Should videothorascopic surgery be the first choice in isolated traumatic hemothorax? A prospective randomized controlled study

Abstract

BACKGROUND In this study, patients with hemothorax due to blunt or penetrating thorax trauma and treated by tube thoracostomy were compared with the patients treated by videothoracoscopic surgery (VATS) in order to determine whether VATS can be the first choice in treatment. METHODS Sixty patients with hemothorax due to trauma were examined prospectively. Thirty patients with isolated hemothorax and treated by tube thoracostomy were classified as Group I (50%), and 30 patients treated by VATS were classified as Group II (50%). Patients were compared according to healing duration, tube thoracostomy duration, hospitalization duration, success rate of treatment, morbidity, and mortality. RESULTS When Group I and II were compared according to the duration of tube thoracostomy and hospitalization, Group I was found to have longer duration statistically (p=0.001). When the two groups were compared according to morbidity, statistical morbidity was found higher in Group I (p=0.030). CONCLUSION VATS seems to be better in the treatment of hemothorax when compared with traditional drainage method because of its advantage of direct diagnosis and hemostasis by diagnostic thoracoscopy. If clotted blood is evacuated, empyema and fibrothorax are preventable. In these cases, chest tube duration and hospital length of stay are shorter. Therefore, these patients can be discharged early.