20.500.12556/DiRROS-24969 The role of video-assisted thoracoscopic surgery in blunt and penetrating chest trauma timing of intervention and clinical outcomes - a review of the current evidence Video-assisted thoracoscopic surgery (VATS) has emerged as a valuable tool in the management of both blunt and penetrating chest trauma. Indications for VATS include retained haemothorax, persistent pneumothorax, and diagnostic clarification of suspected intrathoracic injuries. Compared to open thoracotomy, VATS offers reduced postoperative pain, shorter hospital stay, and decreased infection rates, particularly when performed early, ideally within 72 hours of injury. In cases of blunt trauma, early VATS enables effective evacuation of clotted blood, reduces ventilator days, and minimizes complications such as empyema or fibrothorax. In penetrating trauma, VATS allows for minimally invasive inspection and management of diaphragmatic, pulmonary, and pleural injuries in haemodynamically stable patients, with early intervention showing superior outcomes. The role of VATS in rib fracture stabilization is expanding, with data supporting its feasibility and effectiveness in anatomically challenging cases, such as posterior or subscapular fractures. Thoracoscopic-assisted fixation may offer comparable or superior outcomes to open techniques, particularly when novel devices like memory alloy plates are used. While early surgical stabilization of rib fractures (SSRF) is generally favoured, recent evidence suggests that delayed SSRF does not necessarily worsen clinical outcomes, allowing prioritization of other life-threatening injuries in polytrauma scenarios. Despite promising retrospective and cohort data, there remains a lack of randomized controlled trials (RCTs) to definitively guide timing and patient selection for VATS in trauma. Standardized protocols for integrating VATS into trauma algorithms are needed. This review synthesizes current evidence and proposes pragmatic recommendations for the timing and indications of VATS in modern thoracic trauma care. video-assisted thoracoscopic surgery VATS thoracic trauma rib fixation blunt trauma penetrating trauma true false true Angleški jezik Ni določen V članku navedeno: "© AME Publishing Company." Na pristajalni strani članka navedeno: "This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0)." (https://vats.amegroups.org/article/view/11897/html, 6. 1. 2026) Neznano 2026-01-06 11:28:54 2026-01-06 11:28:55 2026-01-07 03:43:18 0000-00-00 00:00:00 2025 0 0 Nasl. z nasl. zaslona; Opis z dne 6. 1. 2026; str. 1-10 [article no.] 33 Vol. 10 2025 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 616-089 2519-0792 10.21037/vats-25-32 263552259 RAZ_Patel_Akshay_J._2025.pdf RAZ_Patel_Akshay_J._2025.pdf 1 DEAD92647D5E1467D4334ADD9DD4A082 0df8799a3430b01cf69af09b8a24db3d81546b2278e9594e04dc35616a01a130 78d3c3ae-eaeb-11f0-94a7-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=37413 https://vats.amegroups.org/article/view/11897/html 0 81fba491-eaeb-11f0-94a7-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=37414 Univerzitetni klinični center Ljubljana 0 0 0