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Journal of the Korean Society of Traumatology 2010;23(2):170-174.
Clinical Feasibility of Video-assisted Thoracic Surgery for Thoracic Trauma
Do Kyun Kang, Hyeong Ryul Kim, Yong Hee Kim, Dong Kwan Kim, Seung Il Park
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea. hrkim09@amc.seoul.kr
흉부외상 치료에서의 비디오 흉강경 수술의 유용성
강도균∙김형렬∙김용희∙김동관∙박승일
울산대학교 의과대학 서울아산병원 흉부외과
Abstract
PURPOSE
As techniques and instruments for video-assisted thoracic surgery (VATS) have been evolving, attempts to perform VATS for chest trauma have been increasing. Several studies have demonstrated the feasibility and safety of VATS for thoracic trauma. We reviewed our experience to evaluate the clinical feasibility and safety of VATS for thoracic trauma.
METHODS
Fifty-two patients underwent thoracic surgery for chest trauma in Asan Medical Center from January 1990 to December 2009. VATS was performed in 21 patients who showed stable vital signs. We reviewed retrospectively the medical records of those patients to investigate the results of VATS for thoracic trauma.
RESULTS
Thoracic exploration for chest trauma was performed in 52 patients. There were 46 males (88.5%) and 6 females (11.5%). The median age was 46.0 years (range: 11~81 years). There were 39 blunt and 13 penetrating traumas. A standard posterolateral thoracotomy was performed in 31 patients, and VATS was tried in 21 patients. We performed successful VATS in 13 patients; 11 males (84.5%) and 2 females (15.5%) with a median age of 46.0 years (range: 24~75 years). The indication of VATS was persistent intrathoracic hemorrhage in 10 patients and clotted hemothorax in 3 patients. There were no complications, but there were two mortalities due to multiple organ failure after massive transfusion. In 8 patients, VATS was converted to a standard posterolateral thoracotomy for several reasons. The reason was inadequate visualization for bleeding control or evacuation of the hematoma in 5 patients. In 3 patients, VATS was performed to evaluate diaphragmatic injury. After the diaphragmatic injury had been confirmed, a standard posterolateral thoracotomy was performed to repair the diaphragm.
CONCLUSION
VATS should be safe and efficient method for diagnostic evaluation and surgical management of stable patients with thoracic trauma.
Key Words: Video-assisted thoracic surgery; Thorax; Trauma


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