J Korean Soc Traumatol.  2017 Jun;30(2):33-40. 10.20408/jti.2017.30.2.33.

Thoracoscopy in Management of Chest Trauma: Our Three-year Jeju Experience

• Lee SH
• Yie K
• Lee JH
• Kang JG
• Lee MK
• Kwon OS
• Chon SH

• KMID: 2392705
• DOI: http://doi.org/10.20408/jti.2017.30.2.33

Abstract

PURPOSE
The role for minimally invasive surgery in chest trauma is vague, one that recently is more frequently performed, and one attractive option to be considered. Thoracoscopic surgery may improve morbidity, mortality, hasten recovery and shorten hospital stay.
METHODS
A total of 31 patients underwent video assisted thoracoscopic surgery for the treatment of blunt and penetrating chest trauma from June 9th, 2013 to March 21st, 2016 in Jeju, South Korea.
RESULTS
Twenty-three patients were males and eight patients were females. Their ages ranged from 23 to 81 years. The cause of injury was due to traffic accident in 17 patients, fall down in 5 patients, bicycle accident in 2 patients, battery in 2 patients, crushing injury in 2 patients, and slip down, kicked by horse, and stab wound in one patient each. Video assisted thoracoscopic exploration was performed in the 18 patients with flail chest or greater than 3 displaced ribs. The thoracoscopic procedures done were hematoma evacuation in 13 patients, partial rib fragment excision in 9 patients, lung suture in 5 patients, bleeding control (ligation or electrocautery) in 3 patients with massive hemothorax, diaphragmatic repair in two patients, wedge resection in two patients and decortication in 1 patient. There was only one patient with conversion to open thoracotomy.
CONCLUSION
There is a broad range of procedures that can be done by thoracoscopic surgery and a painful thoracotomy incision can be avoided. Thoracoscopic surgery can be done safely and swiftly in the trauma patient.

Keyword

Thoracic trauma; Trauma surgery; Video assisted thoracoscopic surgery

MeSH Terms

Accidents, Traffic
Female
Flail Chest
Hematoma
Hemorrhage
Hemothorax
Horses
Humans
Korea
Length of Stay
Lung
Male
Minimally Invasive Surgical Procedures
Mortality
Ribs
Sutures
Thoracic Surgery, Video-Assisted
Thoracoscopy*
Thoracotomy
Thorax*
Wounds, Stab