• Erik Öberg Westin, Fagevik OlsénMonikaMDepartment of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Per Dubbsgatan 15, Gothenburg SE 413 45, Sweden; Department of Physical Therapy, Institute of Neuroscience and Physiology, Sahlgrensk, Per Örtenwall, and Eva-Corina Caragounis.
• Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Per Dubbsgatan 15, Gothenburg SE 413 45, Sweden. Electronic address: erik.westin@vgregion.se.
• Injury. 2023 Mar 10.

BackgroundSurgical management of chest wall injuries is a common procedure. However, operative techniques are diverse, and no universal guidelines exist. There is a lack of studies comparing the outcome with different operative techniques for chest wall surgery. The aim of this study was to compare hospital outcomes between patients operated for chest wall injuries with a conventional method with large incisions and often a thoracotomy or a minimally invasive, muscle sparing method.Patients And MethodsA retrospective study was carried out including patients ≥18 years operated for chest wall injuries 2010-2020. Patients were divided into two groups based on the surgery performed: conventional surgery (C-group) and minimally invasive surgery (M-group). Data on demographics, trauma, surgery, and outcomes were extracted from patient records. Primary outcome was length of stay on mechanical ventilator (MV-LOS). Secondary outcomes were length of stay in intensive care (ICU-LOS) and in hospital (H-LOS), and complications such as re-operation, incidence of empyema, tracheostomy, pneumonia, and mortality.ResultsOf 311 included patients, 220 were in the C-group and 91 in the M-group. The groups were similar in demographics and injury pattern. MV-LOS was 0 (0-65) in the C-group vs 0 (0-34) in the M-group (p < 0.001). ICU-LOS and H-LOS were significantly shorter in the M-group as compared to the C-group (p < 0.001), however with a large overlap. Tracheostomy was performed in 22.3% of patients in the C-group vs 5.4% in the M-group (p < 0.001). Pneumonia was diagnosed in 32.3% of patients in the C-group vs 16.1% in the M-group (p = 0.004). In-hospital mortality was lower in the M-group compared to the C-group but there was no difference in mortality within 30 days or a year.ConclusionsOur study indicates that a minimally invasive technique was favorable regarding clinical outcomes for patients operated for chest wall injuries.Copyright © 2023 Elsevier Ltd. All rights reserved.

6 keywords...

hide…