Surgical treatment of lung injuries and diseases in patients with blunt chest trauma

Bykov V.P.

Northern State Medical University

Pavlov K.O.

Arkhangelsk Regional Clinical Hospital

Popov V.A.

Burdenko Neurosurgical Institute;
Human Cell Neurophysiology Laboritory, N.N. Semenov Institute of Chemical Physics, Russian Academy of Sciences

Korobitsyn A.P.

Northern State Medical University

Fedoseev V.F.

Northern State Medical University

Sobinin O.V.

Arkhangelsk Regional Clinical Hospital

Surgical treatment of lung injuries and diseases in patients with blunt chest trauma

Authors:

Bykov V.P., Pavlov K.O., Popov V.A., Korobitsyn A.P., Fedoseev V.F., Sobinin O.V.

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Journal: Pirogov Russian Journal of Surgery. 2020;(12): 64‑69

DOI: 10.17116/hirurgia202012164

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To cite this article:

Bykov VP, Pavlov KO, Popov VA, Korobitsyn AP, Fedoseev VF, Sobinin OV. Surgical treatment of lung injuries and diseases in patients with blunt chest trauma. Pirogov Russian Journal of Surgery. 2020;(12):64‑69. (In Russ.)
https://doi.org/10.17116/hirurgia202012164

Подписка 2025 (Pirogov Russian Journal of Surgery)

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OBJECTIVE

To establish the indications for optimal open lung surgery in patients with severe blunt chest injury.

MATERIAL AND METHODS

Hematomas, lung wounds and purulent pulmonary complications were studied in four groups of victims. Causes of injuries included road accidents (n=426), falling and beating (n=387), catatrauma (n=217), squeezing the body with a massive weight (n=46). Majority of victims (n=731, 67.9%) were transferred to the hospital within 1-5 hours after injury; 345 (32.1%) patients were transferred from other hospitals to treat combined injuries of head, chest, abdomen and complications within 1-49 days after injury.

RESULTS

Lung surgery was applied in 48 patients. Typical resections and pneumonectomies made up 77.1%. Indications for surgery included lung wounds complicated by pulmonary hemorrhage grade IIa and severe hemothorax, intrapulmonary hematoma ≥6 cm with high risk of bleeding and suppuration, gangrene, gangrenous and purulent abscesses of aspiration genesis, lung cancer first diagnosed in victims. Postoperative mortality was 14.6%. Twelve victims with unrecognized deep lung wounds and pulmonary root rupture were not operated. Thus, 5.6% of victims with severe blunt chest trauma need for open lung surgery.

Keywords:

blunt chest injury

hematoma

wound

abscess

gangrene

lung cancer

Authors:

Bykov V.P.

Northern State Medical University

Pavlov K.O.

Arkhangelsk Regional Clinical Hospital

Popov V.A.

Burdenko Neurosurgical Institute;
Human Cell Neurophysiology Laboritory, N.N. Semenov Institute of Chemical Physics, Russian Academy of Sciences

Korobitsyn A.P.

Northern State Medical University

Fedoseev V.F.

Northern State Medical University

Sobinin O.V.

Arkhangelsk Regional Clinical Hospital

Received:

11.12.2019

Accepted:

12.03.2020

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