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2007 | 79 | 10 | 643-648
Tytuł artykułu

Surgical Treatment for Thoracic Injuries - One Clinic's Experience

Treść / Zawartość
Warianty tytułu
Języki publikacji
EN
Abstrakty
EN
The aim of the study was to present one clinic's experience in the treatment of thoracic injuries. Particular attention was paid to the methods for treatment of patients after thoracic injuries.Material and methods. During the years 1996-2006, 273 patients with thoracic injuries were hospitalized in the clinic; 0.9% of all patients treated during this time. There were 66 women (24.2%) and 207 men (75.8%), aged 17 to 85 years (average: 34.9).Results. Among all of the thoracic injuries analyzed, the most common was traffic accidents, which made up 111 (40.7%) cases. Next, accidents of violence made up 87 (31.9%) cases, and accidental falls and falls from heights 62 (22.7%) cases. Rare were self-mutilations, crash traumas and gunshot traumas. Isolated injury was observed in 107 cases, and 166 (60.8%) patients had multifocal trauma and multi-organ injuries. 50 patients (18.3%) had acute, penetrating injuries, and 223 patients (81.7%) had blunt thoracic injuries. During hospitalization, other traumas were diagnosed: rib fractures in 107 cases (39.2%), pleurohematoma in 37 cases (13.6%), pneumothorax in 36 cases (13.2%), pneumohemothorax in 26 cases (9.5%), lung contusion in 43 cases (15.8%), posttraumatic aorta aneurysm in 31 cases (11.4%), and contusion of the heart or great vessels in 8 cases (2.9%).The applied treatment was: pleural cavity drainage in 86 cases (27.8%), immediate thoracotomy in 24 cases (8.8%), laparotomy in 23 cases (8.4%), stent-graft implantation in posttraumatic aneurysms in 30 cases (11%), and other specialized operations in 46 cases (16.9%). Qualified surgical treatment was performed in 176 cases (64.5%) out of 273. Multispecialized treatment was used in 46 cases (16.8%). 16 patients died (5.9%), most directly after admission to the hospital.Conclusions. 1. Over 30% of patients need no surgical treatment after thoracic trauma. 2. The most common coexisting injuries with thoracic trauma are cranio-cerebral injuries and bone fractures. 3. The main cause of death is oligovolemic shock due to heart and great vessels contusion.
Wydawca
Rocznik
Tom
79
Numer
10
Strony
643-648
Opis fizyczny
Daty
wydano
2007-10-01
online
2008-02-11
Twórcy
  • Department of General and Thoracic Surgery, Medical University, Warsaw
  • Department of General and Thoracic Surgery, Medical University, Warsaw
  • Department of General and Thoracic Surgery, Medical University, Warsaw
  • Department of General and Thoracic Surgery, Medical University, Warsaw
  • Department of General and Thoracic Surgery, Medical University, Warsaw
  • Department of General and Thoracic Surgery, Medical University, Warsaw
  • Department of General and Thoracic Surgery, Medical University, Warsaw
  • Department of General and Thoracic Surgery, Medical University, Warsaw
Bibliografia
  • Gao JM, Gao YH, Zeng JB, et al.: Polytrauma with thoracic and/or abdominal injuries: experience in 540 cases. Chin J Traumatol 2006; 9(2): 108-14.
  • Heng K, Bystrzycki A, Fitzgerald M, et al.: Complications of intercostal catheter insertion using EMST techniques for chest trauma. ANZ J Surg 2004; 74(6): 420-23.[PubMed][Crossref]
  • Basoglu A, Akdag AO, Celik B, et al.: Thoracic trauma: an analisis of 521 patients. Ulus Trauma Acil Cerrahi Derg 2004; 10(1): 42-46.
  • Esme H, Solak O, Yurumez Y, et al.: The factors affecting the morbidity and mortality in chest trauma. Ulus Travma Acil Cerrahi Derg 2006; 12(4): 305-10.[PubMed]
  • Rokicki W, Rokicki M: Stłuczenie płuca jako problem diagnostyczno-leczniczy. Pol Przegl Chir 2002; 74(9): 837-43.
  • Patel VI, Thadepalli H, Patel PV, et al.: Thoracoabdominal injuries in the elderly: 25 years of experience. J Natl Med Assoc 2004; 96(12):1553-57.
  • Pogorzelski R, Radziszewski J, Szostek M: Urazy klatki piersiowej - diagnostyka i leczenie. Pol Przegl Chir 1992; 64(12): 1098-1102.
  • Segers P, Van Schil P, Jorens P, et al.: Thoracic trauma: an analysis of 187 patients. Acta Chir Belg 2001; 101(6): 277-82.
  • Adegboye VO, Lapido JK, Brimmo IA, et al.: Blunt chest trauma. Afr J Med Med Sci 2002; 31(4): 315-20.[PubMed]
  • Sirmali M, Turut H, Topcu S, et al.: A comprehensive analysis of traumatic rib fractures: morbidity, mortality and management. Eur J Cardiothorac Surg 2003; 24(1): 133-38.[PubMed][Crossref]
  • Hładki W, Barczyński M, Anielski R: Niezdolność do pracy jako odległe następstwo mnogich obrażeń ciała. Pol Przegl Chir 2001; 73(12): 1083-91.
  • Tekinbas C, Eroglu A, Kurkcuoglu IC i wsp: Chest trauma: analysis of 592 cases. Ulus Travma Acil Cerrahi Derg 2003; 9(4): 275-80.
  • Farooq U, Raza W, Zia N, et al.: Classification and management of chest trauma. J Coll Physicians Surg Pak 2006; 16(2): 101-03.
  • Bardenheuer M, Obertacke U, Waydhas C: Epidemiology of the severely injured patient. A prospective assessment of preclinical and clinical management. AG Polytrauma of DGU. Unfallchirurg 2000; 103(5): 355-63.[PubMed][Crossref]
  • Borman JB, Aharonson-Daniel L, Savitsky B, et al.: Unilateral flail chest is seldom a lethal injury. Emerg Med J 2006; 23(12): 903-05.[PubMed][Crossref]
  • Lowdermilk GA, Naunheim KS: Thoracoscopic evaluation and treatment of thoracic trauma. Surg Clin North Am 2000; 80(5): 1535-42.[Crossref][PubMed]
  • Paci M, Annessi V, de Franco S, et al.: Videothoracoscopic evaluation of thoracic injures. Chir Ital 2002; 54(3): 335-39.
  • Mineo TC, Ambrogi V, Cristino B, et al.: Changing indications for thoracotomy in blunt chest trauma after the advent of videothoracoscopy. J Trauma 1999; 47(6): 1088-91.[PubMed][Crossref]
  • Balm R, Legemate DA: Traumatic aortic rupture. B J Surg 2006; 93(9): 1033-34.[PubMed]
  • Heller G, Immer FF, Savolainen H, et al.: Aortic rupture in high-speed skiing crsshes. J Trauma 2006; 61(4): 979-80.[Crossref][PubMed]
  • Schumacher H, Bockler D, von Tengg-Kobligk H, et al.: Acute traumatic aortic tear: open versus stent-graft repair. Semin Vasc Surg 2006; 19(1): 48-59.[Crossref]
  • Scheinert D, Krankenberg H, Schmidt A, et al.: Endoluminal stent-graft placement for acute rupture of the descending thoracfic aorta. Eur Heart J 2004; 25(8): 694-700.[PubMed][Crossref]
  • Dąbrowiecki S, Witkowski A, Morawski A i wsp: Epidemiologia obrażeń klatki piersiowej w podregionie grudziądzkim. Pol Przegl Chir 1998; 70(12): 1239-46.
Typ dokumentu
Bibliografia
Identyfikatory
Identyfikator YADDA
bwmeta1.element.-psjd-doi-10_2478_v10035-007-0100-0
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