Lung-sparing surgery after penetrating trauma using tractotomy, partial lobectomy, and pneumonorrhaphy

George C. Velmahos, Craig Baker, Demetrios Demetriades, Jeremy Goodman, James A. Murray, Juan A. Asensio

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Objective: To evaluate the role of lung-sparing surgical techniques in the surgical management of penetrating pulmonary injuries. Design: Retrospective case series. Setting: Academic level I trauma center. Patients and Methods: Forty patients underwent thoracic surgery for penetrating lung injuries during a 63-month period from January 1993 to March 1997. Five (12.5%) underwent anatomical lobectomy, 3 (7.5%) pneumonorrhaphy, 9 (22.5%) stapled wedge resection, and 23 (57.5%) stapled tractotomy. In total, 34 patients (85%) were treated with stapling techniques (1 anatomical lobectomy, 1 pneumonorrhaphy, 9 stapled wedge resections, and 23 stapled tractotomies) and 35 (87.5%) underwent had tung-sparing surgery for trauma. Results: Morbidity and mortality rates were 40% and 5%, respectively. Patients who underwent anatomical lobectomy required longer mechanical ventilatory sup port, intensive care unit stay, and hospital stay and had a higher morbidity rate compared with patients who underwent lung-sparing surgery for trauma but had central and extensive pulmonary injuries. Stapled tractotomy was efficient in controlling bleeding and bronchial leaks, but, in 3 patients, parts of the divided lung parenchyma were devascularized and had to be resected. Conclusions: Lung-sparing surgery for trauma with the use of staplers can be used in the majority of patients with penetrating pulmonary injuries requiring operation. Stapled tractotomy is a rapid and effective method for controlling hemorrhage and air leaks.

Original languageEnglish
Pages (from-to)186-189
Number of pages4
JournalArchives of Surgery
Volume134
Issue number2
DOIs
StatePublished - 1999
Externally publishedYes

Fingerprint

Lung
Lung Injury
Wounds and Injuries
Aleurites
Hemorrhage
Morbidity
Trauma Centers
Thoracic Surgery
Intensive Care Units
Length of Stay
Air
Mortality

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Lung-sparing surgery after penetrating trauma using tractotomy, partial lobectomy, and pneumonorrhaphy. / Velmahos, George C.; Baker, Craig; Demetriades, Demetrios; Goodman, Jeremy; Murray, James A.; Asensio, Juan A.

In: Archives of Surgery, Vol. 134, No. 2, 1999, p. 186-189.

Research output: Contribution to journalArticle

Velmahos, George C. ; Baker, Craig ; Demetriades, Demetrios ; Goodman, Jeremy ; Murray, James A. ; Asensio, Juan A. / Lung-sparing surgery after penetrating trauma using tractotomy, partial lobectomy, and pneumonorrhaphy. In: Archives of Surgery. 1999 ; Vol. 134, No. 2. pp. 186-189.
@article{cfcb619de2bd4358b33942b0f9c082d4,
title = "Lung-sparing surgery after penetrating trauma using tractotomy, partial lobectomy, and pneumonorrhaphy",
abstract = "Objective: To evaluate the role of lung-sparing surgical techniques in the surgical management of penetrating pulmonary injuries. Design: Retrospective case series. Setting: Academic level I trauma center. Patients and Methods: Forty patients underwent thoracic surgery for penetrating lung injuries during a 63-month period from January 1993 to March 1997. Five (12.5{\%}) underwent anatomical lobectomy, 3 (7.5{\%}) pneumonorrhaphy, 9 (22.5{\%}) stapled wedge resection, and 23 (57.5{\%}) stapled tractotomy. In total, 34 patients (85{\%}) were treated with stapling techniques (1 anatomical lobectomy, 1 pneumonorrhaphy, 9 stapled wedge resections, and 23 stapled tractotomies) and 35 (87.5{\%}) underwent had tung-sparing surgery for trauma. Results: Morbidity and mortality rates were 40{\%} and 5{\%}, respectively. Patients who underwent anatomical lobectomy required longer mechanical ventilatory sup port, intensive care unit stay, and hospital stay and had a higher morbidity rate compared with patients who underwent lung-sparing surgery for trauma but had central and extensive pulmonary injuries. Stapled tractotomy was efficient in controlling bleeding and bronchial leaks, but, in 3 patients, parts of the divided lung parenchyma were devascularized and had to be resected. Conclusions: Lung-sparing surgery for trauma with the use of staplers can be used in the majority of patients with penetrating pulmonary injuries requiring operation. Stapled tractotomy is a rapid and effective method for controlling hemorrhage and air leaks.",
author = "Velmahos, {George C.} and Craig Baker and Demetrios Demetriades and Jeremy Goodman and Murray, {James A.} and Asensio, {Juan A.}",
year = "1999",
doi = "10.1001/archsurg.134.2.186",
language = "English",
volume = "134",
pages = "186--189",
journal = "JAMA Surgery",
issn = "2168-6254",
publisher = "American Medical Association",
number = "2",

}

TY - JOUR

T1 - Lung-sparing surgery after penetrating trauma using tractotomy, partial lobectomy, and pneumonorrhaphy

AU - Velmahos, George C.

AU - Baker, Craig

AU - Demetriades, Demetrios

AU - Goodman, Jeremy

AU - Murray, James A.

AU - Asensio, Juan A.

PY - 1999

Y1 - 1999

N2 - Objective: To evaluate the role of lung-sparing surgical techniques in the surgical management of penetrating pulmonary injuries. Design: Retrospective case series. Setting: Academic level I trauma center. Patients and Methods: Forty patients underwent thoracic surgery for penetrating lung injuries during a 63-month period from January 1993 to March 1997. Five (12.5%) underwent anatomical lobectomy, 3 (7.5%) pneumonorrhaphy, 9 (22.5%) stapled wedge resection, and 23 (57.5%) stapled tractotomy. In total, 34 patients (85%) were treated with stapling techniques (1 anatomical lobectomy, 1 pneumonorrhaphy, 9 stapled wedge resections, and 23 stapled tractotomies) and 35 (87.5%) underwent had tung-sparing surgery for trauma. Results: Morbidity and mortality rates were 40% and 5%, respectively. Patients who underwent anatomical lobectomy required longer mechanical ventilatory sup port, intensive care unit stay, and hospital stay and had a higher morbidity rate compared with patients who underwent lung-sparing surgery for trauma but had central and extensive pulmonary injuries. Stapled tractotomy was efficient in controlling bleeding and bronchial leaks, but, in 3 patients, parts of the divided lung parenchyma were devascularized and had to be resected. Conclusions: Lung-sparing surgery for trauma with the use of staplers can be used in the majority of patients with penetrating pulmonary injuries requiring operation. Stapled tractotomy is a rapid and effective method for controlling hemorrhage and air leaks.

AB - Objective: To evaluate the role of lung-sparing surgical techniques in the surgical management of penetrating pulmonary injuries. Design: Retrospective case series. Setting: Academic level I trauma center. Patients and Methods: Forty patients underwent thoracic surgery for penetrating lung injuries during a 63-month period from January 1993 to March 1997. Five (12.5%) underwent anatomical lobectomy, 3 (7.5%) pneumonorrhaphy, 9 (22.5%) stapled wedge resection, and 23 (57.5%) stapled tractotomy. In total, 34 patients (85%) were treated with stapling techniques (1 anatomical lobectomy, 1 pneumonorrhaphy, 9 stapled wedge resections, and 23 stapled tractotomies) and 35 (87.5%) underwent had tung-sparing surgery for trauma. Results: Morbidity and mortality rates were 40% and 5%, respectively. Patients who underwent anatomical lobectomy required longer mechanical ventilatory sup port, intensive care unit stay, and hospital stay and had a higher morbidity rate compared with patients who underwent lung-sparing surgery for trauma but had central and extensive pulmonary injuries. Stapled tractotomy was efficient in controlling bleeding and bronchial leaks, but, in 3 patients, parts of the divided lung parenchyma were devascularized and had to be resected. Conclusions: Lung-sparing surgery for trauma with the use of staplers can be used in the majority of patients with penetrating pulmonary injuries requiring operation. Stapled tractotomy is a rapid and effective method for controlling hemorrhage and air leaks.

UR - http://www.scopus.com/inward/record.url?scp=0033057590&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033057590&partnerID=8YFLogxK

U2 - 10.1001/archsurg.134.2.186

DO - 10.1001/archsurg.134.2.186

M3 - Article

VL - 134

SP - 186

EP - 189

JO - JAMA Surgery

JF - JAMA Surgery

SN - 2168-6254

IS - 2

ER -