- 期刊
- OpenAccess
Video-Assisted Thoracoscopic Surgery for Early Evacuation of Traumatic Clotted Hemothoraces
並列摘要
Background: Traumatic hemothorax without early adequate evacuation of intrathoracic blood often results in prolonged hospitalization and severe complications such as empyema and fibrothorax. The efficacy of video-assisted thoracoscopic surgery (VATS) applied on this disease entity was studied. Methods: Chest trauma patients who developed retained clotted hemothoraces after initial management with chest intubation were prospectively randomized to treatment with either traditional posterolateral thoracotomy (group 1, n=9) or video-assisted thoracoscopic surgery (group 2, n=9). In group 1 patients, the goal of operative procedure was to evacuate blood clots, with the thoracotomy wound being less extensive as possible. Duration of chest tube drainage, total amount of tube drainage, hospital stay and estimated costs of both groups were studied. Results: Patients in group 2 had shorter duration of postoperative tube drainage (3.44±0.68 versus 5.67±1.53 days; p＜0.001), shorter hospital days after the procedure (4.56±1.06 versus 9.11±2.64 days; p＜0.001), and shorter total hospital stay (8.56±1.83 versus 15.22±3.58 days; p＜0.001) compared to group 1 patients. Hospital costs were also less in group 2 (NT$ 51,556±16,561 versus 78,656±14,105; p＜0.001). There were no mortalities in either group of patients. No conversion to thoracotomy procedure was needed in group 2 patients. Conclusion: VATS performed early on patients who failed the initial chest intubation to treat traumatic retained clotted hemothoraces significantly decreases the expected time of tube drainage, the length of hospital stay, and total hospital cost. Thoracotomy itself, relatively time wasting and labor consuming, could be reserved as a second choice in case there are contraindications to VATS procedure.
延伸閱讀
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