2003:Zhestkov K G; Guliaev A A; Abakumov M M; Voskresenskii O V;
Barskii B V

[Thoracoscopy in surgery of thoracic wounds]


One hundred and sixty-eight thoracoscopic operations were performed in
patients with closed (47.5%) and open (52.5%) trauma of the chest.
Thoracoabdominal injuries were diagnosed in 23.9% patients.
Thoracoscopic surgeries were performed in 79.8% patients, surgeries from
the mini-approach - in 17.3%. Injuries uncorrectable by endosurgically
were diagnosed during thoracoscopy in 2.9% patients. Indications for
urgent thoracoscopy in thoracic injuries are the following: 1) middle
and small hemothorax or hemopneumothorax; 2) suspicion for heart wound;
3) suspicion for diaphragm injury; 4) tense pneumothorax. Surgical
policy and technique of endosurgeries in open thoracic trauma are
optimized. Up-to-date surgical policy based on thoracoscopy permitted us
to improve results of surgical treatment: to reduce lethality by 4.7%,
number of complications - 2.9 times and completely avoid unjustified
'diagnostic' thoracotomies. Mini-invasive surgical methods promoted
early rehabilitation of patients with trauma of the ches