Video-assisted thoracoscopic surgery in the management of penetrating and blunt thoracic trauma.
BACKGROUND
The role of video-assisted Thoracoscopic Surgery (VATS) is still being defined in the management of thoracic trauma. We report our trauma cases managed by VATS and review the role of VATS in the management of thoracic trauma.


METHODS
All the trauma patients who underwent VATS from 2000 to 2007 at Cedars-Sinai Medical Center were retrospectively studied.


RESULTS
Twenty-three trauma patients underwent 25 cases of VATS. The most common indication for VATS was retained haemothorax. Thoracotomy was avoided in 21 patients. VATS failed in two cases. On an average VATS was performed on trauma day seven (range 1-26) and the length of hospital stay was 20 days (range 3-58). There was no mortality. VATS was performed in an emergency (day 1-2), or in the early (day 2-7) or late (after day 7) phases of trauma.


CONCLUSIONS
VATS can be performed safely for the management of thoracic traumas. VATS can be performed before or after thoracotomy and at any stage of trauma. The use of VATS in trauma has a trimodal distribution (emergent, early, late), each with different indications.
Milanchi
S
S
Department of Surgery, Thoracic Surgery and Trauma, Surgical Director, Women's Guild Lung Institute, Program Director, General Thoracic Surgery Fellowship, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Makey
I
I
McKenna
R
R
Margulies
D R
DR