EMERGENCY THORACOTOMY WITH LUNG RESECTION FOLLOWING TRAUMA

Over a 7-year period, 9443 trauma patients were evaluated with 2934 (3 1%) sustaining chest trauma. Of these, 347 (12%) patients required tho racotomy, with 12 patients undergoing emergency lung resection. Mean a ge was 23.1 years with mean Injury Severity Score of 32. Mechanism of injury was blunt in three (25%), gunshot wound in seven (58%), and sta b wound in two (17%). Associated injuries included head injury in two (17%), intra-abdominal injury requiring laparotomy in four (33%), card iac injury in three (25%), and great vessel injury in one (8%). Indica tions for operation included persistent hemorrhage in 11 and suspected tracheobronchial disruption in one. Non-anatomic lung resection was p erformed in five patients, lobectomy in three patients, and pneumonect omy in four patients. Overall mortality was 33 per cent: 20 per cent f or non-anatomical lung resection, 33 per cent for lobectomy, and 50 pe r cent for pneumonectomy. All survivors fully recovered except for one patient with an associated head injury. Our experience supports the s elective use of lung resection, including pneumonectomy, to immediatel y control hemorrhage and to impact survival in severe chest trauma.