Videothoracoscopy an effective method for evaluating and managing thoracic trauma patients.
BACKGROUND
The objective of this study was to assess the diagnostic and therapeutic effectiveness of videothoracoscopy in thoracic trauma patients.


METHODS
The design was a retrospective review. The setting was a major trauma center at an urban county hospital. Forty-one hemodynamically stable patients sustaining thoracic trauma were reviewed (34 penetrating and 7 blunt injuries). In the acute setting (< 24 h), videothoracoscopy was used for continued bleeding(6) and suspected diaphragmatic injury(17). Thoracoscopy was used in delayed settings (> 24 h) for treatment of thoracic trauma complications(18) including clotted hemothorax(14), persistent air leak(1), widened mediastinum(1), and suspected diaphragmatic injury(2).


RESULTS
The average Injury Severity Score (ISS) of these patients was 18.9 +/- 10.0. Three of 6 patients (50%) with continued bleeding were successfully treated thoracoscopically. Nine of 10 (90%) diaphragmatic injuries were confirmed by thoracoscopy, and 7 of these 9 patients (77%) were repaired thoracoscopically. Thirteen of 14 patients (93%) with clotted hemothoraces and one with a persistent air leak were treated successfully using thoracoscopy. An aortic injury was ruled out in one patient.


CONCLUSIONS
Videothoracoscopy is a safe, accurate, minimally invasive, and potentially cost-effective method for the diagnosis and therapeutic management of thoracic trauma patients.
Wong
M S
MS
Department of Surgery, University of California, Davis-East Bay, Alameda County Medical Center, Oakland 94602, USA.
Tsoi
E K
EK
Henderson
V J
VJ
Hirvela
E R
ER
Forest
C T
CT
Smith
R S
RS
Fry
W R
WR
Organ
C H
CH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013898:Thoracic Injuries / Q000175:diagnosis* / Q000601:surgery*; D013903:Thoracic Surgery / Q000295:instrumentation; D020708:Thoracoscopes; D013906:Thoracoscopy / Q000379:methods; D016896:Treatment Outcome; D014741:Video Recording