Emergency major surgery in thoracic trauma: Timing and decision process

Eray Çınar; Kubilay İnan; Ozgur Omer Yildiz

EN

Emergency major surgery in thoracic trauma: Timing and decision process

Abstract

Background: Surgery is required in 10-15% of patients with thoracic injuries. Surgery performed within the first few hours of the injury is considered as an emergency surgery. The aim of study is to share our experiences with emergency surgical approaches in thoracic trauma. Methods: Our study was carried out between June 2012-June 2020, by retrospective analysis of cases who were evaluated for thoracic trauma in the emergency department and who underwent emergency surgery. Results: There were 5784 patients who requested for thoracic surgery consultation due to thoracic trauma. Of these cases, 1317 (22.8%) were patients who were evaluated in the emergency service due to isolated thoracic trauma. There were 18 patients (1.3%) who underwent emergency surgery for isolated thoracic trauma. Glasgow score was higher in the group that was discharged after recovery among all groups; and this was statistically significant (p= 0.045). It was statistically significant that intubation and low modified trauma scores were a poor prognostic factor (respectively p= 0.035, p=0,025). Conclusions: Tube thoracostomy is sufficient for most of the thoracic traumas. After emergency evaluation, fast and correct decision in the appropriate surgical indication significantly reduces mortality.

Keywords

Thoracic Trauma , Emergency Surgery , Prognostic Factors

Kaynakça

1.Eray O. Approach to Multiple Trauma Patient (Golden Hour). Dogan R, Tastepe I, Liman ST (editors). Trauma. 1th, Ankara: MN Medikal & Nobel; 2006: pp.93-103.
2. Çakan A,Yuncu G, Olgaç G, Alar T, Sevinc S, et al. Thoracic trauma: analysis of 987 cases. Ulus Travma Derg. 2001; 7(4): 236-241.
3. Kahraman C, Akçal Y, Emirogulları N et al. Künt toraks travması. Erciyes Tıp Dergisi. 1995; 17: 318-324.
4. Kish G, Kozloff L, Joseph WL, Adkins PC. Indications for early thoracotomy in the management of chest trauma. Ann Thorac Surg 1976;22(1):23-8.
5. Hines MH, Meredith JW. Special problems of thoracic trauma. In: Ritchie WP, Steele Jr G, Dean RH (editors). General surgery. Philadelphia: JB Lippincott; 1995. pp. 859–72
6. Onat S, Ulku R, Avci A, Ates G, Ozcelik C. Urgent thoracotomy for penetrating chest trauma: analysis of 158 patients of a single center. Injury 2011;42(9):900-4.
7.Champion HR, Sacco WJ, Copes WS, Gann DS, Gennarelli TA, Flanagan ME. A revision of the Trauma Score. J Trauma 1989; 29(5): 623-9.
8.Adebonojo SA. Management of chest trauma: a review. West Afr J Med 1993;12(2):122-32.
9.Wall Jr MJ, Storey JH, Mattox KL. Indications for thoracotomy. In: Mattox KL, Feliciano DV, Moore EE (editors). Trauma. 4th ed. New York: McGraw-Hill; 2000. pp. 473
10.Ali N, Gali BM. Pattern and management of chest injuries in Maiduguri, Nigeria. Ann Afr Med 2004;3(4):181-4.

11.Siemens R, Polk HC, Gray LA, Fulton RL. Indications for thoracotomy following penetrating thoracic injury. J Trauma 1977(7);17: 493-500.
12.Oparah S, Mandal A. Operative management of penetrating wounds of the chest in civilian practice. J Thorac Cardiouasc Surg 1979;77(2):162-8. 13.Hines MH, Meredith JW. Special problems of thoracic trauma. In: Ritchie WP,Steele Jr G, Dean RH (editors). General surgery. Philadelphia: JB Lippincott; 1995.pp. 859–72.
14.Thompson DA, Rowlands BJ, Walker WE, Kuykendall RC, Miller PW, et al. Urgent thoracotomy for pulmonary or tracheobronchial injury. J Trauma 1988;28(3):276–80.
15.Karmy-Jones R, Nathens A, Jurkovich GJ, Shatz DV, Brundage S, Wall MJ Jr, et al. Urgent and emergent thoracotomy for penetrating chest trauma. J Trauma 2004;56(3):664–668.
16.Zakharia AT. Cardiovascular and thoracic battle in the Lebanon war: Analysis of 3,000 personal cases. J Thorac Cardiovasc Surg 1985;89(5):723-733.
17.Degiannis E, Loogna P, Doll D, Bonanno F, Bowley DM, Smith MD. Penetrating cardiac injuries: recent experience in south africa. World J Surg 2006;30:1258–64.
18.Karmy-Jones R, Jurkovich GJ, Nathens AB, Shatz DV, Brundage S, Wall MJ Jr, et al. Timing of urgent thoracotomy for hemorrhage after trauma: a multicenter study. Arch Surg 2001;136(5):513–8.
19.Asensio JA, Arroyo Jr H, Veloz W, Forno W, Gambaro E, Roldan GA, et al. Penetrating thoracoabdominal injuries:ongoing dilemma—which cavity and when? World J Surg 2002;26(5):539–43.
20.Hirshberg A, Wall Jr MJ, Allen MK, Mattox K. Double jeopardy: thoracoabdominal injuries requiring surgical intervention in both chest and abdomen. J Trauma 1995;39(2):225-231

Ayrıntılar

Birincil Dil

İngilizce

Konular

Klinik Tıp Bilimleri

Bölüm

Klinik Araştırma

Yazarlar

Eray Çınar
0000-0002-4564-6097
Türkiye

Kubilay İnan
0000-0002-1409-4760
Türkiye

Ozgur Omer Yildiz ^*
0000-0001-7314-3131
Türkiye

Yayımlanma Tarihi

22 Eylül 2021

Gönderilme Tarihi

10 Eylül 2021

Kabul Tarihi

13 Eylül 2021

Yayımlandığı Sayı

Yıl 1970 Cilt: 2 Sayı: 3

IZ

https://izlik.org/JA32ES45WJ

APA

Çınar, E., İnan, K., & Yildiz, O. O. (2021). Emergency major surgery in thoracic trauma: Timing and decision process. Archives of Current Medical Research, 2(3), 204-211. https://izlik.org/JA32ES45WJ

Archives of Current Medical Research (ACMR), araştırmaları ücretsiz sunmanın daha büyük bir küresel bilgi alışverişini desteklediğini göz önünde bulundurarak, tüm içeriğe anında açık erişim sağlar. Kamunun erişimine açık olması, daha büyük bir küresel bilgi alışverişini destekler.

http://www.acmronline.org/

Emergency major surgery in thoracic trauma: Timing and decision process

Emergency major surgery in thoracic trauma: Timing and decision process

Abstract

Keywords

Öz

Kaynakça

Ayrıntılar

Birincil Dil

Konular

Bölüm

Yazarlar

Yayımlanma Tarihi

Gönderilme Tarihi

Kabul Tarihi

Yayımlandığı Sayı

IZ

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