Video-assisted thoracoscopic surgery in the treatment of chest trauma: long-term benefit.
BACKGROUND
Video-assisted thoracoscopic surgery (VATS) has gained an increasing importance as a diagnostic and therapeutic tool in chest trauma. Several studies have demonstrated its feasibility and safety, but only a few addressed the long-term benefit of VATS. The aim of this study was to evaluate the short-term and long-term benefits of VATS in chest trauma, with emphasis on the patient's point of view.


METHODS
Medical records of patients with chest trauma during a 10-year period were reviewed. The study included 77 patients (37 patients in the VATS group and 40 in the thoracotomy group). Forty-four patients who underwent operative treatment during the study period were excluded from the study. Hospital charts and a telephone questionnaire were used to evaluate the outcome.


RESULTS
No deaths occurred in either group. Clotted hemothorax was the most common finding. The incidence of wound and pulmonary complication were higher in the thoracotomy group. Patients in the thoracotomy group needed significantly higher doses of narcotic analgesia. Average time to resume normal activity was shorter in the VATS group. More than 2 years after discharge, the rate of return to a normal lifestyle was 81% in the VATS group and 60% of the thoracotomy group. Patients in the VATS group were generally more satisfied with their health status and surgical scars.


CONCLUSIONS
The results of this study show that for stable patients with chest trauma, video assisted thoracic surgery is feasible and safe. Moreover, it is tolerated better than open thoracotomy, has a favorable postoperative course, a superior long-term outcome, and greater patient satisfaction.
Ben-Nun
Alon
A
Department of General Thoracic Surgery, Rambam Medical Center, Haifa, Israel. a_ben_nun@rambam.health.gov.il
Orlovsky
Michael
M
Best
Lael Anson
LA
D000293:Adolescent; D000328:Adult; D004305:Dose-Response Relationship, Drug; D005260:Female; D006491:Hemothorax / Q000209:etiology; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009294:Narcotics / Q000008:administration & dosage / Q000627:therapeutic use; D020127:Recovery of Function; D011795:Surveys and Questionnaires; D013898:Thoracic Injuries / Q000601:surgery*; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects / Q000592:standards*; D013908:Thoracotomy / Q000009:adverse effects / Q000592:standards; D013927:Thrombosis / Q000209:etiology; D013997:Time Factors
D009294:Narcotics