Díaz BCZ, Ferrufino MAL, Vázquez MJC

Language: Spanish
References: 8
Page: 37-40
PDF size: 80.25 Kb.

ABSTRACT

One of the pathological phenomena more common in the thoracic trauma is the persistence of the intrapleurals hematics collections (hemothorax retained). The blood within the pleural space tends to coagulate, later developing to processes of angiofibroplasia and dense intracavitary healing, which can cause important alterations in the mechanics ventilatory, interchange of gases and in the explanation of secretions. The minimumly invasive surgery has been great height in the last years old and their indications continue expanding. The evacuation of hemothorax traumatic coagulated is one of them and must be made of early form to be more affective. We made a descriptive and retrospective study reviewing the clinical files of patients submissive thoracoscopic surgery for drainage of hemothorax retained. To all the patients one evaluated by means of X-ray of thorax and computed tomography to them, being made the surgery within the first 7 days from the traumatic. Ten thoracoscopies for drainage of hemothorax were made coagulated, the 10 were of masculine sex, with an age average of 33 years. The etiology number one was by projectile of firearm in 7 patients. The days that passed from the initial trauma to the day of the surgical event were of 2 days with rank from 1 to 4. The surgical time average was of 90 minutes. The amount average of hemothorax drained was of 400 mL. Associate to hemothorax existed other surgical findings coagulated and due to these in a case it became to thoracotomy. The endopleural sounding was retired in a period of 3 to 8 days. Having like time of hospital stay average 5 days. The complications were: atelectasis 3, pneumonia 1, pachypleuritis 1. We had a mortality of 0% in the present study. The thoracoscopic in an excellent method to evacuate hemothorax coagulated, with the advantages of simplicity in the equipment, minor cost and prevention of delayed complications. Its future depends on the permanent instruction to the residents and surgeons of the technological development and the use of the acquired experience to need the indications the procedure. This it is a preliminary study of our experience in this technique.

REFERENCES

1. Andrade AR, Pérez JG, Ávila A. Toracoscopia rígida en el manejo del hemotórax traumático coagulado. Rev Inst Nal Enf Resp Mex 2005; 18: 195-198.

2. García NL, Padilla SR, Lever RC. Hemotórax retenido ¿Qué debo saber una vez que lo he encarado? Trauma 2005; 8: 82-88.

3. Dan MM, Michael EJ, Michael AW. Early evacuation of traumatic retained hemothoraces using thoracoscopy: A prospective, randomized trial. Ann Thorac Surg 1997; 64: 1396-1401.

4. Heniford BT, Carrillo EH, Spain DA. The role of thoracoscopy in the management of retained thoracic collections after trauma. Ann Thorac Surg 1997; 63:940-3.

5. Pradeep HN, Richard JV, Andrew JN. Thoracoscopic evacuation of retained post-traumatic hemothorax. Ann Surg 2004; 78: 282-6.

6. Bodney JL, Robert JK. Thoracoscopy for empyema and hemothorax. Chest 1995; 109: 18-24.

7. Villegas MI, Morales CH. Drenaje del hemotórax coagulado mediante toracoscopia factores predictivos de éxito.

8. Andrade-Alegre R, Ávila A, Pérez JG. Hemotórax coagulado traumático. Rev Med Cient 2005; 18: 18-21.