A prospective evaluation of video-assisted thoracic surgery for persistent air leak due to trauma

Am J Surg. 1999 Jun;177(6):480-4. doi: 10.1016/s0002-9610(99)00100-2.

Abstract

Background: The time required for air leak resolution after chest trauma is not well described. Based on an institutional review of posttraumatic air leaks our hypothesis was that video-assisted thoracic surgery (VATS) for persistent posttraumatic air leak would decrease chest tube days and length of stay compared with nonoperative management.

Methods: Patients were offered VATS versus nonoperative management when air leaks persisted longer than 3 days and the patients were otherwise ready for discharge. Chest tube days and length of stay were recorded.

Results: Of 223 trauma patients requiring chest tubes, 50 had persistent air leaks, 39 of whom were otherwise ready for discharge. Twenty-five chose VATS and 14 nonoperative (NOP) treatment. The mean chest tube days was 8.1 for VATS versus 11.8 for NOP (P = 0.001). Mean length of stay was 9.7 days for VATS and 16.5 days for NOP (P = 0.002).

Conclusions: In patients otherwise ready for discharge VATS reduces chest tube days and length of stay when used to treat persistent posttraumatic air leak.

MeSH terms

  • Chest Tubes
  • Endoscopy / methods*
  • Female
  • Hemothorax / etiology
  • Hemothorax / surgery*
  • Hemothorax / therapy
  • Humans
  • Length of Stay
  • Male
  • Pneumothorax / etiology
  • Pneumothorax / surgery*
  • Pneumothorax / therapy
  • Prospective Studies
  • Thoracic Injuries / complications*
  • Thoracoscopy
  • Time Factors