Results of manangement for post-chest trauma and chest wound retrained hemothorax and empyema by VATs at Viet Duc University Hospital

Abstract

Abstract Introduction: To describe several clinical and para-clinical signs of patients with post-chest trauma and chest wound retained hemothorax and empyema treated at Viet Duc Hospital from 1/2015 to 4/2018, and to report the early results of treatment. Material and Methods: Retrospective descriptive study of patients diagnosed post-chest trauma and chest wound retained hemothorax and empyema treated by Video Assisted Thoracoscopic (VAT) surgery at Viet Duc Hospital from 1/2015 to 4/2018. Results: 59 patients, of them the mean age was 39,63 ± 15,78. The mean duration from injury onset to surgery was 16,64 ± 9,81 days. Chest trauma were 45 cases (76,27%), and chest wounds were 14 cases (23,73%). 46 patients (90,2%) had been treated by chest tube drainage at lower level hospitals. The rate of patients with fever and high white blood cells were 18,6 % and 64,4% respectively. There were 50,85% treated by thoracoscopic surgery, and other in 49,15% treated by VAT surgery. The mean duration of the removal of chest drainage after the thoracoscopic surgery was 4,93 days shorter than the group underwent VAT surgery was 7,01 days (p = 0.004). The post-operative days in group with total thoracoscopic surgery lower than 7 days was 83,33%, higher than the group of patients underwent VAT surgery (41,38%) with p = 0.003. The rate of patients indicated for pain-killer and complications occurred after the total thoracoscopic surgery were 23,33% and 6,67%, lower than those in group with VAT surgery, were 58,62% and 10,34%. Conclusion: Post-chest trauma and chest wound retained hemothorax and empyema were most common surgical emergencies. Thoracoscopic surgery is a safe and effective treatment method to the patients. Keywords: Retained hemothorax, post-trauma and chest wound empyema, video-assisted thoracoscopic surgery.