Thoracoscopic Exploration in Comparison to Exploratory Thoracotomy in Chest Trauma

Study Overview
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Brief Summary
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Video-assisted thoracic surgery has a standard role in diagnosis and therapy in thoracic surgery, In the past, most patients necessitating surgical treatment secondary to chest trauma was exposed to open thoracotomy, which was the most morbid of surgical incisions

Detailed Description
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Video-assisted thoracoscopic surgery has become a popular and acceptable method for diagnosis of intra-thoracic lesions since 1990s with the developments in surgical techniques. It is also used for treatment of retained pleural collections, it is a simple alternative to open thoracotomy. Although it's multiple advantages, timing of surgery and its effects on patients' results are not well elucidated. Multiple studies report that prognosis of patients is better with the earlier interventions in injured chest. However, there is so many differences for the optimal time for surgery in these studies . Indications of VATS have been extended for management of diagnosis and treatment of chest trauma since 1990. This approach has multiple advantages as chest tube setting, minimally invasive surgery, less postoperative pain, and chest exploration. Today, VATS is used for empyema, persistent pneumothorax, retained haemothorax, mediastinal and diaphragmatic exploration, pleuro-pericardial ruptures, surgery for thoracic duct injury and aspiration of symptomatic foreign bodies.

Official Title
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Uni-portal Thoracoscopic Exploration in Comparison to Exploratory Thoracotomy in Hemodynamically Stable Thoracic Trauma Patients

Conditions
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Thoracic Injury

Intervention / Treatment
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* Procedure: Video Assisted Thoracoscopic Surgery (VATS)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patient aged more than 13 yards old Hemo-dynamically stable patients with chest trauma Willing and able to provide written informed consent and comply with study requirements. Exclusion Criteria: patient aged less than 13 yards old. Hemo-dynamically instable patients Head trauma patients. missing informed consent Participation in another clinical research.

Ages Eligible for Study
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Minimum Age: 13 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: cohort study
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: case<br>Use of vedio assisted thoracoscopic surgery in exploration in diagnosis and treatment of chest trauma patients whos heamodynamically stable | Procedure: Video Assisted Thoracoscopic Surgery (VATS)<br>* VATS is minimally invasive procedure for exploration to diagnose and treat thoracic injuries alternative to exploratory thoracotomy.<br>* Other names: Thoracoscopic Exploration;|
| Other: control<br>exploratory thoracotomy inchest trauma patients in failure of vedio assisted thoracoscopic surgery or in haemodynamically instable patients | Procedure: Video Assisted Thoracoscopic Surgery (VATS)<br>* VATS is minimally invasive procedure for exploration to diagnose and treat thoracic injuries alternative to exploratory thoracotomy.<br>* Other names: Thoracoscopic Exploration;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Duration of airleak, lung expansion and post operative bleeding. | • Duration of complete healing: By Radiological (chest x-ray ant-post view and lat view & MSCT chest post-operative. Clinical examination post operative. | 2 weaks postoperative |