Milanchi S, Makey I, McKenna R, Margulies D R
Department of Surgery, Thoracic Surgery and Trauma, Surgical Director, Women's Guild Lung Institute, Program Director, General Thoracic Surgery Fellowship, Cedars-Sinai Medical Center, Los Angeles, California, USA.
J Minim Access Surg. 2009 Jul-Sep;5(3):63-6. doi: 10.4103/0972-9941.58499.
The role of video-assisted Thoracoscopic Surgery (VATS) is still being defined in the management of thoracic trauma. We report our trauma cases managed by VATS and review the role of VATS in the management of thoracic trauma.
All the trauma patients who underwent VATS from 2000 to 2007 at Cedars-Sinai Medical Center were retrospectively studied.
Twenty-three trauma patients underwent 25 cases of VATS. The most common indication for VATS was retained haemothorax. Thoracotomy was avoided in 21 patients. VATS failed in two cases. On an average VATS was performed on trauma day seven (range 1-26) and the length of hospital stay was 20 days (range 3-58). There was no mortality. VATS was performed in an emergency (day 1-2), or in the early (day 2-7) or late (after day 7) phases of trauma.
VATS can be performed safely for the management of thoracic traumas. VATS can be performed before or after thoracotomy and at any stage of trauma. The use of VATS in trauma has a trimodal distribution (emergent, early, late), each with different indications.
电视辅助胸腔镜手术（VATS）在胸部创伤治疗中的作用仍有待明确。我们报告了采用VATS治疗的创伤病例，并回顾了VATS在胸部创伤治疗中的作用。
对2000年至2007年在雪松西奈医疗中心接受VATS治疗的所有创伤患者进行回顾性研究。
23例创伤患者接受了25例VATS手术。VATS最常见的适应证是血胸残留。21例患者避免了开胸手术。2例VATS手术失败。VATS平均在创伤后第7天（范围1 - 26天）进行，住院时间为20天（范围3 - 58天）。无死亡病例。VATS在创伤的紧急期（第1 - 2天）、早期（第2 - 7天）或晚期（第7天之后）进行。
VATS可安全用于胸部创伤的治疗。VATS可在开胸手术之前或之后以及创伤的任何阶段进行。VATS在创伤治疗中的应用呈三峰分布（紧急、早期、晚期），各有不同的适应证。
