Journal of the Egyptian Society of Cardio-Thoracic Surgery最新文献

{"title":"Urgent versus elective coronary artery bypass grafting in acute coronary artery syndrome","authors":"Waseim Atteya Mohammad ,&nbsp;Zahra Ashraf ,&nbsp;Hosam F. Sayed","doi":"10.1016/j.jescts.2017.12.005","DOIUrl":"10.1016/j.jescts.2017.12.005","url":null,"abstract":"<div><h3>Background</h3><p>In this retrospective study, we aimed to evaluate the clinical outcomes, risk factors of mortality and prognosis after urgent coronary artery bypass grafting (CABG) in acute coronary syndrome (ACS) patients.</p></div><div><h3>Methods</h3><p>Our study included 100 patients who underwent CABG for ACS (50 urgent and 50 elective). All patients were followed for 30 days after surgery, both clinically and echocardiographically. Data were analyzed using the SPSS software in accordance to the Society of Thoracic Surgeons (STS) National Cardiac Surgery Database guidelines.</p></div><div><h3>Results</h3><p>Patients in the urgent CABG group were of younger age (p = .03) and had a higher frequency of smoking (p = .04) and dyslipidemia (p = .004); otherwise, all baseline characteristics were comparable between the two groups. The cardiopulmonary bypass (CPB) (p = .003) and aortic cross-clamp times (p = .02) were significantly longer in the urgent CABG group compared to the elective CABG group. Although both groups had a relatively similar survival rate (p = .056), urgent CABG patients were more liable to postoperative myocardial infarction (p = .02), as well as prolonged ventilation time (p = .002) and hospital stay (p &lt; .001). Our analysis showed that preoperative low ejection fraction (EF) (p = .03), use of inotropes (p = .002) and prolonged CPB time (p = .04) were independent risk factors for mortality after urgent CABG.</p></div><div><h3>Conclusions</h3><p>Urgent CABG increased the risk of myocardial infarction and prolonged hospital stay in comparison to elective CABG. Moreover, preoperative low EF and prolonged CPB time were associated with a significant increase in the risk of mortality after urgent CABG.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"26 1","pages":"Pages 17-23"},"PeriodicalIF":0.0,"publicationDate":"2018-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2017.12.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89721887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of pulmonary hypertension severity on the outcomes of mitral valve replacement for rheumatic mitral stenosis","authors":"Waseim Atteya Mohammad ,&nbsp;Hosam F. Sayed ,&nbsp;Abdallah Nosair","doi":"10.1016/j.jescts.2018.01.004","DOIUrl":"10.1016/j.jescts.2018.01.004","url":null,"abstract":"<div><h3>Background</h3><p>We performed this study to evaluate the effects of pulmonary hypertension (PH) severity on the hemodynamic and echocardiographic outcomes of mitral valve replacement (MVR) for rheumatic mitral stenosis (MS).</p></div><div><h3>Methods</h3><p>Patients with rheumatic MS were divided into two groups: Group-A with mean pulmonary arterial pressure (mPAP) equal to 26–40 mmHg and group-B with mPAP &gt; 55 mmHg. We compared the hemodynamic and arterial blood gases (ABG) data between both groups.</p></div><div><h3>Results</h3><p>Our analysis showed no significant difference between mild and severe PH groups in terms of all analyzed baseline and pre-operative data (p &lt; 0.05), except for NYHA class distribution and O₂ saturation on room-air, which were better in the mild PH group. Moreover, post-induction ABG data and heart rate were similar between both groups; however, post-induction central venous pressure (p = 0.01) and systolic blood pressure (p &lt; 0.001) were significantly higher in the severe PH group, compared to the mild PH. All analyzed hemodynamic and ABG data in the 24 post-operative hours were comparable between both groups. The hospital stay duration was significantly longer (p = 0.01) in the severe PH group than the mild PH group. Concerning the echocardiographic data at three-months of follow-up, the left atrial size was comparable (p = 0.4) between both groups; however, the left ventricular end-systolic (p = 0.009) and end-diastolic (p = 0.01) dimensions were significantly higher in the severe PH group, compared to the mild PH group.</p></div><div><h3>Conclusions</h3><p>Our study showed that both mild and severe PH groups were comparable in most operative and post-operative hemodynamic and ABG outcomes of MVR surgery.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"26 1","pages":"Pages 43-48"},"PeriodicalIF":0.0,"publicationDate":"2018-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2018.01.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88460351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nadir oxygen delivery to the brain as a risk factor for post-operative neurocognitive impairment in patients undergoing coronary artery bypass grafting: A myth or fact","authors":"Mohammed Abd Al Jawad ,&nbsp;Salem Taha","doi":"10.1016/j.jescts.2018.01.002","DOIUrl":"10.1016/j.jescts.2018.01.002","url":null,"abstract":"<div><h3>Background</h3><p>There are many factors that determine the best neurocognitive outcome following cardiac surgery. Optimum oxygen delivery to the tissues has always been the goal to optimum perfusion. Some patients may exhibit neurocognitive impairments in the early postoperative period; that could be easily missed clinically as they are not associated with radiographic evidence of structural brain damage. At this study we aimed to correlate the lowest oxygen delivery levels with incidence of neurocognitive impairment in the early postoperative period by Folstein test.</p></div><div><h3>Methods</h3><p>A non-randomized, prospective pilot study was designed to correlate the nadir oxygen delivery (DO₂) during CPB with post-operative cognitive impairment. The study included 271 patients of both sexes, an age group of 50–60 years with university level of education, scheduled for elective, isolated CABG for three vessel disease. All patients underwent pre-and post-operative neurocognitive test by a specialized neuropsychiatric doctor.</p></div><div><h3>Results</h3><p>with a mean nadir DO₂ of 291 mL/min/m², the majority of the patients exhibited “normal” results, with a mean nadir DO₂ of 266 mL/min/m² 92 patients showed mild impairment in their cognitive behavior, while the worst results “moderate” and “severe” were associate with means of 244,200 mL/min/m² successively.</p></div><div><h3>Conclusions</h3><p>The nadir oxygen delivery is a risk factor for development of post-operative neurocognitive impairment. A level below 260 mL/min/m² is generally associated with higher risk while a level below 220 mL/min/m² carries the worst prognosis.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"26 1","pages":"Pages 49-56"},"PeriodicalIF":0.0,"publicationDate":"2018-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2018.01.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79489032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2-Octyl Cyanoacrylate (Dermabond®) skin adhesive versus polyglactin for skin closure in endoscopic radial artery harvesting","authors":"Ahmed Mostafa Omran ,&nbsp;Amir Mohamed ,&nbsp;Yousry Shaheen ,&nbsp;Adel Maher ,&nbsp;Ahmed S. Mahlab","doi":"10.1016/j.jescts.2018.01.003","DOIUrl":"10.1016/j.jescts.2018.01.003","url":null,"abstract":"<div><h3>Background</h3><p>As the goal of endoscopic conduit harvesting is to decrease pain and better cosmetic appearance, and as the optimal choice of skin closure after endoscopic radial artery harvesting (ERAH) has not yet been determined, we started this study with an aim to compare wound complications, patient satisfaction and scar healing between glue (Dermabond) versus polyglactin intra-cuticular suture for skin closure after ERAH.</p></div><div><h3>Methods</h3><p>This observational study was done at Al Dabbous Cardiac Center, Kuwait, from January 2017 till October 2017 enrolling 40 patients divided into two equal groups (Dermabond group and sutures group). Inclusion criterion was patients underwent coronary artery bypass grafting (CABG) using ERAH, while open technique for radial artery harvesting and Negro race are considered as exclusion criteria. Demographic data were collected, (gender, age, race, body mass index (BMI), preoperative medication and albumin level, as well as diabetes or peripheral vascular disease. Operatively, wound closure time was calculated for all patients. Postoperatively: Cosmetic appearance was assessed using the Hollander scale. Patient satisfaction was recorded at week 6–8 weeks.</p></div><div><h3>Results</h3><p>Demographic and preoperative data were comparable; Dermabond group showed shorter closure time, better scar pigmentation, shape and patient satisfaction. Pain, scar size, infection and hematoma showed no statistical difference.</p></div><div><h3>Conclusion</h3><p>Dermabond can be used safely in closure of skin after ERAH. The excellent results in the small wound of ERAH encouraged us to use it in larger wounds.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"26 1","pages":"Pages 37-42"},"PeriodicalIF":0.0,"publicationDate":"2018-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2018.01.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73913805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tricuspid annuloplasty ring prototype testing","authors":"Hosam Fawzy ,&nbsp;Amro Serag ,&nbsp;Mohammed Abo El-Nasr ,&nbsp;Hazem Warda ,&nbsp;Hatem El-Shora ,&nbsp;Alaa Mostafa ,&nbsp;Ahmed Morsy ,&nbsp;Lee Errett","doi":"10.1016/j.jescts.2018.01.001","DOIUrl":"10.1016/j.jescts.2018.01.001","url":null,"abstract":"<div><h3>Background</h3><p>Current surgical technique to fix the tricuspid valve regurgitation carry a high percentage (up to 37%) of recurrence of severe tricuspid valve regurgitation in mid-term follow up. There is a need for anatomically and physiologically correct Tricuspid annulus device. Our ring is developed in the way that mimics the normal anatomy &amp; physiology of Tricuspid annulus. The aim of this study is to test three prototypes and choose the proper prototype that is tested and suitable to conform well to the normal shape of the tricuspid annulus with no distortion of the movement during the different phases of the cardiac cycle.</p></div><div><h3>Methods</h3><p>We used an acute open heart model in sheep as an animal model to test three prototypes. We used adult sheep (6 males and 6 females), body weight 60–70 Kg, age: 1–3 years old. We followed the protocol of open heart model in animals.</p></div><div><h3>Results</h3><p>Post Prototype implantation, Tricuspid valve leaflet coaptation was verified with no induced tricuspid regurgitation. On the other hand, there was no ring distortion or ring material fracture.</p><p>All the three prototypes conformed well to the normal shape of the tricuspid annulus with no distortion of the movement during the different phases of the cardiac cycle (both in systole and diastole).</p></div><div><h3>Conclusions</h3><p>All the three tested prototypes seemed to be effective and reproducible.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"26 1","pages":"Pages 30-36"},"PeriodicalIF":0.0,"publicationDate":"2018-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2018.01.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84366283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short term outcome of conventional versus off-pump coronary artery bypass grafting for high-risk patients","authors":"Ahmed F. Elmahrouk ,&nbsp;Tamer E. Hamouda ,&nbsp;Ibrahim Kasab ,&nbsp;Mohamed F. Ismail ,&nbsp;Ahmed A. Jamjoom","doi":"10.1016/j.jescts.2017.10.003","DOIUrl":"10.1016/j.jescts.2017.10.003","url":null,"abstract":"<div><h3>Background</h3><p>Off-pump coronary artery bypass grafting (OPCAB), avoiding the use of cardiopulmonary bypass, has attracted the interest of an increasing number of surgeons and patients, and has assumed an increasing role in surgical practice. Whether OPCAB have better outcome in high-risk patients as compared to Conventional coronary artery bypass grafting (C-GABG) remains to be confirmed. We describe an analysis of early clinical outcomes of high-risk coronary artery disease (CAD) patients, subjected to both techniques.</p></div><div><h3>Methods</h3><p>We studied 450 patients with additive EuroSCORE of ≥5 on admission. Patients were divided into 2 groups; Group A was assigned for patients underwent conventional C-CABG, and Group B for patients underwent OPCAB. Data, including gender, age, demographic variables and postoperative complications were extracted from the medical records.</p></div><div><h3>Results</h3><p>Both groups were matched with regard to age, gender, smoking, Diabetes mellitus, dyslipidemia, renal hemodialysis and the mean Euro-Score. We demonstrated a decrease in the incidence of early postoperative atrial fibrillation and renal failure in the Off-pump group. However, we recorded no statistical difference of neurologic complications, acute myocardial infarction or early mortality between the two groups.</p></div><div><h3>Conclusions</h3><p>We recommend OPCAB in high-risk CAD patients, as this technique may carry potential benefits without compromising their clinical outcomes.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"26 1","pages":"Pages 57-63"},"PeriodicalIF":0.0,"publicationDate":"2018-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2017.10.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82149095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early outcome of mini aortic valve replacement surgery","authors":"Shawky Fareed,&nbsp;Ashraf Bassiony","doi":"10.1016/j.jescts.2017.07.001","DOIUrl":"10.1016/j.jescts.2017.07.001","url":null,"abstract":"<div><h3>Background</h3><p>Minimally invasive aortic valve surgery (MIAVS) has evolved into a well-tolerated, efficient surgical treatment option in experienced centers, providing greater patient satisfaction and lower complication rates. Potential advantages of MIAVR arise from the concept that patient morbidity and potential mortality could be reduced without compromising the excellent results of the conventional procedure which include improved cosmetic results, safer access in the case of reoperation, less postoperative bleeding, lower intensive care unit (ICU) and in-hospital stays, as well as the absence of sternal wound infection. These results were achievable also in high-risk patients. Reduced pain and hospital length of stay, decreased time until return to full activity and decreased blood product use have also been demonstrated.</p></div><div><h3>Methods</h3><p>Sixty patients with aortic valve disease randomized into two equal groups; group “A” underwent aortic valve surgery through a minimally invasive limited upper sternotomy. Group “B” underwent aortic valve surgery through a full median sternotomy. The Pain was evaluated on 2nd, 3rd day post-operatively and at the 3rd, 6th month after discharge. Echocardiographic data were performed preoperatively and at the 3rd, 6th month after discharge in all patients. Standard aortic and bicaval cannulation with cold antegrade crystalloid cardioplegia was adopted in group“B”, while in group “A” femoral vein with ascending aortic cannulation was adopted with antegrade blood cardioplegia.</p></div><div><h3>Results</h3><p>There was no statistical difference between the two groups preoperatively regarding their age, sex, NYHA class, EF%, LA dimension, spirometric study. There was no operative mortality in both groups but few postoperative complications occurred in both groups. Total hospital stay, ICU stay, postoperative bleeding, inotropic requirement, ventilatory support, blood transfusion was less in group “A”, with better cosmetic appearance, and more cost effective.</p></div><div><h3>Conclusions</h3><p>Limited upper sternotomy minimally invasive technique for aortic valve replacement provides excellent exposure of the aortic valve and offers a better cosmetic scar. In addition, minimally invasive limited upper sternotomy is as safe as full median sternotomy for aortic valve surgery, with fewer complications and postoperative pain, less ICU and hospital stay, fast recovery to work with limited movement restriction after surgery. It is better to use the limited upper sternotomy incision as an initial approach for aortic valve surgery.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"26 1","pages":"Pages 1-7"},"PeriodicalIF":0.0,"publicationDate":"2018-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2017.07.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84055901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative study between outcome of intercostal tube drainage and video assisted thoracoscopic surgery in management of complicated parapneumonic effusion in children","authors":"Mohamed Shatila ,&nbsp;Walid Abu Arab ,&nbsp;Nader Fasih ,&nbsp;Khaled Karara ,&nbsp;Abdel-Maguid Ramadan","doi":"10.1016/j.jescts.2017.12.002","DOIUrl":"10.1016/j.jescts.2017.12.002","url":null,"abstract":"<div><h3>Background</h3><p>Intercostal tube drainage (ICTD) has been known for the management of complicated parapneumonic effusion (PPE) since the early 1870s. Video assisted thoracoscopic surgery (VATS) has been applied since the early 1990s. The aim of this study was to compare between both surgical procedures in children.</p></div><div><h3>Methods</h3><p>This randomized clinical study included 75 children for drainage of complicated PPE in the Cardiothoracic Surgery Department of Alexandria University hospital, Egypt. They were classified into two groups. Group I included 35 children managed by ICTD while group II included 40 children managed by VATS.</p></div><div><h3>Results</h3><p>The mean age in group I was 7.81 ± 4.04 years and 8.93 ± 1.73 years in group II. Mean duration on medical therapy before and after intervention was 0.74 ± 2.83 days in group I and 4.80 ± 0.94 days in group II, and 11.06 ± 5.31 days in group I, and 2.88 ± 1.52 days in group II respectively. Success rate following primary intervention was 17.1% in group I and 90% in group II. Average amount of pleural fluid drained was 291.14 ± 94.86 ml in group I and 156.50 ± 76.28 ml in group II.</p><p>The mean hospital stay following primary intervention was 11.06 days in the first group and 2.43 days in group II. The mean hospital stay after secondary intervention in group I was 3.74 ± 2.79. In contrast, it was 1.38 days in group II which was significantly shorter than that of the group I. Moreover, the mean total hospital stay was 14.77 ± 7.12 days in the first group and 7.68 ± 2.07 days in the second group.</p></div><div><h3>Conclusions</h3><p>VATS is a safe and effective procedure with low rates of complications. Early VATS should be the first treatment of choice in children with PPE.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"26 1","pages":"Pages 68-72"},"PeriodicalIF":0.0,"publicationDate":"2018-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2017.12.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81438238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intra-myocardial LAD: Is it a contraindication for off-pump coronary artery bypass grafting?","authors":"Ashraf Fawzy Mahmoud","doi":"10.1016/j.jescts.2017.11.007","DOIUrl":"10.1016/j.jescts.2017.11.007","url":null,"abstract":"<div><h3>Background</h3><p>The left anterior descending artery (LAD) is the most important vessel in coronary artery bypass graft surgery (CABG). During CABG, LAD may be intra-myocardial for variable distances and depths. This forms a challenge during LAD exposure and anastomosis.</p><p>The aim was to revise the performed CABG cases to elicit what was the incidence of intramyocardial LAD (IMLAD) among all CABGs, to have an idea about the approaches to the IMLAD and the technique of anastomosis of left internal mammary artery (LIMA) to IMLAD off-pump (OPCAB) and to evaluate the validity and reliability of the off-pump for the IMLAD.</p></div><div><h3>Methods</h3><p>Since September 2008 till May 2017; the data of 1138 Off-Pump CABGs were revised. 923 patients had epicardial LAD and it was visible and easily identified throughout 80% of its length; this was group A. 215 (18.89%) patients had IMLAD; they were referred to as group B.</p></div><div><h3>Results</h3><p>There were no statistical significant differences between both groups as regards the age, the sex, the risk factors or the duration of surgery. The post operative bleeding, ischemia, CCU stay and hospital stay were not statistically significant. Conversion to on-pump for the mere presence of an intramyocardial LAD was zero%, but it was 1.3% in group A and 1.86% in B due to hemodynamic instability during manipulations (statistically insignificant).</p></div><div><h3>Conclusions</h3><p>The incidence of IMLAD was 18.89%. IMLAD was a real technical challenge. It was not impossible for exposure and anastomosisas off-pump. The IMLAD is not a contraindication for OPCAB.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"26 1","pages":"Pages 8-16"},"PeriodicalIF":0.0,"publicationDate":"2018-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2017.11.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73424621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thoracoscopy versus thoracotomy in hemodynamically stable patients with closed thoracic trauma","authors":"Mohamed Abd El-Hafez Fouly ,&nbsp;Ashraf Zahra ,&nbsp;Mahmoud Ghalwash","doi":"10.1016/j.jescts.2017.11.005","DOIUrl":"10.1016/j.jescts.2017.11.005","url":null,"abstract":"<div><h3>Background</h3><p>In this prospective study, we aimed to compare thoracoscopy and thoracotomy in hemodynamically stable patients with closed thoracic trauma.</p></div><div><h3>Methods</h3><p>The study included 30 patients with closed chest trauma. All patients were diagnosed as cases of hemothorax and a chest tube was inserted following investigations, including chest x-ray and computed tomography. All patients were indicated for surgery (thoracoscopy: 15 patients and thoracotomy: 15 patients). A comparison between the two groups was performed in terms of preoperative, operative and postoperative data.</p></div><div><h3>Results</h3><p>Both groups had comparable baseline and preoperative data (p &gt; 0.05). Traffic accidents were the most common cause of thoracic trauma in both groups, followed by fall from a height and violence. Injuries were most common to the intercostal arteries, followed by the lungs. The thoracotomy group was associated with a longer operative time and length of hospital stay (p &lt; 0.001) than the thoracoscopy group. Moreover, thoracoscopy provided the advantages of minimally invasive surgery with a significant reduction (p &lt; 0.001) in the amount of postoperative drainage. Only two cases (13.3%) in the thoracoscopy group were converted into thoracotomy for either uncontrolled bleeding or voluminous hematoma.</p></div><div><h3>Conclusions</h3><p>Thoracoscopy is feasible and safe for the diagnosis and treatment of hemodynamically-stable patients with blunt thoracic trauma.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"26 1","pages":"Pages 64-67"},"PeriodicalIF":0.0,"publicationDate":"2018-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2017.11.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86767471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}