Gerzhyk K. Videothoracoscopic operative intervention in combat injuries and injuries of the chest organs

It has been treated with 103 men with chest trauma of 23 to 52 years (37±1.7) injured in the ATO and JFO zone in eastern Ukraine from 2014 to 2019, and were delivered from the battlefield for treatment at ІІ-III and subsequently at IV levels of medical care. The comparison group comprised 54 wounded and injured, traditional diagnosis, and surgery was performed by drainage of the pleural cavity and various open thoracotomy surgery. The main group consisted of 49 wounded and injured, with diagnostic measures developed by the authors of the methodology, and surgical treatment was performed using videothoroscopy. The study developed and applied the treatment program for wounded with chest trauma, using videothoracoscopy, which is reflected in the main group. To determine the severity of the wounded main group at the II level of medical care, a pulse oximeter with the definition of perfusion index (PI) was used. Due to peculiarities of gunshot wounds of the chest, severity of wound disease, we have developed indications and contraindications to the use of videothoracoscopic treatment of the wounded with chest trauma. The indications for the conversion to the open thoracotomic surgical interventions at the stage of diagnostic and therapeutic measures with the use of videothoracoscopy are developed. The issues of the peculiarities of anesthesiological support of videothoracoscopic operative interventions in combat wounds of the thorax are considered. The technical recommendations of surgical receptions were proposed during the use of videothoracoscopy in the wounded with chest trauma. Based on the results of the study, we have shown a high efficiency of videothoracoscopy in the treatment of 49 wounded with chest trauma. A differentiated approach to the type and volume of operative interventions has allowed to achieve reliable hemostasis of wounds, aerostasis of the lungs, removal of foreign bodies from the organs of chest, thorough sanitation of the pleural cavity, prevention of early and late postoperative complications. The use of videothoracoscopy allowed to avoid diagnostic and therapeutic thoracotomy, which improved the results of treatment of the wounded in the thorax.