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OBJECTIVE: Based on the development and use of minimally invasive endovideothoracoscopic interventions improve the results of treatment of complicated chest injury.
METHODS: Study is based on a comparative evaluation of the results of diagnosis and treatment of complicated injuries to the chest at 342 patients with and without the use videothoracoscopy. Among them were 303 men and 39 women, aged from 16 and up to 83 years (mean age 33,3 ± 9,5 years). Videothoracoscopy always perform in the operating room, fully equipped, if necessary conversion. Found that the use of videoendoscopic technology in complicated chest injuries was effective in 113 (88.9%) patients. It is allowed to reduce frequency of unnecessary thoracotomy duration of drainage of the pleural cavity, the frequency of complications and duration of hospital treatment. The mortality has decreased in 2 times, and was 3.14%. Found that at floating rib fractures are always complications: clotted hemothorax, lung laceration, various sizes subpleural and intrapulmonary chest wall hematoma. A comparative evaluation of various methods of fixation of floating rib fractures and found clear advantages of minimally invasive fixation under control of videothoracoscopy. Already next day after fixation, noted improvement in vital capacity of the lung and blood oxygen saturation
RESULTS: In 66 (90.4%) patients using videoendoscopic technologies made the full amount of surgeries. Conversion required in 7 (9.6%) patients. Comparative studies have shown that the use of minimally invasive interventions in penetrating wounds of the chest allowed to reduce the frequency of thoracotomies in 2,1 times, the duration of drainage of the pleural cavity 2 times, the frequency of complications in 3.3 times, length of hospital treatment in 2 times and mortality in 2 times.
CONCLUSIONS: Videothoracoscopy is an effective diagnostic and therapeutic method in complicated closed chest trauma. Chest carcass recovery under control of videothoracoscopy allows to securely stabilize the chest wall, avoiding wide dissection of injured soft tissue.