Video-Assisted Thoracoscopic Surgery for Open Thoracic Traumas / 中国微创外科杂志

ABSTRACT

Objective To evaluate the video-assisted thoracoscopic surgery(VATS) in the diagnosis and treatment of open thoracic traumas. Methods From July 2003 to July 2008,video-assisted thoracoscopic surgeries,including thoracic exploration,repair of the pulmonary laceration,parietal pericardium and diaphragm,hemostasis,evacuation of the clotted hemothorax,and mini-incision thoracotomy,were carried out in 64 selected patients with open thoracic traumas. Results Via VATS,all the 64 patients were diagnosed accurately pulmonary laceration in 43(56 lesions),pericardiac rupture in 7(one of them showed right ventricular rupture),diaphragmatic rupture in 9(5 of them were complicated with spleen rupture,1 with hepatic rupture,and 1 with gastric rupture perforation),single intercostal vessel injury in 5,and combined intercoastal vessel injury in 3.The procedures involved VATS pulmonary laceration repair in 24(combined with thoracic wall hemostasis in 2),VATS combined mini-incision thoracotomy pulmonary laceration repair with Endo-GIA in 11(silk suture was employed in 6,and pulmonary wedge resection in 2).Through VATS procedure,hemostasis and repair were completed for pericardiac repair in 3,and diaphragmatic repair in 5.Thirteen cases were converted to open thoracic surgery.The duration of VATS procedure ranged from 32 to 124 minutes with a mean of 65.8 minutes.After the procedure,6 patients developed pneumothorax,4 showed mild subcutaneous emphysema,and 9 had slight hemoptysis in 1 to 12 days after the treatment.The patients were followed up for 2 to 60 months(mean,28.5 months).Chest X-ray performed during the period showed no pleural effusion,pneumothorax or other trauma-related complications.Conclusion VATS is effective for the diagnosis and treatment of open thoracic traumas with less surgical injuries and good outcomes.