Serkan Yazgan1, Ahmet Üçvet1, Soner Gürsoy1, Özgür Samancılar1. 1. Department of Thoracic Surgery, University of Health Sciences, Dr. Suat Seren Chest Diseases and Surgery Training and Research Hospital, İzmir, Turkey.
Abstract
BACKGROUND: This study aims to examine the indications, timing and risk factors of rethoracotomy, analyze the postoperative results, and give suggestions to reduce the risks. METHODS: A total of 3,292 patients operated via thoracotomy between January 2006 and January 2017 were evaluated retrospectively. Demographic data, initial operative indications, surgical procedures, indications for rethoracotomy and preoperative risk factors, intraoperative findings and surgical methods, timing of rethoracotomy, morbidity and mortality results were analyzed of 66 patients (60 males, 6 females; mean age 59.4±12.4 years; range, 17 to 80 years) who were performed rethoracotomy before being discharged. Rethoracotomies performed within 72 hours after the first operation constituted the early and those performed after 72 hours constituted the late rethoracotomy group. RESULTS: Rethoracotomy was performed in average 4.7 days (range, 1 to 17 days). Early rethoracotomy was performed on 42 patients (1.3%) and 38 (90.4%) of these were due to hemorrhage. The most frequent indication for rethoracotomy was hemorrhage (n=41, 1.2%), followed by bronchopleural fistula (n=17, 0.5%). The other indications were chylothorax, lobe torsion, parenchymal air leak and collapse, and diaphragmatic laceration. Eight patients had rib fractures and all of these patients were over the age of 60. Eight patients who were performed rethoracotomy due to hemorrhage were using antiaggregant drugs. The postoperative morbidity and mortality rates were 33.3% (n=22) and 24.2% (n=16), respectively. CONCLUSION: Rethoracotomy still has high morbidity and mortality rates. The main cause of rethoracotomy performed due to hemorrhage may be rib fractures or antiaggregant drugs. The most remarkable indications of rethoracotomy are hemorrhage and bronchopleural fistula.
BACKGROUND: This study aims to examine the indications, timing and risk factors of rethoracotomy, analyze the postoperative results, and give suggestions to reduce the risks. METHODS: A total of 3,292 patients operated via thoracotomy between January 2006 and January 2017 were evaluated retrospectively. Demographic data, initial operative indications, surgical procedures, indications for rethoracotomy and preoperative risk factors, intraoperative findings and surgical methods, timing of rethoracotomy, morbidity and mortality results were analyzed of 66 patients (60 males, 6 females; mean age 59.4±12.4 years; range, 17 to 80 years) who were performed rethoracotomy before being discharged. Rethoracotomies performed within 72 hours after the first operation constituted the early and those performed after 72 hours constituted the late rethoracotomy group. RESULTS: Rethoracotomy was performed in average 4.7 days (range, 1 to 17 days). Early rethoracotomy was performed on 42 patients (1.3%) and 38 (90.4%) of these were due to hemorrhage. The most frequent indication for rethoracotomy was hemorrhage (n=41, 1.2%), followed by bronchopleural fistula (n=17, 0.5%). The other indications were chylothorax, lobe torsion, parenchymal air leak and collapse, and diaphragmatic laceration. Eight patients had rib fractures and all of these patients were over the age of 60. Eight patients who were performed rethoracotomy due to hemorrhage were using antiaggregant drugs. The postoperative morbidity and mortality rates were 33.3% (n=22) and 24.2% (n=16), respectively. CONCLUSION: Rethoracotomy still has high morbidity and mortality rates. The main cause of rethoracotomy performed due to hemorrhage may be rib fractures or antiaggregant drugs. The most remarkable indications of rethoracotomy are hemorrhage and bronchopleural fistula.
Authors: Christian W Hamm; Jean-Pierre Bassand; Stefan Agewall; Jeroen Bax; Eric Boersma; Hector Bueno; Pio Caso; Dariusz Dudek; Stephan Gielen; Kurt Huber; Magnus Ohman; Mark C Petrie; Frank Sonntag; Miguel Sousa Uva; Robert F Storey; William Wijns; Doron Zahger Journal: Eur Heart J Date: 2011-08-26 Impact factor: 29.983
Authors: Susan C Van't Westeinde; Nanda Horeweg; Paul De Leyn; Harry J M Groen; Jan-Willem J Lammers; Carla Weenink; Kristiaan Nackaerts; Rob J van Klaveren Journal: Eur J Cardiothorac Surg Date: 2012-04-05 Impact factor: 4.191