Early Thoracotomy in the Treatment of Chest Trauma

Kim, Han Yong; Hwang, Sang Won; Lee, Yeon Jae; Yoo, Byung Ha

Abstract

Trauma to the thorax represents a significant portion of injuries seen in an inner-city emergency room. Although most of these patients may be sucessfully managed without thoracotomy, a certain percentage requires operative intervention either immediately or within several hours. 126 records of patients who had early thoracotomy for chest trauma from March 1986, to June 1997, in the Department of Thoracic and Cardiovascular Surgery in Masan Samsung General Hospital were reviewed. There were 96 males and 30 females whose ages ranged from 4 to 72 years, with a mean age of 32.8 years. The modes of injury were as follows : stab wounds, 55 cases (44%), blunt trauma, 70 cases (55%), and gunshot wound, 1 case (1%). Immediate operation was performed in 105 cases (84%) and delayed operation in 21 cases (16%). Indications that operation was necessary were hemorraging and shock in 66 cases (52%), cardiac tamponade in 27 cases (21%), and rupture of the diaphragm in 33 cases (27%). Most of these patients were sucessfully treated but 21 cases were resulted in death. The mortality rate was 16.6% and common causes of death were irreversible shock and hypoxia.