Journal of Chest Surgery

  • 제56권2호
  • /
  • Pages.120-125
  • /
  • 2023
  • /
  • 2765-1606(pISSN)
  • /
  • 2765-1614(eISSN)
대한심장혈관흉부외과학회 (The Korean Society for Thoracic and Cardiovascular Surgery)
권호 표지
DOI QR코드

DOI QR Code

Clinical Outcomes of Minimally Invasive Surgical Stabilization of Rib Fractures Using Video-Assisted Thoracoscopic Surgery

  • Chae-Min Bae (Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital, School of Medicine, Kyungpook National University) ;
  • Shin-Ah Son (Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital, School of Medicine, Kyungpook National University) ;
  • Yong Jik Lee (Department of Thoracic and Cardiovascular Surgery, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Sang Cjeol Lee (Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital, School of Medicine, Kyungpook National University)
  • 투고 : 2022.10.17
  • 심사 : 2022.11.29
  • 발행 : 2023.03.05
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Background: Multiple rib fractures are common in blunt chest trauma. Until recently, most surgical rib fixations for multiple rib fractures were performed via open thoracotomy. However, due to the invasive nature of tissue dissection and the resulting large wound, an alternative endoscopic approach has emerged that minimizes the postoperative complications caused by the manipulation of injured tissue and lung during an open thoracotomy. Methods: Our study concentrated on patients with multiple rib fractures who underwent surgical stabilization of rib fractures (SSRF) between June 2018 and May 2020. We found 27 patients who underwent SSRF using video-assisted thoracoscopic surgery. The study design was a retrospective review of the patients' charts and surgical records. Results: No intraoperative events or procedure-related deaths occurred. Implant-related irritation occurred in 4 patients, and 1 death resulted from concomitant trauma. The average hospital stay was 30.2±20.1 days, and ventilators were used for 12 of the 22 patients admitted to the intensive care unit. None of the patients experienced major pulmonary complications such as pneumonia or acute respiratory distress syndrome. Conclusion: Minimally invasive rib stabilization surgery with the assistance of a thoracoscope is expected to become more widely used in patients with multiple rib fractures. This method will also assist patients in a quick recovery.

키워드

과제정보

We certify that this study is our own work and all sources of information used in this study have been fully acknowledged.

참고문헌

  1. Sirmali M, Turut H, Topcu S, et al. A comprehensive analysis of traumatic rib fractures: morbidity, mortality and management. Eur J Cardiothorac Surg 2003;24:133-8. https://doi.org/10.1016/s1010-7940(03)00256-2
  2. Bulger EM, Arneson MA, Mock CN, Jurkovich GJ. Rib fractures in the elderly. J Trauma 2000;48:1040-7. https://doi.org/10.1097/00005373-200006000-00007
  3. Nwiloh J, Walker M, Nwiloh M. Surgical stabilization of blunt traumatic chest wall bony injuries. Niger J Cardiovasc Thorac Surg 2016;1:43-8. https://doi.org/10.4103/2468-7391.195926
  4. Chan EG, Stefancin E, Cunha JD. Rib fixation following trauma: a cardiothoracic surgeon's perspective. J Trauma Treat 2016;5:4. https://doi.org/10.4172/2167-1222.1000339
  5. Pieracci FM, Majercik S, Ali-Osman F, et al. Consensus statement: surgical stabilization of rib fractures rib fracture colloquium clinical practice guidelines. Injury 2017;48:307-21. https://doi.org/10.1016/j.injury.2016.11.026
  6. Fokin AA, Hus N, Wycech J, Rodriguez E, Puente I. Surgical stabilization of rib fractures: indications, techniques, and pitfalls. JBJS Essent Surg Tech 2020;10:e0032. https://doi.org/10.2106/JBJS.ST.19. 00032
  7. Liman ST, Kuzucu A, Tastepe AI, Ulasan GN, Topcu S. Chest injury due to blunt trauma. Eur J Cardiothorac Surg 2003;23:374-8. https://doi.org/10.1016/s1010-7940(02)00813-8
  8. Kent R, Woods W, Bostrom O. Fatality risk and the presence of rib fractures. Ann Adv Automot Med 2008;52:73-82.
  9. He Z, Zhang D, Xiao H, et al. The ideal methods for the management of rib fractures. J Thorac Dis 2019;11(Suppl 8):S1078-89. https://doi.org/10.21037/jtd.2019.04.109
  10. Bemelman M, Poeze M, Blokhuis TJ, Leenen LP. Historic overview of treatment techniques for rib fractures and flail chest. Eur J Trauma Emerg Surg 2010;36:407-15. https://doi.org/10.1007/s00068-010-0046-5
  11. Dehghan N, de Mestral C, McKee MD, Schemitsch EH, Nathens A. Flail chest injuries: a review of outcomes and treatment practices from the National Trauma Data Bank. J Trauma Acute Care Surg 2014;76:462-8. https://doi.org/10.1097/TA.0000000000000086
  12. Naidoo K, Hanbali L, Bates P. The natural history of flail chest injuries. Chin J Traumatol 2017;20:293-6. https://doi.org/10.1016/j.cjtee.2017.02.005
  13. Beks RB, de Jong MB, Houwert RM, et al. Long-term follow-up after rib fixation for flail chest and multiple rib fractures. Eur J Trauma Emerg Surg 2019;45:645-54. https://doi.org/10.1007/s00068-018-1009-5
  14. Marasco S, Lee G, Summerhayes R, Fitzgerald M, Bailey M. Quality of life after major trauma with multiple rib fractures. Injury 2015;46:61-5. https://doi.org/10.1016/j.injury.2014.06.014
  15. Pieracci FM, Lin Y, Rodil M, et al. A prospective, controlled clinical evaluation of surgical stabilization of severe rib fractures. J Trauma Acute Care Surg 2016;80:187-94. https://doi.org/10.1097/TA.0000000000000925
  16. Miranda AP, de Souza HC, Santos BF, et al. Bilateral shoulder dysfunction related to the lung resection area after thoracotomy. Medicine (Baltimore) 2015;94:e1927. https://doi.org/10.1097/MD.0000000000001927
  17. Bemelman M, van Baal M, Yuan JZ, Leenen L. The role of minimally invasive plate osteosynthesis in rib fixation: a review. Korean J Thorac Cardiovasc Surg 2016;49:1-8. https://doi.org/10.5090/kjtcs.2016.49.1.1
  18. Zhang Q, Song L, Ning S, Xie H, Li N, Wang Y. Recent advances in rib fracture fixation. J Thorac Dis 2019;11(Suppl 8):S1070-7. https://doi.org/10.21037/jtd.2019.04.99
  19. Pieracci FM. Completely thoracoscopic surgical stabilization of rib fractures: can it be done and is it worth it? J Thorac Dis 2019; 11(Suppl 8):S1061-9. https://doi.org/10.21037/jtd.2019.01.70