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Non-Intubated Video-Assisted Thoracoscopic Surgery
Published on: May 26, 2023
Thoracoscopic evacuation of retained posttraumatic hemothorax
Pradeep H Navsaria1, Richard J Vogel, Andrew J Nicol
1Department of Surgery, Trauma Unit, Groote Schuur Hospital and the Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa. navasaria@uctgsh1.uct.ac.za
The Annals of Thoracic Surgery
|June 30, 2004
Summary
Video-assisted thoracoscopic surgery (VATS) effectively treats retained hemothoraces after trauma. This minimally invasive approach offers a safe and reliable alternative to open surgery for pleural collections.
Area of Science:
- Thoracic Surgery
- Trauma Management
- Minimally Invasive Procedures
Background:
- Residual posttraumatic hemothoraces occur in 1-20% of patients treated with tube thoracostomy.
- Video-assisted thoracoscopic surgery (VATS) is an alternative to thoracotomy for evacuated retained collections.
- This study reviews trauma unit experience with thoracoscopic evacuation of hemothoraces.
Purpose of the Study:
- To evaluate the efficacy and safety of VATS for retained posttraumatic hemothoraces.
- To assess VATS as an alternative to thoracotomy in trauma patients.
- To review the trauma unit's experience with thoracoscopic evacuation of hemothoraces.
Main Methods:
- Retrospective review of trauma patients undergoing surgical intervention for retained hemothoraces.
- Study period: January 2001 to June 2003 (30 months).
- Inclusion criteria: Patients with retained hemothoraces requiring surgical intervention.
Main Results:
- 46 patients with penetrating injuries (40 stab, 6 gunshot) were included.
- VATS successfully evacuated retained pleural fluid in 80% (37 patients).
- VATS failed in 20% (9 patients) due to dense adhesions, requiring conversion to thoracotomy. Mean interval to VATS was 13.3 days.
Conclusions:
- VATS is an accurate, safe, and reliable treatment for retained posttraumatic pleural collections.
- VATS is effective even when performed later than the conventional 3- to 5-day window.
- VATS offers a viable minimally invasive option for managing posttraumatic hemothoraces.
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