Thoracoscopy versus thoracotomy in hemodynamically stable patients with closed thoracic trauma

Background

In this prospective study, we aimed to compare thoracoscopy and thoracotomy in hemodynamically stable patients with closed thoracic trauma.

Methods

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.

Results

Both groups had comparable baseline and preoperative data (p > 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 < 0.001) than the thoracoscopy group. Moreover, thoracoscopy provided the advantages of minimally invasive surgery with a significant reduction (p < 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.

Conclusions

Thoracoscopy is feasible and safe for the diagnosis and treatment of hemodynamically-stable patients with blunt thoracic trauma.