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Iskalni niz: "ključne besede" (video-assisted thoracoscopic surgery) .

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1.
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
Akshay J. Patel, Matic Domjan, Haruchika Yamamoto, 2025, pregledni znanstveni članek

Povzetek: 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.
Ključne besede: video-assisted thoracoscopic surgery, VATS, thoracic trauma, rib fixation, blunt trauma, penetrating trauma
Objavljeno v DiRROS: 06.01.2026; Ogledov: 478; Prenosov: 67
.pdf Celotno besedilo (190,90 KB)
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2.
Impact of chest tube type on pain, drainage efficacy, and short-term treatment outcome following video-assisted thoracoscopic surgery lobectomy : a randomized controlled trial comparing coaxial silicone drains and standard polyvinyl chloride drains
Boris Greif, Janez Žgajnar, Tomaž Štupnik, 2025, izvirni znanstveni članek

Povzetek: Background: Chest drains are routinely used after video-assisted thoracoscopic surgery (VATS) lung resections to evacuate fluid and air from the pleural space. We compared the impact of coaxial silicone (SIL) drains vs. standard polyvinyl chloride (PVC) drains on postoperative pain, drainage efficacy, and short-term treatment outcome following VATS lobectomy. Methods: The prospective randomized study included 80 patients who underwent VATS lobectomy for lung cancer between September 2020 and June 2023. Patients were randomized into two groups based on the type of chest drain used postoperatively: 40 in the experimental group (coaxial SIL drain Fr 24) and 40 in the control group (standard PVC drain Fr 24). The researchers collecting the data and the caregivers were not blinded to the group allocation. The primary objective was to evaluate pain over the initial 2 postoperative days by assessing analgesic consumption, respiratory muscle strength [measured as maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP)], and pain intensity using the visual analog scale (VAS). MIP, MEP, and VAS were measured both at rest and during physical activity. Results: Sixty-nine patients were included in the final analysis: 35 in the experimental group and 34 in the control group. The groups were comparable in terms of drainage efficacy and short-term treatment outcome, but pain was significantly lower in the experimental group (coaxial SIL drain). Diclofenac consumption was significantly lower in the experimental group (P=0.004), with a trend toward lower consumption of other analgesics. All respiratory muscle strength measurements were higher in the experimental group, with significant differences in static MIP on the second postoperative day (P=0.046), both static (P=0.02) and dynamic (P=0.050) MEP on the first postoperative day, and static MEP on the second postoperative day (P=0.02). Static VAS (S-VAS) on the first postoperative day was statistically significantly lower in the experimental group (P=0.003). Dynamic VAS (D-VAS) was comparable between the groups. Conclusions: This study confirmed the hypothesis that coaxial SIL drains, owing to their softer material, cause less pain while maintaining efficacy comparable to standard PVC drains.
Ključne besede: video-assisted thoracoscopic surgery, VATS, lobectomy, postoperative pain, chest tube, analgesia
Objavljeno v DiRROS: 12.12.2025; Ogledov: 206; Prenosov: 107
.pdf Celotno besedilo (284,09 KB)
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