Thoracoscopic evaluation and treatment of thoracic trauma.

VATS has a diagnostic and therapeutic role in the treatment of patients with chest trauma, but the basic rule of safety over technology must be applied. It is an effective means for managing diaphragmatic injuries, hemothorax, empyemas, and persistent air leaks in selected hemodynamically stable patients. An overview of reported series (Table 1) demonstrates that VATS can be used successfully in the evaluation of patients with blunt and penetrating trauma. In appropriately selected cases, thoracoscopy can prove to be useful, with conversion to thoracotomy in only 10% of patients. Additional studies must be performed to determine any cost benefit compared with conventional therapy.