Thoracoscopy in chest trauma: an update
Open Access
- 1 April 2001
- journal article
- research article
- Published by SAGE Publications in Trauma
- Vol. 3 (2), 111-117
- https://doi.org/10.1177/146040860100300205
Abstract
The role of thoracoscopy in the management of patients with chest injuries is constantly being redefined as more reports on its use continue to emerge in the literature. As of today video-thoracoscopy has been used mainly as a diagnostic tool for certain occult injuries, such as of the diaphragm, as well as a minimally invasive management option in specific therapeutic situations including early evacuation of retained thoracic collections. It has the potential to replace open surgery in the management of more than 50% of civilian and military thoracic injuries previously considered candidates for open surgical management with all the benefits of minimally invasive surgery. In addition, it is a promising tool for earlier detection of missed injuries in patients otherwise managed nonoperatively. The procedure-related complication rate is low and there are only few contraindications for thoracoscopy, mainly haemodynamic instability and obliterated pleural space caused by previous infections or surgical interventions. However, the scientific evaluation of the global impact of thoracoscopy in the management of thoracic injuries is currently limited to descriptive series, some of them using historical controls, and a few non-randomized prospective studies. Until more well-designed, prospective, randomized studies emerge which compare thoracoscopy to standard management protocols in defined patient populations with thoracic injuries using relevant end points, the potential benefit of thoracoscopy in chest trauma remains unvalidated and its value is limited to isolated patients depending on individual surgeon’s preferences and skills.Keywords
This publication has 18 references indexed in Scilit:
- Changing Indications for Thoracotomy in Blunt Chest Trauma after the Advent of VideothoracoscopyThe Journal of Trauma and Acute Care Surgery, 1999
- Occult Injuries to the Diaphragm: Prospective Evaluation of Laparoscopy in Penetrating Injuries to the Left Lower ChestJournal of the American College of Surgeons, 1998
- A comparison of rigid -v- video thoracoscopy in the management of chest traumaInjury, 1998
- Operative Videothoracoscopy in the Surgical Treatment of Penetrating Firearms Wounds of the ChestMilitary Medicine, 1998
- Penetrating Chest Injuries: Unusually High Incidence of High‐velocity Gunshot Wounds in Civilian PracticeWorld Journal of Surgery, 1998
- Design of trials should depend on whether new skills are requiredBMJ, 1996
- PREVENTABLE MORTALITY FOLLOWING SHARP PENETRATING CHEST TRAUMAThe Journal of Trauma and Acute Care Surgery, 1994
- PROSPECTIVE EVALUATION OF THORACOSCOPY FOR DIAGNOSING DIAPHRAGMATIC INJURY IN THORACOABDOMINAL TRAUMA: A PRELIMINARY REPORTThe Journal of Trauma and Acute Care Surgery, 1993
- Penetrating gunshot wounds of the chest in civilian practice: Experience with 250 consecutive casesBritish Journal of Surgery, 1978
- Thoracoscopy as a Method of Exploration in Penetrating Injuries of the Thorax (Preliminary Report)Diseases of the Chest, 1946