Hemothorax is treated following basic concepts that are well-accepted by trauma and cardiothoracic surgeons, whether it is spontaneous or connected to thoracic trauma injuries. A tube thoracostomy is only required in a small number of patients; for the remainder, a nonoperative method is acceptable and safe. Due to a retained hemothorax, chronic bleeding, or arriving complications, only a small fraction of patients require surgery (i.e. pleural empyema or entrapped lung). Early in the 1990s, significant technological advancements led to an increase in diagnostic and therapeutic indications for Multi-port Video-assisted Thoracic Surgery (VATS) as the gold standard therapy for retained and persistent hemothorax, allowing for earlier diagnosis, total clot removal, and better tube placement, with less morbidity, post-operative pain, and a shorter hospital stay. Even though there is no consensus in the literature on when to drain a hemothorax, the greatest results are obtained when the drainage is done during the first five days of commencement. The uniportal approach is an essential advancement of the old multi-port strategy, with the same results as open surgical procedure and the true benefit of a non-rib-spreading single small incision. Currently, this technique is employed for diagnostic and therapeutic interventions such as hemothorax evacuation as well as more difficult procedures such as lobectomies, bronchial sleeve, and vascular reconstructions in the hands of competent surgeons. Many writers have validated the benefits of single-port over multi-port procedure in terms of better post-operative pian control, easier surgical approach, and better cosmetic results, but with a longer and more difficult learning curve.
Author (S) Details
Stefano Sanna
Thoracic Surgery Unit, GB Morgagni L Pierantoni Hospital, Forlì, Italy and Department of Thoracic Diseases, University of Bologna, Italy.
Angelo Ciarrocchi
Thoracic Surgery Unit, GB Morgagni L Pierantoni Hospital, Forlì, Italy and Department of Thoracic Diseases, University of Bologna, Italy.
Alessio Campisi
Thoracic Surgery Unit, GB Morgagni L Pierantoni Hospital, Forlì, Italy and Department of Thoracic Diseases, University of Bologna, Italy.
Desideria Argnani
Thoracic Surgery Unit, GB Morgagni L Pierantoni Hospital, Forlì, Italy and Department of Thoracic Diseases, University of Bologna, Italy.
Sara Mazzarra
Thoracic Surgery Unit, GB Morgagni L Pierantoni Hospital, Forlì, Italy and Department of Thoracic Diseases, University of Bologna, Italy.
Stefano Congiu
Thoracic Surgery Unit, GB Morgagni L Pierantoni Hospital, Forlì, Italy and Department of Thoracic Diseases, University of Bologna, Italy.
Fabio Davoli
Thoracic Surgery Unit, GB Morgagni L Pierantoni Hospital, Forlì, Italy and Department of Thoracic Diseases, University of Bologna, Italy.
Franco Stella
Thoracic Surgery Unit, GB Morgagni L Pierantoni Hospital, Forlì, Italy and Department of Thoracic Diseases, University of Bologna, Italy.
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