Objectives: To evaluate the rule and efficacy of thoracoscopy in the management of retained post-traumatic hemothorax, the evaluation
includes the feasibility of the procedure, the success rate and the best time for doing it.
Patients and Methods: This is a prospective study conducted in 4 tertiary centers in Egypt since August 2006 till January 2016. All
patients complained from either blunt or sharp trauma. Patients with incomplete drainage of hemothorax by chest tube underwent
thoracoscopic evacuation of the retained hemothorax. VATS procedure was done through three ports which were made along the
thoracotomy line for conversion to thoracotomy in case of failure of the VATS procedure.
Results: The study included 1226 patients; with isolated unilateral traumatic hemothorax. The cause of hemothorax was blunt
trauma in 56% of patients, gunshot in 17% of patients and stab wound in 27% of patients. Total success rate of VATS intervention was
77.1% in all cases. Success rate was 100% for those operated by the 3rd day, 79.9% for those operated by the 4th day, 77.6% for those
operated by the 5th day, 57.1% for those operated by the 6th day and 50% for those operated by the 7th day. There was no intraoperative,
no postoperative mortality in patients operated thoracoscopically or those converted to open thoracotomy.
Conclusion: Thoracoscopic evacuation of post-traumatic hemothorax is not a complicated procedure and carries high success rates
if done early. |
