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 language | English |
|---|---|
| Pages (from-to) | 186-189 |
| Number of pages | 4 |
| Journal | Archives of Surgery |
| Volume | 134 |
| Issue number | 2 |
| DOIs | |
| State | Published - 1999 |
| Externally published | Yes |
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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 journal › Article
}
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.
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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 -