From September 1994 to August 2000, there were 206 patients with abdominal-thoracic injuries who admitted the Popular Hospital. Among these, there were 22 patients (10.7%) included 20 males and 2 females had heart and major blood vessel injuries. Mean age of patients was 30 years. All of them were stabbed with knife. 2/22 patients had treated previously in the other hospital. 20 patients had the mean time from accident to admission was 1 hour and 14 minutes (ranged from 15 minutes to 3 hours). Among 12 deaths, 4 cases occurred before admission, 2 before surgical intervention, 5 during operation, and 1 in second day post-operation. So, there were only 11 patients underwent surgical treatment, included 2 patients with heart injuries and 9 with major blood vessel injuries. 10/11 patients gained good outcome after operation. 1 in 11 patients was dead from abdominal aortic injury.
Injuries ; surgery ; Thoracic Injuries ; Wounds and Injuries

China ; Esophageal Diseases ; surgery ; Humans ; Lung Diseases ; surgery ; Thoracic Injuries ; surgery ; Thoracic Neoplasms ; surgery ; Thoracic Surgery ; Trachea ; surgery

Background: Spinal injury is a severe, common injury in surgical emergency. In Vietnam, there are only few studies on fixing thoracolumbar spine. Objectives: To assess and to provide some preliminary remarks on the results of emergency surgery fixing thoracolumbar spine, performed in Viet Duc Hospital. Subjects and method: A descriptive, prospective study was conducted on 31 patients with thoracolumbar spinal injury (22 males, 9 females, the average age 35 years old), operated in Viet Duc hospital from January, 2005 to July, 2006. Results:Patients with thoracolumbar spinal injury was common seen in working ages. 45.2% of them were farmers. 21/31 patients caused by falls. For non-complete paralysis patients, emergency surgery was required as soon as possible. The most of patients recovered completely. For thoracolumbar spinal injury, Burst-fracture and non complete paralysis, surgery with anterior way should be performed to release cord compression and bone graft. For cases of Burst-fracture, no paralysis, surgery with anterior way helped bone fractures were easy to heal, avoiding postoperative humpback recurrence. Conclusion: Combined surgery with 2 ways (before and after) guaranteed fixing spine, making bone healing was more better in case of rupture of vertebrae, releasing directly spinal cord and facilitating to the best recovery of the spinal cord.
Spinal Injuries/ surgery ; Thoracic Vertebrae/ injuries ; surgery ; Lumbar Vertebrae/ injuries ; surgery ; Fractures ; Bone Emergencies ;

According to the literature, only a small proportion of occurrences regarding penetrating trauma of the thoracic aorta can be treated successfully. Herein we reported our experience of a recent rescue of such a patient in a countryside hospital lacking advanced instruments for cardiopulmonary bypass operations. A 20-year-old male was admitted for a penetrating injury with disrupted innominate vein and right common carotid artery together with a 1.5-cm laceration on the aortic arch between the innominate artery and the left common carotid artery. The patient was successfully saved without the implementation of cardiopulmonary bypass. Presentation and management in this case were discussed.
Adult ; Aorta, Thoracic ; injuries ; surgery ; Humans ; Male ; Wounds, Penetrating ; surgery

OBJECTIVETo explore the advantages and indications of the paraspinal approach by anatomical study and clinical application.

METHODSThe anatomical data and clinical practice of 27 cases were analyzed to explore the accurate approach between the paraspinal muscles and the structure of ambient tissues, as well as the results of clinical application of paraspinal approach. The operation time, blood loss, incision length, radiographic result (Cobb angle, height of anterior edge of the vertebrae) were compared with those in 24 cases treated by traditional approach.

RESULTSComplete exposure of the facets could be easily performed by identifying natural cleavage plane between the multifidus and longissimus muscles. The natural muscular cleavage was (1.47+/-0.23) cm lateral to the midline for females, and (1.64+/-0.35) cm for males at T(12) level. The distance was (3.3+/-0.6) cm lateral to the midline for females, and (3.7+/-1.0) cm for males at L(4) level. In paraspinal approach group, the operation time was (76.2+/-15.7) min, blood loss was (91.6+/-16.9) ml and incision length was (7.6+/-0.8) cm. In traditional approach group, the operation time was (121.4+/-19.6) min, blood loss was (218.7+/-32.3) ml and incision length was (17.4+/-2.1) cm. To compare paraspinal approach with traditional approach, the operation time, blood loss and incision length had statistical difference (P less than 0.05) and the radiographic result (Cobb angle, height of anterior edge of the vertebrae) had no statistical difference (P larger than 0.05).

CONCLUSIONSWhen the paraspinal approach is performed through natural cleavage plane between the multifidus and longissimus muscles, there are no wide muscular disinsertions, leaving the supraspinous and interspinous ligaments intact. The distance of natural cleavage to the midline is different at T(12) and L(4) planes. By this approach, the facet joints can be explored easily and completely, and a clear surgical field will be available for the placement of pedicle screws. As a minimally invasive approach, it can be widely used in thoracolumbar spine surgery.

Female ; Humans ; Lumbar Vertebrae ; injuries ; surgery ; Male ; Spinal Fractures ; surgery ; Thoracic Vertebrae ; injuries ; surgery ; Time Factors

BACKGROUND: A method of wound closure using knotless suture material in the chest tube site has been introduced at our center, and is now widely used as the primary method of closing chest tube wounds in video- assisted thoracic surgery (VATS) because it provides cosmetic benefits and causes less pain. METHODS: We included 109 patients who underwent VATS pulmonary resection at Samsung Medical Center from October 1 to October 31, 2016. Eighty-five patients underwent VATS pulmonary resection with chest drain wound closure utilizing knotless suture material, and 24 patients underwent VATS pulmonary resection with chest drain wound closure by the conventional method. Complications related to the chest drain wound were compared between the 2 groups. RESULTS: There were 2 cases of pneumothorax after chest tube removal in both groups (8.3% in the conventional group, 2.3% in the knotless suture group; p=0.172) and there was 1 case of wound discharge due to wound dehiscence in the knotless suture group (0% in the conventional group, 1.2% in the knotless suture group; p=0.453). There was no reported case of chest tube dislodgement in either group. The complication rates were non-significantly different between the 2 groups. CONCLUSION: The results for the complication rates of this new chest drain wound closure method suggest that this method is not inferior to the conventional method. Chest drain wound closure using knotless suture material is feasible based on the short-term results of the complication rate.
Chest Tubes ; Humans ; Lung ; Methods* ; Pneumothorax ; Sutures* ; Thoracic Surgery ; Thoracic Surgery, Video-Assisted ; Thorax* ; Wounds and Injuries*

Humans ; Spinal Fractures ; classification ; diagnosis ; therapy ; Thoracic Vertebrae ; injuries ; surgery

OBJECTIVETo investigate the feasibility and the efficacy of video-assisted thoracoscopic surgery in treating thoracolumbar fractures.

METHODSFrom October 2000 to December 2009, the data of 44 patients with thoracolumbar fractures were retrospetively analyzed. All patients were treated with anterior decompression, auto-iliac bone graft and anterior internal fixation system. They were divided into thoracoscopic group (23 cases, treated with video-assisted thoracoscopic surgery) and traditional group (21 cases, treated with traditional anterior approach surgery). In the thoracoscopic group, there were 15 males and 8 females with an average age of 41.4 years (ranged, 19 to 76); and in the traditional group, there were 14 males and 7 females with an average age of 39.3 years (ranged, 20 to 74). All patients were followed up from 6 to 36 months with an average of 18 months. The operative time, volume of the blood loss, the decreased value of the occupation ratio of spinal canal (OR), the corrected and loss degree of Cobb angle, the improved condition of ASIA classification were compared between two groups.

RESULTSIn traditional group, operative time, volume of the blood loss, the decreased value of the occupation ratio of spinal canal (OR), the corrected and loss degree of Cobb angle, the improved grade of ASIA classification were (150.0 +/- 19.4) min, (970.0 +/- 72.0) ml, (35.5 +/- 6.4)%, (25.1 +/- 4.8) degrees, (1.0 +/- 0.7) degrees, (1.8 +/- 0.9) grades, respectively; and in thoracoscopic group, the above items were (170.0 +/- 20.8) min, (650.0 +/- 65.4) ml, (33.2 +/- 8.0)%, (23.6 +/- 5.4) degrees, (1.1 +/- 0.8) degrees, (2.0 +/- 1.1) grades, respectively. There was significant difference in volume of the blood loss between two groups (P < 0.05); there was no significant difference in operative time, the decreased value of the occupation ratio of spinal canal (OR), the corrected and loss degree of Cobb angle,the improved grade of ASIA classification between two groups (P > 0.05). The rate of fusion of all patients was 100%.

CONCLUSIONCompared with the traditional anterior approach surgery, video-assisted thoracoscopic surgery has advantages of little incision,less blood loss, less trauma, can obtain same clinical outcome and is a safe,effective method in treating thoracolumbar fractures.

Adult ; Aged ; Female ; Humans ; Lumbar Vertebrae ; injuries ; surgery ; Male ; Middle Aged ; Retrospective Studies ; Spinal Injuries ; surgery ; Thoracic Surgery, Video-Assisted ; methods ; Thoracic Vertebrae ; injuries ; surgery

Scapulothoracic dissociation is a rare and complex injury pattern with varied presentation. Here we describe a case of a 32-year-old male who presented with scapulothoracic dissociation associated with brachial plexus injury, along with scapholunate dissociation. We also propose an injury mechanism that might link the two injury patterns, suggesting that the association might be more than by chance. The patient was managed according to established trauma care and resuscitation protocols followed by open reduction and internal fixation of the clavicle fracture, and fixation of scapholunate dissociation and had a successful outcome at follow-up.
Adult ; Arm Injuries ; surgery ; Fracture Fixation, Internal ; methods ; Humans ; Joint Dislocations ; surgery ; Male ; Multiple Trauma ; Scapula ; injuries ; Thoracic Injuries ; surgery

A 55-year-old male patient suffered from severe high-voltage electric burn with an area of 20%TBSA full-thickness injury. The injury involved the distal end of left upper limb, right trunk, and whole abdominal wall. Fracture of the 7th-10th ribs was found in the right side of chest, with perforation of abdominal cavity, and bilateral pleural effusion was found. Part of the small intestine was necrotic and exposed. At the early stage, xeno-acellular dermal matrix was grafted after debridement of abdominal wound; peritoneal lavage was performed; negative pressure drainage was performed in orificium fistula of intestine for promoting the adhesion between perforated intestine and abdominal scar. Two orificium fistulas formed after closure of abdominal granulation wound by autologous skin grafting. Eschar of chest wall and denatured ribs were retained. The risk of infection of thoracic cavity was decreased by promoting the adhesion between lung tissue and chest wall. During the treatment, the patient was diagnosed with Henoch-Schonlein purpura nephritis by renal biopsy, with the symptoms of purpura in the lower limbs, heavy proteinuria, severe hypoalbuminemia, edema, etc. After control of kidney damage by immunosuppressive treatment instead of glucocorticoid, alleviation of the levels of proteinuria and blood albumin, free latissimus dorsi myocutaneous flap was excised to repair chest wall, and free skin graft was excised to repair intestinal fistula. After all the wounds were successfully covered, the patient was treated with glucocorticoid combined with immunosuppressants for more than 1 year. The patient was followed up for 3 years, and his renal function was completely recovered with satisfactory clinical outcome.
Abdominal Cavity ; Abdominal Injuries ; complications ; surgery ; Burns, Electric ; complications ; surgery ; Humans ; Male ; Middle Aged ; Nephritis ; complications ; surgery ; Purpura, Schoenlein-Henoch ; complications ; surgery ; Thoracic Cavity ; Thoracic Injuries ; complications ; surgery