Lee Carlin, Nahmias Jeffry, Lekawa Michael, Fairbairn Kelly, Grigorian Areg
Department of Surgery, Division of Trauma, Burn, Critical Care & Acute Care Surgery, University of California Irvine, Orange, CA, USA.
Department of Surgery, Division of Thoracic Surgery, University of California Irvine, Orange, CA, USA.
Am Surg. 2025 Aug;91(8):1368-1377. doi: 10.1177/00031348251341964. Epub 2025 May 8.
Pediatric thoracic trauma is a major cause of pediatric morbidity and mortality. Pediatric patients have unique anatomy and physiology that account for differences in injury patterns when compared to adult patients. These differences warrant special consideration in injury recognition and intraoperative management. The initial management of pediatric thoracic trauma should follow the principles of the primary survey in that life-threatening injuries should be ruled out. Hemodynamically unstable patients with serious thoracic injury warrant thoracotomy for expeditious management of life-threatening conditions. However, the management of hemodynamically stable patients with thoracic injury has evolved with the advent of minimally invasive surgery and the well-documented benefits of video-assisted thoracoscopic surgery (VATS) compared to traditional thoracotomy. Multiple studies have shown that VATS can be performed safely and effectively for traumatic injuries in children in both the acute and delayed setting. In this article, we provide an overview of pediatric thoracic trauma and the use of VATS in the management of these conditions.
小儿胸外伤是小儿发病和死亡的主要原因。小儿患者具有独特的解剖结构和生理特点,与成人患者相比,这些特点导致损伤模式存在差异。这些差异在损伤识别和术中管理方面值得特别考虑。小儿胸外伤的初始处理应遵循初级评估的原则,即应排除危及生命的损伤。血流动力学不稳定且伴有严重胸外伤的患者需要进行开胸手术,以便迅速处理危及生命的情况。然而,随着微创手术的出现以及与传统开胸手术相比电视辅助胸腔镜手术(VATS)已被充分证明的优势,血流动力学稳定的胸外伤患者的治疗方法也有所发展。多项研究表明,无论是在急性还是延迟情况下,VATS都能安全有效地用于治疗儿童创伤性损伤。在本文中,我们概述了小儿胸外伤以及VATS在这些疾病管理中的应用。