| The role of videothoracoscopy in management of precordial thoracic penetrating injuries. | |
| | |
MedLine Citation:
|
PMID: 12103365 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVES: To report on the value of diagnostic videothoracoscopy in patients with possible penetrating cardiac wounds. METHODS: Thirteen patients admitted over a 4 year period with hemodynamic stability and a penetrating injury in cardiac proximity had exploratory videothoracoscopy. All data related to those patients were retrospectively reviewed. RESULTS: Eighty-five percent of patients had videothoracoscopy within 8 h of trauma. In most cases (eight of 13), operations were performed on patients in the supine position with the chest slightly rotated. Nine patients had a left hemothorax, five had pulmonary lacerations and five had a bleeding parietal vessel. Pericardial exploration was achieved either by direct vision (nine patients), or by the performance of a pericardial window (four patients). Acute hemopericardium related to a cardiac wound was diagnosed in two patients. Procedures included evacuation of clotted hemothorax (six patients), stapling of pulmonary laceration (four patients), and electrocoagulation of bleeding parietal vessel (four patients). Four patients required conversion to thoracotomy: two for repair of a cardiac wound, one for adequate exposure of the pericardium and one for ligation of a bleeding intercostal artery. The mean operative time was 37+/-23 min. Two patients experienced postoperative complications (coagulopathy, subcutaneous emphysema) and the in-hospital mortality was 0%. The mean hospital stay was 10+/-4 days. CONCLUSIONS: In the hands of an experienced surgeon, videothoracoscopy may represent a valid alternative to subxiphoid pericardial window in patients with hemodynamic stability and a suspected cardiac wound. Videothoracoscopy can rule out a cardiac injury and allows for the performance of associated procedures such as diaphragm assessment/repair, evacuation of clotted hemothorax, hemostasis of parietal vessels or pulmonary laceration and removal of projectiles. |
| | |
Authors:
|
F Pons; L Lang-Lazdunski; X de Kerangal; O Chapuis; P M Bonnet; R Jancovici |
Related Documents
:
|
10171655 - Hematological assessment of patients undergoing plasmapheresis during cardiac surgery. 4032745 - Radionuclide imaging for assessment of myocarditis and postmyocarditic state in infant ... 1597875 - Peripartum cardiac failure in the gambia. 9586605 - Cardiac arrhythmias with external fixed-rate signal generators in shock wave lithotrips... 16918265 - Combination therapy with ezetimibe and simvastatin to achieve aggressive ldl reduction. 12546375 - Quantitative pupillometry, a new technology: normative data and preliminary observation... |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery Volume: 22 ISSN: 1010-7940 ISO Abbreviation: Eur J Cardiothorac Surg Publication Date: 2002 Jul |
Date Detail:
|
Created Date: 2002-07-09 Completed Date: 2002-09-26 Revised Date: 2004-11-17 |
Medline Journal Info:
|
Nlm Unique ID: 8804069 Medline TA: Eur J Cardiothorac Surg Country: England |
Other Details:
|
Languages: eng Pagination: 7-12 Citation Subset: IM |
Affiliation:
|
Department of Thoracic and General Surgery, Percy Military Hospital, Clamart, France. fpons@mail3.imaginet.fr |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adolescent Adult Algorithms Female Hemothorax / surgery Humans Male Middle Aged Retrospective Studies Thoracic Injuries / surgery* Thoracic Surgery, Video-Assisted* Wounds, Penetrating / surgery* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Outcomes of minimally invasive esophagectomy (MIE) for high-grade dysplasia of the esophagus.
Next Document: Transcutaneous electrical nerve stimulation for pain management in patients with uncomplicated minor...