Abstract：
Early video-assisted thoracoscopic surgery (VATS) is the recommended treatment of choice for retained hemothorax (RH). A prospective single-center randomized control study was conducted to compare outcomes between VATS and thoracostomy tube (TT) reinsertion for patients with RH after penetrating trauma in a resource constrained unit. Our hypothesis was that patients with a RH receiving VATS instead of TT reinsertion would have a shorter hospital stay and lesser complications.
From January 2014 to November 2019, stable patients with thoracic penetrating trauma complicated with retained hemothoraces were randomized to either VATS or TT reinsertion. The outcomes were length of hospital stay (LOS) and complications.
Out of the 77 patients assessed for eligibility, 65 patients were randomized and 62 analyzed: 30 in the VATS arm and 32 in the TT reinsertion arm. Demographics and mechanisms of injury were comparable between the two arms. Length of hospital stay was: preprocedure: VATS 6.8 (+/-2.8) days and TT 6.6 (+/- 2.4) days (p = 0.932) and postprocedure: VATS 5.1 (+/-2.3) days, TT 7.1 (+/-6.3) days (p = 0.459), total LOS VATS 12 (+/- 3.9) days, and TT 14.4 (+/-7) days (p = 0.224). The TT arm had 15 complications compared to the VATS arm of four (p = 0.004). There were two additional procedures in the VATS arm and 10 in the TT arm (p = 0.014).
VATS proved to be the better treatment modality for RH with fewer complications and less need of additional procedures, while the LOS between the two groups was not statistically different.
From January 2014 to November 2019, stable patients with thoracic penetrating trauma complicated with retained hemothoraces were randomized to either VATS or TT reinsertion. The outcomes were length of hospital stay (LOS) and complications.
Out of the 77 patients assessed for eligibility, 65 patients were randomized and 62 analyzed: 30 in the VATS arm and 32 in the TT reinsertion arm. Demographics and mechanisms of injury were comparable between the two arms. Length of hospital stay was: preprocedure: VATS 6.8 (+/-2.8) days and TT 6.6 (+/- 2.4) days (p = 0.932) and postprocedure: VATS 5.1 (+/-2.3) days, TT 7.1 (+/-6.3) days (p = 0.459), total LOS VATS 12 (+/- 3.9) days, and TT 14.4 (+/-7) days (p = 0.224). The TT arm had 15 complications compared to the VATS arm of four (p = 0.004). There were two additional procedures in the VATS arm and 10 in the TT arm (p = 0.014).
VATS proved to be the better treatment modality for RH with fewer complications and less need of additional procedures, while the LOS between the two groups was not statistically different.
摘要：
背景：早期电视胸腔镜手术（VATS）是保留血胸（RH）的推荐治疗选择。进行了一项前瞻性单中心随机对照研究，以比较在资源有限的单位中穿透性创伤后的RH患者的VATS和胸腔镜造口管（TT）重新插入的结果。我们的假设是，接受VATS而不是TT重新插入的RH患者的住院时间较短，并发症较少。
方法：从2014年1月至2019年11月，将稳定的胸部穿通伤合并保留血胸的患者随机分为VATS或TT再插入。结果为住院时间（LOS）和并发症。
结果：在评估合格的77名患者中，65名患者被随机分配并分析了62名：VATS组30名，TT再插入组32名。两组之间的人口统计学和损伤机制具有可比性。住院时间为：术前：VATS6.8（+/-2.8）天和TT6.6（+/-2.4）天（p=0.932），术后：VATS5.1（+/-2.3）天，TT7.1（+/-6.3）天（p=0.459），总LOSVATS12（+/-3.9）天，和TT14.4(+/-7)天(p=0.224)。与VATS组的4例相比，TT组有15例并发症（p=0.004）。在VATS臂中有两个额外的程序，在TT臂中有10个额外的程序（p=0.014）。
结论：VATS被证明是RH较好的治疗方式，并发症少，需要额外的手术。而两组间的LOS无统计学差异。
方法：从2014年1月至2019年11月，将稳定的胸部穿通伤合并保留血胸的患者随机分为VATS或TT再插入。结果为住院时间（LOS）和并发症。
结果：在评估合格的77名患者中，65名患者被随机分配并分析了62名：VATS组30名，TT再插入组32名。两组之间的人口统计学和损伤机制具有可比性。住院时间为：术前：VATS6.8（+/-2.8）天和TT6.6（+/-2.4）天（p=0.932），术后：VATS5.1（+/-2.3）天，TT7.1（+/-6.3）天（p=0.459），总LOSVATS12（+/-3.9）天，和TT14.4(+/-7)天(p=0.224)。与VATS组的4例相比，TT组有15例并发症（p=0.004）。在VATS臂中有两个额外的程序，在TT臂中有10个额外的程序（p=0.014）。
结论：VATS被证明是RH较好的治疗方式，并发症少，需要额外的手术。而两组间的LOS无统计学差异。
