A prospective evaluation of video-assisted thoracic surgery for persistent air leak due to trauma.
BACKGROUND
The time required for air leak resolution after chest trauma is not well described. Based on an institutional review of posttraumatic air leaks our hypothesis was that video-assisted thoracic surgery (VATS) for persistent posttraumatic air leak would decrease chest tube days and length of stay compared with nonoperative management.


METHODS
Patients were offered VATS versus nonoperative management when air leaks persisted longer than 3 days and the patients were otherwise ready for discharge. Chest tube days and length of stay were recorded.


RESULTS
Of 223 trauma patients requiring chest tubes, 50 had persistent air leaks, 39 of whom were otherwise ready for discharge. Twenty-five chose VATS and 14 nonoperative (NOP) treatment. The mean chest tube days was 8.1 for VATS versus 11.8 for NOP (P = 0.001). Mean length of stay was 9.7 days for VATS and 16.5 days for NOP (P = 0.002).


CONCLUSIONS
In patients otherwise ready for discharge VATS reduces chest tube days and length of stay when used to treat persistent posttraumatic air leak.
Schermer
C R
CR
Department of Surgery, University of New Mexico, Albuquerque, USA.
Matteson
B D
BD
Demarest
G B
GB
Albrecht
R M
RM
Davis
V H
VH
D015505:Chest Tubes; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006491:Hemothorax / Q000209:etiology / Q000601:surgery* / Q000628:therapy; D006801:Humans; D007902:Length of Stay; D008297:Male; D011030:Pneumothorax / Q000209:etiology / Q000601:surgery* / Q000628:therapy; D011446:Prospective Studies; D013898:Thoracic Injuries / Q000150:complications*; D013906:Thoracoscopy; D013997:Time Factors