Book contents
- Atlas of Surgical Techniques in Trauma
- Atlas of Surgical Techniques in Trauma
- Copyright page
- Dedication
- Contents
- Contributors
- Foreword
- Preface
- Acknowledgments
- Section 1 The Trauma Operating Room
- Section 2 Resuscitative Procedures in the Emergency Room
- Section 3 Head
- Section 4 Neck
- Section 5 Chest
- Chapter 14 General Principles of Chest Trauma Operations
- Chapter 15 Cardiac Injuries
- Chapter 16 Thoracic Vessels
- Chapter 17 Lungs
- Chapter 18 Thoracic Esophagus
- Chapter 19 Diaphragm
- Chapter 20 Surgical Fixation of Rib Fractures
- Chapter 21 Video-Assisted Thoracoscopic Evacuation of Retained Hemothorax
- Section 6 Abdomen
- Section 7 Pelvic Fractures and Bleeding
- Section 8 Upper Extremities
- Section 9 Lower Extremities
- Section 10 Orthopedic Damage Control
- Section 11 Soft Tissues
- Index
Chapter 21 - Video-Assisted Thoracoscopic Evacuation of Retained Hemothorax
from Section 5 - Chest
Published online by Cambridge University Press: 21 October 2019
- Atlas of Surgical Techniques in Trauma
- Atlas of Surgical Techniques in Trauma
- Copyright page
- Dedication
- Contents
- Contributors
- Foreword
- Preface
- Acknowledgments
- Section 1 The Trauma Operating Room
- Section 2 Resuscitative Procedures in the Emergency Room
- Section 3 Head
- Section 4 Neck
- Section 5 Chest
- Chapter 14 General Principles of Chest Trauma Operations
- Chapter 15 Cardiac Injuries
- Chapter 16 Thoracic Vessels
- Chapter 17 Lungs
- Chapter 18 Thoracic Esophagus
- Chapter 19 Diaphragm
- Chapter 20 Surgical Fixation of Rib Fractures
- Chapter 21 Video-Assisted Thoracoscopic Evacuation of Retained Hemothorax
- Section 6 Abdomen
- Section 7 Pelvic Fractures and Bleeding
- Section 8 Upper Extremities
- Section 9 Lower Extremities
- Section 10 Orthopedic Damage Control
- Section 11 Soft Tissues
- Index
Summary
The majority of traumatic hemothoraces can be managed successfully with a chest tube placement.
Retained hemothorax is defined as residual pleural blood >300–500 mL after initial thoracostomy tube evacuation.
The gold standard for diagnosing retained hemothorax is a noncontrast CT scan of the chest. A chest X-ray is not reliable in the accurate diagnosis of retained hemothorax.
VATS is usually contraindicated in patients with previous thoracic operations and in patients with respiratory failure or significant contralateral lung injury, such as contusion, atelectasis, or pneumonia, because single-lung ventilation may not be tolerated.
Ideally, VATS should be done within the first 3–5 days. Early VATS (within 72 hours of admission) for evacuation of retained hemothorax reduces hospital length of stay, number of procedures, and cost. VATS is more difficult and less effective if performed more than 7–10 days after the injury, due to clot organization and dense adhesions.
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- Information
- Atlas of Surgical Techniques in Trauma , pp. 164 - 170Publisher: Cambridge University PressPrint publication year: 2020