[Early rethoracotomies for diseases and chest traumas]

Rethoracotomies were performed on 34 patients operated for diseases and traumas of the chest, diseases of the esophagus which made up 1.3%. Emergency and reoperations were performed on 14 (46%) patients for ongoing intrapleural bleeding, clotted hemothorax and pulmonary bleeding. Emergency and delayed rethoracotomies were performed on 7 patients for non-hermeticity of the lung and incompetence of the bronchus suture, on 5 patients for incompetence of esophagogastroanastomosis, necrosis of the transplant and gastric wall, 3 patients for chylothorax not-arrested conservatively, 2 patients for gangrene of the residual lung lobe due to disturbed venous outflow. Postoperative complications resulted in death of 12 (37.5%) patients. Causes of lethal outcomes were purulent complications (pleural empyema, mediastinitis, sepsis, polyorganic insufficiency--in 5), massive blood loss with the development of coagulopathy (in 4), pneumonia of the only lung after pulmonectomy (in 2), pulmonary embolism (in 1). In addition, torsion of the residual lung lobe, foreign body in the pleural cavity can be considered as indications for rethoracotomy.