TY  - JOUR
T1  - LUng-sparing surgery after penetrating trauma using tractotomy, partial lobectomy, and pneumonorrhaphy
AU  - Velmahos GC, Baker C, Demetriades D, Goodman J, Murray JA, Asensio JA
Y1  - 1999/02/01
N1  - 10.1001/archsurg.134.2.186
JO  - Archives of Surgery
SP  - 186
EP  - 189
VL  - 134
IS  - 2
N2  - Objective 
    To evaluate the role of lung-sparing surgical techniques in the surgical management of penetrating pulmonary injuries.Design 
    Retrospective case series.Setting 
    Academic level I trauma center.Patients and Methods 
    Forty patients underwent thoracic surgery for penetrating lung injuries during a 63-month period from January 1993 to March 1997. Five (12.5%) underwent anatomical lobectomy, 3 (7.5%) pneumonorrhaphy, 9 (22.5%) stapled wedge resection, and 23 (57.5%) stapled tractotomy. In total, 34 patients (85%) were treated with stapling techniques (1 anatomical lobectomy, 1 pneumonorrhaphy, 9 stapled wedge resections, and 23 stapled tractotomies) and 35 (87.5%) underwent had lung-sparing surgery for trauma.Results 
    Morbidity and mortality rates were 40% and 5%, respectively. Patients who underwent anatomical lobectomy required longer mechanical ventilatory support, intensive care unit stay, and hospital stay and had a higher morbidity rate compared with patients who underwent lung-sparing surgery for trauma but had central and extensive pulmonary injuries. Stapled tractotomy was efficient in controlling bleeding and bronchial leaks, but, in 3 patients, parts of the divided lung parenchyma were devascularized and had to be resected.Conclusions 
    Lung-sparing surgery for trauma with the use of staplers can be used in the majority of patients with penetrating pulmonary injuries requiring operation. Stapled tractotomy is a rapid and effective method for controlling hemorrhage and air leaks.
SN  - 0004-0010
M3  - doi: 10.1001/archsurg.134.2.186
UR  - http://dx.doi.org/10.1001/archsurg.134.2.186
ER  -