Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
Pulmonary tractotomy as an abbreviated thoracotomy technique
Autore:
Wall, MJ; Villavicencio, RT; Miller, CC; Aucar, JA; Granchi, TA; Liscum, KR; Shin, D; Mattox, KL;
Indirizzi:
Baylor Coll Med, Cora & Webb Mading Dept Surg, Houston, TX 77030 USA Baylor Coll Med Houston TX USA 77030 ing Dept Surg, Houston, TX 77030 USA Ben Taub Gen Hosp, Houston, TX 77030 USA Ben Taub Gen Hosp Houston TX USA77030 ub Gen Hosp, Houston, TX 77030 USA
Titolo Testata:
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE
fascicolo: 6, volume: 45, anno: 1998,
pagine: 1015 - 1023
Fonte:
ISI
Lingua:
ENG
Soggetto:
PLANNED REOPERATION; DAMAGE CONTROL; TRAUMA; INJURIES;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
15
Recensione:
Indirizzi per estratti:
Indirizzo: Wall, MJ Baylor77030 Med, Cora & Webb Mading Dept Surg, 1 Baylor Plaza, Houston, TX Baylor Coll Med 1 Baylor Plaza Houston TX USA 77030 , Houston, TX
Citazione:
M.J. Wall et al., "Pulmonary tractotomy as an abbreviated thoracotomy technique", J TRAUMA, 45(6), 1998, pp. 1015-1023

Abstract

Background: Operative abbreviated thoracotomy techniques in thoracic trauma include emergency center thoracotomy, ligation of major arterial branches, packing the thoracic cavity for diffuse bleeding, towel clip or Bogota bag closure of the chest, and pulmonary tractotomy. Pulmonary tractotomy withselective vascular ligation was originally described for deep through-and-through lung injuries that did not involve hilar vessels or airways. Pulmonary tractotomy has evolved into use as an abbreviated thoracotomy techniquein patients,vith severe thoracic or multivisceral trauma. As with any operative technique in high-risk patients, specific procedure-related complications may occur and are analyzed herein. The objective of this manuscript isto review the indications, techniques, and results for pulmonary tractotomy in trauma patients requiring abbreviated thoracotomy. Methods: Medical records were retrospectively reviewed for 30 of 32 consecutive tractotomy patients treated at Ben Taub General Hospital, during a 3-year period. By using a model for logistic regression analysis, the characteristics of each patient and their clinical course were tested for impact on mortality. Results: Seventy percent of patients had at least one intraoperative parameter indicative of acidosis (pH < 7.2), coagulopathy (prothrombin time > 13.8 or partial thromboplastin time > 38.0 seconds), or hypothermia (core temperature < 34 degrees C), and 50% of patients manifested two of these threeparameters. The mortality rate among the 30 patients was 17%. Three of thefive patients who died were noted to be acidotic, coagulopathic, and hypothermic. Twelve of 25 patients who survived more than 1 day had at least onethoracic complication. There were no late deaths. There was one failed tractotomy and one missed injury. A second thoracotomy was not required for control of a lung injury in any patient. Logistic regression analysis showed that intraoperative blood loss was the only predictive factor for mortality. Conclusion: Pulmonary tractotomy is a simple and effective technique in injured patients who require an abbreviated thoracotomy and has an acceptablemortality and complication rate. This follow-up report notes that as definitive therapy, tractotomy continues to allow for direct control of bleedingand air leak and obviates the need for formal resection.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 10/07/20 alle ore 03:09:08