Thoracoscopy versus thoracotomy in hemodynamically stable patients with closed thoracic trauma

Background: In this prospective study, we aimed to compare thoracoscopy and thoracotomy in hemodynamically stable patients with closed thoracic trauma. Methods: The study included 30 patients with closed chest trauma. All patients were diagnosed as cases of hemothorax and a chest tube was inserted following investigations, including chest x-ray and computed tomography. All patients were indicated for surgery (thoracoscopy: 15 patients and thoracotomy: 15 patients). A comparison between the two groups was performed in terms of preoperative, operative and postoperative data. Results: Both groups had comparable baseline and preoperative data (p > 0.05). Traffic accidents were the most common cause of thoracic trauma in both groups, followed by fall from a height and violence. Injuries were most common to the intercostal arteries, followed by the lungs. The thoracotomy group was associated with a longer operative time and length of hospital stay (p < 0.001) than the thoracoscopy group. Moreover, thoracoscopy provided the advantages of minimally invasive surgery with a significant reduction (p < 0.001) in the amount of postoperative drainage. Only two cases (13.3%) in the thoracoscopy group were converted into thoracotomy for either uncontrolled bleeding or voluminous hematoma. Conclusions: Thoracoscopy is feasible and safe for the diagnosis and treatment of hemodynamically-stable patients with blunt thoracic trauma. Keywords: Chest trauma, Hemodynamics, Thoracoscopy, Thoracotom