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Thoracoscopic evacuation of retained post-traumatic hemothorax
Tanveer Ahmad1, Syed Waqar Ahmed, Niaz Hussain Soomro
1Department of Thoracic Surgery, Jinnah Postgraduate Medical Centre, Karachi. tanveerahma@gmail.com
Summary
Video Assisted Thoracoscopy (VATS) effectively treats post-traumatic retained hemothorax, reducing hospitalization and complications. Early VATS intervention within six days improves outcomes and avoids surgical thoracotomy.
Area of Science:
- Thoracic Surgery
- Trauma Management
- Minimally Invasive Procedures
Background:
- Post-traumatic retained hemothorax poses significant risks, including empyema thoracis, prolonged hospitalization, and entrapped lung requiring decortication.
- Video Assisted Thoracoscopy (VATS) offers a less invasive approach to managing retained hemothorax.
Purpose of the Study:
- To evaluate the efficacy and safety of VATS for treating retained or clotted hemothoraces.
- To determine the impact of early intervention on patient outcomes.
Main Methods:
- A retrospective analysis of 110 consecutive patients undergoing VATS for retained hemothorax between December 2004 and July 2009.
- Data collected included patient demographics, timing of intervention, conversion rates to thoracotomy, and post-operative outcomes.
Main Results:
- VATS successfully achieved full lung expansion and complete hemothorax evacuation in 79% of patients.
- Chest tubes were removed within the first week in 90.9% of patients, shortening drainage duration.
- Early VATS intervention (within 6 days) was associated with a lower rate of conversion to thoracotomy (7.3% overall).
Conclusions:
- VATS is a safe, reliable, and effective technique for evacuating retained hemothorax in hemodynamically stable patients.
- Early surgical intervention (within 6 days) via VATS is recommended to improve short- and long-term outcomes and potentially avoid thoracotomy.
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