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Experience in the use of thoracoscopy in emergency surgery

Lobanov L.   (Chita state medical Academy)

Shapovalov K.   (Chita state medical Academy)

Hanina Y.   (Chita state medical Academy)

Lobanov Y.   (Chita state medical Academy)

Yashnov A.   (Chita state medical Academy)

Konovalova O.   (Chita state medical Academy)

Lobanov S.   (Chita state medical Academy)

Despite the active introduction of minimally invasive technologies, such a well-known method as thoracoscopy has not yet received sufficient dissemination in wide medical practice. To study the possibilities and scope of thoracoscopic interventions in the clinic for emergency surgery. The results of 232 thoracoscopy in patients hospitalized in the City Clinical Hospital No. 1 in Chita are analyzed. The most common indication in 171 cases (73.7%) was a chest injury (knife wound). In 35 cases (15.1%), thoracic sympathectomy was performed with regard to frostbite of the upper limbs. Less often, thoracoscopy was carried out for purulent complications, in particular pleural empyema -15 (6.4%) and spontaneous pneumothorax-11 (4.7%). The first instrument was usually inserted into the 5th intercostal space along the anterior cavity. To insulate the lungs, insufflation was very insignificant. After the examination of the pleural cavity, according to the indications, additional puncture sites and the introduction of appropriate instruments were identified. After diagnostic and therapeutic measures, the question of further tactics was resolved. In thoracoscopically inevitable complications, thoracotomy was required. In the case of successful thoracoscopy, the operation was stopped by draining the pleural cavity through one of the most adequately located punctures. Thoracoscopy is an effective method of determining the further tactics of this pathology. With a trauma in the "danger zone", 41 of 62 patients managed to avoid conversion. Using thoracoscopy can reduce the amount of thoracotomy 2-2.5 times. Thoracoscopic thoracic sympathectomy is a promising method of complex treatment of cold trauma with frostbite of upper extremities, which, improving microcirculation, improves regenerative processes and shortens the duration of treatment.

Keywords:thoracoscopy, thoracic trauma, thoracoscopic sympathectomy
 

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Citation link:
Lobanov L. , Shapovalov K. , Hanina Y. , Lobanov Y. , Yashnov A. , Konovalova O. , Lobanov S. Experience in the use of thoracoscopy in emergency surgery // Современная наука: актуальные проблемы теории и практики. Серия: Естественные и Технические Науки. -2019. -№05. -С. 160-162
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