The role of video-assisted thoracic surgery on the diagnostic evaluation and the therapeutic management of thoracic injuries

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AIM: The aim of this study was to evaluate the experience of our department with the use of video-assisted thoracic surgery (VATS) in chest trauma. MATERIALS - METHODS : Between January 1999 and December 2013, 88,244 patients presented with chest trauma to the emergency room, and 8064 were admitted to our department. Sixty five hemodynamically stable patients (0,8%) underwent VATS. They were 54 men and 11 women with an average age of 42 years (range, 19–67 years). RESULTS : Indications included post-traumatic hemothorax in 31 patients, and post-traumatic empyema in 9, treated after 24 h of trauma. Indications for exploratory VATS in the acute phase(‹ 24h) included suspected diaphragmatic injury in 6 patients, persistent huge pneumothorax in 6, continued hemorrhage in 8 and removal of intrathoracic foreign body in 5. There was no mortality and complications occurred in 9 patients (13,7%). CONCLUSIONS: Management of thoracic injuries by using VATS in hemodynamically stable patients provides diagnostic accuracy and therapeutic efficacy. It can be successfully applied in the trauma setting and thoracic surgeons should gain experience with its use.

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