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Updated: Jun 12, 2026
05:39
Non-Intubated Video-Assisted Thoracoscopic Surgery
Published on: May 26, 2023
Post-Operative Hemothorax: Uniportal Video-Assisted Thoracic Surgery vs Thoracotomy-Analysis of Outcomes and Costs
Antonio Giulio Napolitano1, Claudia Bellettati1, Adriana Nocera1
1Department of General Thoracic Surgery, Fondazione Policlinico Universitario "A. Gemelli", IRCCS, Università̀ Cattolica del Sacro Cuore, Rome, Italy.
Seminars in Thoracic and Cardiovascular Surgery
|June 10, 2026
Summary
Uniportal video-assisted thoracic surgery (U-VATS) reoperation for post-operative hemothorax (PH) is safer and more cost-effective than thoracotomy. This approach leads to fewer complications and shorter hospital stays for thoracic surgery patients.
Area of Science:
- Thoracic Surgery
- Surgical Complications
- Minimally Invasive Surgery
Background:
- Post-operative hemothorax (PH) is a critical complication following thoracic surgery.
- Prompt treatment is essential for managing PH.
- Reoperation is often required for persistent or significant PH.
Purpose of the Study:
- To compare outcomes and costs of reoperation for PH using Uniportal Video-Assisted Thoracic Surgery (U-VATS) versus thoracotomy.
- To identify risk factors for complications after PH reoperation.
Main Methods:
- Retrospective analysis of 52 patients who developed PH after thoracic operations (2016-2024).
- Patients underwent reoperation via U-VATS or thoracotomy.
- Data collected included complications, intensive care unit (ICU) admission, hospital stay, and costs.
Main Results:
- PH occurred in 3.12% of 1663 thoracic operations.
- Thoracotomy group had significantly higher post-operative complications (34.48% vs 8.69%) and ICU admissions (48.27%).
- U-VATS was associated with shorter hospital stays (4.35 vs 7.07 days) and lower overall costs (€5238.79 vs €6708.94).
- Open approach was an independent risk factor for complications (OR=5.53).
Conclusions:
- U-VATS reoperation for PH is safe, effective, and associated with lower post-operative complications and costs compared to thoracotomy.
- Thoracotomy increases the risk of complications, prolonged hospital stay, and healthcare expenses in PH reoperation.
- U-VATS offers a potentially superior approach for managing post-operative hemothorax.
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