liver–kidney transplant recipients were retrospectively collected from ten Transplantation Centers’ institutional databases, over a 10-year period. Clinical parameters, management strategies and survival data about post-operative HT were analyzed and reported. Thirty patients developed HT during hospitalization (0.42%). Thoracentesis was found to be the most common cause of HT (16 patients). A non-surgical management was performed in 17 patients, while 13 patients underwent surgery. 19 patients developed thoracic complications after HT treatment, with an overall mortality rate of 50%. The median length of stay in Intensive Care Units was 22 days (IQR 25–75 5–66.5). Postoperative hemothorax is mainly due to iatrogenic causes in LT recipients. Despite rare, it represents a serious complication with a high mortality rate and a challenging medical and surgical management. Its occurrence should always be prevented.

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Section: Discussionmentioning

confidence: 99%

Morbidity and mortality of iatrogenic hemothorax occurring in a cohort of liver transplantation recipients: a multicenter observational study

et al. 2021

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“…Uniportal video-assisted thoracoscopic surgery in hemothorax 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).…”

Section: Review Article On Thoracic Surgerymentioning

confidence: 99%

“…Spontaneous hemothorax is a very rare clinical scenario and it is due to concomitant pneumothorax, to vascular disorders, connective tissue disease, neoplasms, extramedullary haematopoiesis, endometriosis or pulmonary sequestration (1)(2)(3)(4).…”

Section: Introductionmentioning

confidence: 99%

“…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). …”

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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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