B Phillips1, L Turco2, M Mirzaie3, C Fernandez4. 1. Department of Surgery, Creighton University School of Medicine, Omaha, NE, United States; Department of Clinical Science and Translational Research, Creighton University School of Medicine, Omaha, NE, United States. Electronic address: Bjpmd02@gmail.com. 2. Department of Surgery, University of Kansas Medical Center, Kansas City, KS, United States. Electronic address: LTurco@kumc.edu. 3. Department of Surgery, Creighton University School of Medicine, Omaha, NE, United States. Electronic address: MinaMirzaie@creighton.edu. 4. Department of Surgery, Creighton University School of Medicine, Omaha, NE, United States. Electronic address: Carlos.Fernandez@alegent.org.
Abstract
PURPOSE: Thoracic injuries are common in both blunt and penetrating trauma. Most thoracic injuries are managed non-operatively, approximately 7-20% undergo thoracotomy. Of the injuries requiring thoracotomy, 1-6% ultimately require pulmonary resection. Wedge resection and lobectomies are well-studied in the literature; however, there is a paucity regarding reports on total pneumonectomy in the setting of trauma. Our objectives were to summarize the evidence supporting the role of trauma pneumonectomy (TP) in the current era and reiterate that despite the associated morbidity and mortality TP is justified in selective cases. METHODS: A review of the world's literature was conducted following standard guidelines. Inclusion criteria included those studies reviewing blunt and penetrating trauma to the lungs in adults (age greater than 15 year) that reported mortality rates and outcome measures. RESULTS: The PubMed search yielded 713 studies. Of these, 14 studies included pertinent information on TP. Studies included in this review were published from 1985 to 2017 and involved patient data that was collected from 1972 to 2014. Mortality ranged from 50% to 100% (median 63%; mean 68%). CONCLUSION: In the setting of severe thoracic trauma, pulmonary resection may be necessary. Less aggressive techniques are options in a stable patient; however, in the setting of ongoing hemorrhage, TP should be considered and expediently conducted. The role of damage control thoracic surgery and related techniques is vitally important in these patients to improve the significant mortality of trauma pneumonectomy.
PURPOSE: Thoracic injuries are common in both blunt and penetrating trauma. Most thoracic injuries are managed non-operatively, approximately 7-20% undergo thoracotomy. Of the injuries requiring thoracotomy, 1-6% ultimately require pulmonary resection. Wedge resection and lobectomies are well-studied in the literature; however, there is a paucity regarding reports on total pneumonectomy in the setting of trauma. Our objectives were to summarize the evidence supporting the role of trauma pneumonectomy (TP) in the current era and reiterate that despite the associated morbidity and mortality TP is justified in selective cases. METHODS: A review of the world's literature was conducted following standard guidelines. Inclusion criteria included those studies reviewing blunt and penetrating trauma to the lungs in adults (age greater than 15 year) that reported mortality rates and outcome measures. RESULTS: The PubMed search yielded 713 studies. Of these, 14 studies included pertinent information on TP. Studies included in this review were published from 1985 to 2017 and involved patient data that was collected from 1972 to 2014. Mortality ranged from 50% to 100% (median 63%; mean 68%). CONCLUSION: In the setting of severe thoracic trauma, pulmonary resection may be necessary. Less aggressive techniques are options in a stable patient; however, in the setting of ongoing hemorrhage, TP should be considered and expediently conducted. The role of damage control thoracic surgery and related techniques is vitally important in these patients to improve the significant mortality of trauma pneumonectomy.
Authors: Ramiro Manzano-Nunez; Julian Chica; Alexandra Gómez; Maria P Naranjo; Harold Chaves; Luis E Muñoz; Javier E Rengifo; Isabella Caicedo-Holguin; Juan C Puyana; Alberto F García Journal: Eur J Trauma Emerg Surg Date: 2020-06-28 Impact factor: 3.693
Authors: Piotr Ostrowski; Maria J Strandberg Eriksson; Kajetan Kiełbowski; Nikola Ruszel; Jarosław Pieróg; Janusz Wójcik; Bartosz Kubisa Journal: Kardiochir Torakochirurgia Pol Date: 2021-01-15
Authors: Alberto García; Mauricio Millán; Carlos A Ordoñez; Daniela Burbano; Michael W Parra; Yaset Caicedo; Adolfo González Hadad; Mario Alain Herrera; Luis Fernando Pino; Fernando Rodríguez-Holguín; Alexander Salcedo; Maria Josefa Franco; Ricardo Ferrada; Juan Carlos Puyana Journal: Colomb Med (Cali) Date: 2021-05-10