Ahmed N, Jones D
Trauma Program and Division of General Surgery, St. Michael's Hospital, Suite 3073 Queen Wing, 30 Bond Street, Toronto, Ontario, Canada M5B 1W8.
Injury. 2004 May;35(5):479-89. doi: 10.1016/S0020-1383(03)00289-4.
The majority of chest-injured patients are managed with resuscitation and placement of chest tubes. Further interventions are required for complications or missed injuries. Video-assisted thoracic surgery (VATS) has become standard in elective surgery. Our purpose was to review the use of VATS in trauma. The literature and our experience support the use of VATS for specific indications. These indications are: (1) management of retained haemothorax; (2) management of persistent pneumothorax; (3) evaluation of the diaphragm in penetrating thoraco-abdominal injuries and management; (4) management of infected pleural space collections; and (5) diagnosis and management of on-going bleeding in haemodynamically stable patients. VATS for specific indications in trauma is associated with improved outcomes and decreased length of stay. VATS provides diagnostic and therapeutic benefit and should be included in the trauma surgeon's clinical armamentarium.
大多数胸部受伤患者通过复苏和放置胸管进行治疗。对于并发症或漏诊的损伤则需要进一步干预。电视辅助胸腔镜手术(VATS)已成为择期手术的标准术式。我们的目的是回顾VATS在创伤治疗中的应用。文献及我们的经验支持在特定指征下使用VATS。这些指征包括:(1)处理存留性血胸;(2)处理持续性气胸;(3)评估穿透性胸腹联合伤中的膈肌并进行处理;(4)处理感染性胸腔积液;以及(5)诊断和处理血流动力学稳定患者的持续性出血。针对创伤特定指征的VATS可改善预后并缩短住院时间。VATS具有诊断和治疗价值,应纳入创伤外科医生的临床技能范畴。