Related Experiment Video
Updated: Aug 22, 2026

Non-Intubated Video-Assisted Thoracoscopic Surgery
Published on: May 26, 2023
Increased pulmonary morbidity and mortality with early video-assisted thoracic surgery for retained hemothorax
Denise M Garofalo1, Michael R Bronsert2, Christina M Stuart3
1Department of Surgery, University of Colorado School of Medicine, 12631 E 17th Avenue, Aurora, CO, 80045, USA; Healthcare Access & Equity Research, University of Colorado School of Medicine, Aurora, CO, USA; Surgical Outcomes & Applied Research, University of Colorado School of Medicine, Aurora, CO, USA.
Introduction:
Video-assisted thoracic surgery (VATS) is recommended for approximately 30% of hemothoraces that become retained, yet the optimal timing for VATS remains debated. We sought to compare the relationship between VATS timing and associated outcomes.
Methods:
The pulmonary morbidity and mortality of early (≤4d), intermediate (5-10d) and late (≥10d) VATS in adults were compared in the 2017-2021 Trauma Quality Improvement Program.
Results:
Of the 9784 VATS identified, pulmonary morbidity (57%) and mortality (4.5%) were higher in the early group relative to the intermediate (41, 3.0%) and late groups (48, 2.9%, p < 0.01) with higher rates of reintervention including secondary thoracotomy (4.5 vs. 3.1 vs. 3.2% p = 0.04) and tube thoracostomy (51 vs. 24 vs. 24%, p < 0.01). Risk-adjusted rates of both outcomes were inversely proportional to VATS days (p < 0.01).
Conclusion:
This study adds to ongoing debate regarding the optimal timing of VATS for retained hemothorax, supporting the need for prospective study.
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