Background: Hemothorax is collection of blood in pleural cavity
caused by blunt or sharp trauma.Retained hemothorax is an undrained
collection in pleura that can lead to fibro-thorax or empyema. Chest
tube placement is described as a method of management. Now, videoassisted
thoracoscopic surgery (VATS) has evolved to become a gold
standard in the management of retained hemothorax. Our objective is
to compare VATS with limited thoracotomy in treatment of traumatic
retained hemothorax.
Patients and Methods: A prospective comparative study
conducted on 60 patients with traumatic clotted hemothorax studied
between January 2016 and December 2019. Patients were selected
and classified into two groups each included 30 patients, Group I
managed by open thoracotomy and group II managed by VATS.
Results: Our study revealed no difference between both groups
regarding age, gender, side of affection or preoperative ICT period.
There were a significant reduction in operative time (55.67 Vs 101.3;
P = 0.001), post-operative pain (P = 0.001) and postoperative period
of ICT insertion (1.2 vs 1.2 day, P = 0.021) and postoperative total
hospital stay (3.03 vs. 5.53 day; P = 0.001) and the period needed for
return to normal activity (1.03 vs. 2.2 days; P = 0.01) in VATS group
versus open thoracotomy group.
Conclusion: We concluded that thoracoscopy is feasible, safe and
tolerable method for management of retained traumatic hemothorax
and so, we recommended it as a suitable method for this type of
hemothorax. |
