VIDEO-ASSISTED THORACOSCOPY IN THE TREATMENT OF CHEST INJURIES
M.E.RAMAZANOV, M.M.BATIRKHANOV, T.S.ESHMURATOV,
M.M.SUNDETOV, P.P.LUKYANCHENKO, N.S.JARILKAPOV, A.M.ELEUSIZOV
National Scientific Center of Surgery named after A.N.Sizganov, Almaty, KAZAKHSTAN
Materials and methods. Īver the past 20 years, 200 patients with various injuries of the chestwere examined in the NSCS named after A.N. Sizganov.
The vast majority of the examined were males aged between 17-75 years. There were 174 (87%) men, and 26 (13%) women. Of them, 148 patients were admitted routinely and 52 urgently. Post-traumatic hemothorax-49;Post-traumatic hemopneumothorax - 12, post-traumatic pneumoempyema-6, post-traumatic pneumothorax-24, post-traumatic bronchopleural fistula-7, empyema - 17, post-traumatic fibrinous pleurisy-27, a penetrating stab and cut wounds of chest -41, gunshot wound of the chest-5, blunt chest injury 6 were found.
142 patients with closed injuries were with complicated breast trauma, others with penetrating wounds of the chest.
All patients with stab and cut wound of the chest wall underwent primary surgical debridement. As a mandatory method of diagnosis there was performed surveyradiography of the chest, which allowed to determine the presence or absence of pneumothorax, its size and prevalence, presence of hemothorax, hemopericardium, the degree of lung collapse.
Video-assisted thoracoscopic operation for post-traumatic diseases of the chest cavity of the thoracic cavity was performed in 92 patients.
Most often,video-assisted thoracoscopicoperations wereperformed for hemothorax. Closure of the lung by video-assisted thoracoscopicmethod was performed in 44 patients, 13 patients were performed thoracoscopicclosure of the intercostal artery. 10 patients were performed thoracotomy, closure of the lung. No complications and mortality was observed in the postoperative period.
Conclusion. The use of video-assisted thoracoscopy as a diagnostic and therapeutic method in chest injuries provides timely detection of the nature of injuries, represents a minimally invasive method and allows to avoid ungrounded thoracotomies.
Date: 2014-12-28; view: 350