Optimum Timing of Video Assisted Thoracoscopic Surgery in Acute Chest Injury

Abstract

Objective: To compare the length of hospital stay, duration of chest tube drainage use, conversion to open thoracotomy and post-injury chest infections between the Early VATS and Late VATS groups.

Study Design: Cross-sectional comparative study.

Place and Duration of Study: Department of surgery Benazir Bhutto Hospital, Rawalpindi Pakistan, from Oct 2020 till Sep 2022.

Methodology: Sixty-two patients undergoing VATs for acute chest injury were divided into two groups; early VATs within first 5 days of chest injury and late VATs after 5th day of chest injury. Outcome variables compared between the two groups were length of hospital stay, duration of chest tube drainage, conversion to open thoracotomy and chest infection rate. Numericaldata were compared using the independent sample T-test and categorical variables were compared using the Chi square test. A p-value of < 0.05 was considered statistically significant.

Results: In our study the Early VATS group had a significantly shorter length of hospital stay, lesser days on ventilator, shorter total duration of chest tube drainage as compared to Late VATS group. However, duration of post VATS tube drainage, requirement for secondary VATS and conversion rate to open thoracotomy were similar in both groups. Moreover, infection rate was significantly lower in the Early VATS group.

Conclusion: Early VATS in chest injury is associated with better clinical outcome.