title: Videothoracoscopy an effective method for evaluating and managing thoracic trauma patients.
abstract: 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.
authors.affiliation: Department of Surgery, University of California, Davis-East Bay, Alameda County Medical Center, Oakland 94602, USA.
authors.forename: M S
authors.initials: MS
authors.lastname: Wong
authors.forename: E K
authors.initials: EK
authors.lastname: Tsoi
authors.forename: V J
authors.initials: VJ
authors.lastname: Henderson
authors.forename: E R
authors.initials: ER
authors.lastname: Hirvela
authors.forename: C T
authors.initials: CT
authors.lastname: Forest
authors.forename: R S
authors.initials: RS
authors.lastname: Smith
authors.forename: W R
authors.initials: WR
authors.lastname: Fry
authors.forename: C H
authors.initials: CH
authors.lastname: Organ
mesh_terms: 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