title: Role of early thoracoscopy for management of penetrating wounds of the chest.
abstract: Most nonlife-threatening penetrating wounds of the chest (PWC) are treated with a chest tube alone. This may be inadequate because missed injuries, retained hemothorax, or foreign material may be difficult to address later. Early thoracoscopy should improve outcome. We conducted a retrospective review of 88 stable patients with PWC initially treated with a chest tube and had retained a hemothorax beyond 48 hours. Twenty-seven underwent an early video-assisted thoracoscopy (VATS). Fifty-five were observed, chest tubes were manipulated, or an additional one placed. The outcome was compared with the National Trauma Data Bank and controlled for Injury Severity Score. Early VATS reduced length of stay (4.3 vs 9.4 days), days in the intensive care unit (1.3 vs 3.2), and open thoracotomy (0 vs 7). A chest tube undertreats a nonlife-threatening PWC correctable by timely VATs.
authors.affiliation: Department of Surgery, University of Mississippi, Jackson, Mississippi 39216, USA. NAhmed@umc.edu
authors.forename: Naveed
authors.initials: N
authors.lastname: Ahmed
authors.forename: Raphael
authors.initials: R
authors.lastname: Chung
mesh_terms: D000704:Analysis of Variance; D015505:Chest Tubes; D006491:Hemothorax / Q000601:surgery*; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay / Q000706:statistics & numerical data; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013898:Thoracic Injuries / Q000601:surgery*; D020775:Thoracic Surgery, Video-Assisted; D013908:Thoracotomy; D016896:Treatment Outcome; D014948:Wounds, Gunshot / Q000601:surgery*; D014951:Wounds, Stab / Q000601:surgery*