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Objective:To investigate the risk factors associated with the complications of video-assisted thoracic surgery (VATS) in the treatment of traumatic hemothorax.Methods:A retrospective case-control study was conducted to analyze the clinical data of 94 patients with traumatic hemothorax undergone VATS treatment in Tangdu Hospital of Air Force Medical University from January 1, 2012 to December 31, 2018. There were 75 males and 19 females, aged from 15-78 years [(45.8±14.6)years]. Postoperative complications occurred in 12 patients (complication group) and not in 82 patients (non-complication group). The following data were analyzed for complication-related risk factors using univariate analysis and Logistic regression analysis, including gender, age, mechanism of injury, pneumothorax and hemothorax, number of fractured ribs, abbreviated injury score (AIS), injury severity score (ISS), time from injury to operation, operation time, rib fixation or not, pulmonary air leakage or not, duration of drainage, postoperative volume of drainage, and postoperative length of hospital stay.Results:The proportion of patients with time from injury to operation (>3 days), duration of drainage and postoperative length of hospital stay in complication group [75%(9/12), (7.8±2.6) days, (10.2±2.7)days] were significantly higher or longer than those in non-complication group [37%(30/82), (5.5±1.6)days, (8.0±2.3)days] ( P<0.05 or 0.01). There were no statistically significant differences between the two groups in gender, age, mechanism of injury, pneumothorax and hemothorax conditions, number of fractured ribs (≥3), AIS, ISS, operation time, rib fixation or not, pulmonary air leakage or not and postoperative volume of drainage ( P>0.05). Logistic regression analysis showed time from injury to operation (>3 days) and pulmonary air leakage were significantly associated with the complications of VATS ( P<0.05). Conclusion:Time from injury to operation (>3 days) and pulmonary air leakage are independent risk factors for the complications of VATS in the treatment of traumatic hemothorax.
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Objective@#To identify the risk factors of failed observational treatment of traumatic hemothorax.@*Methods@#Clinical data of traumatic hemothorax combined with observational treatment were selected from the data of chest trauma cases admitted to the thoracic surgery department from January 2012 to December 2018. The treatment effect was analyzed, and the risk factors of failed observational treatment were analyzed by multivariate analysis.@*Results@#The total failure rate of observational treatment was 59.26%(32/54), and the details of hemothorax volume, length of stay in hospital, pneumothorax and patients with more than 3 rib fractures in the failed conservative treatment group were more than those in the successful treatment group(P<0.05). Independent risk factors of failed observational treatment were more than 3 rib fractures(OR=5.535, 95%CI: 1.065-28.754, P=0.042)and pneumothorax(OR=9.529, 95%CI: 1.988-45.580, P=0.005).@*Conclusion@#Pneumothorax and more than 3 rib fractures are the independent risk factors of failed observational treatment, and should be included in the observational treatment decision of traumatic hemothorax.
ABSTRACT
Objective:To identify the risk factors of failed observational treatment of traumatic hemothorax.Methods:Clinical data of traumatic hemothorax combined with observational treatment were selected from the data of chest trauma cases admitted to the thoracic surgery department from January 2012 to December 2018. The treatment effect was analyzed, and the risk factors of failed observational treatment were analyzed by multivariate analysis.Results:The total failure rate of observational treatment was 59.26%(32/54), and the details of hemothorax volume, length of stay in hospital, pneumothorax and patients with more than 3 rib fractures in the failed conservative treatment group were more than those in the successful treatment group( P<0.05). Independent risk factors of failed observational treatment were more than 3 rib fractures( OR=5.535, 95% CI: 1.065-28.754, P=0.042)and pneumothorax( OR=9.529, 95% CI: 1.988-45.580, P=0.005). Conclusion:Pneumothorax and more than 3 rib fractures are the independent risk factors of failed observational treatment, and should be included in the observational treatment decision of traumatic hemothorax.
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Traumatic hemothorax is a common disease in chest trauma .If it is not treated properly and effectively , it will lead to continuous blood loss, clotted hemothorax, empyema and other life-threatening conditions.Because of no universally ac-cepted guide or consensus in the treatment of traumatic hemothorax , clinicians often choose different ways to treat different de-grees and types of traumatic hemothorax according to their habits and experience .This article focus on recent studies on the treatment of traumatic hemothorax , summarize the latest achievements in the field of traumatic hemothorax , provide evidence for clinicians'clinical decision-making, and find the current insufficiency of traumatic hemothorax and the direction for further re-search.
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Objective:To analyze the curative effects of resection by traditional thoracotomy and thoracoscopy for senile peripheral lung cancer.Methods:65 patients with peripheral lung cancer were randomly divided into traditional thoracotomy surgical group and thoracoscope group.Operation protocol are in accordance with established grouping scheme,compare two groups of patients with general attribute data.indicators related to the operation.Postoperative follow-up last to June 2016,Kaplan Meier-method is used to evaluate patients' 5 year overall survival (OS) and relapse-free survival (RFS).Results:The thoracoscope surgery group operating time significantly longer than thoracotomy group (p＜0.05).The time of intrathoracic drain in thoracoscope group was obviously shortened (p＜0.05).The loss of blood in thoracoscope group is less than thoracotomy group (p＜0.05).Postoperative complications such as VAS score decreased,and the hospitalization time is shorter than thoracotomy group (p＜0.05).But the thoracoscope hospitalization expenditure is more expensive than thoracotomy group (p＜ 0.05).RFS of thoracotomy group for five years was 65.27％,and the thoracoscope group was 67.13％:there was no statistically significant difference (p＞0.05).Thoracotomy patients OS for 5 years was 53.73％,the thoracoscope group was 55.34％,the difference was statistically significant (p＜0.05).Conclusion:Compared with the traditional thoracotomy surgery,blood loss is more than lung cancer resection under thoracoscope.Thoracoscope make the patient recover faster.