From the Guidelines
Thoracostomy is a surgical incision into the chest cavity, which can be performed via thoracotomy (an open incision into the pleural cavity) or video-assisted thoracic surgery (VATS) (instruments introduced into the pleural cavity via ports in the chest wall) 1.
Key Points
- Thoracostomy allows access to the pleural space to perform procedures such as bullectomy, pleurodesis, or pleurectomy as required 2.
- The choice between thoracotomy and VATS depends on various factors, including the patient's condition, the surgeon's preference, and the specific procedure being performed 3.
- Thoracotomy and VATS are used to treat conditions such as pneumothorax, and the decision to use one approach over the other should be made on a case-by-case basis, considering factors such as the risk of recurrence and the patient's occupation 3.
- Accepted indications for surgical advice, including thoracostomy, include first pneumothorax presentation associated with tension, second ipsilateral pneumothorax, and professions at risk (e.g., pilots, divers) 3.
Surgical Approaches
- Thoracotomy: an open incision into the pleural cavity, which allows for direct access to the lung and pleural space 1.
- VATS: a minimally invasive approach, which involves introducing instruments into the pleural cavity via ports in the chest wall, allowing for visualization and manipulation of the lung and pleural space 1.
From the Research
Definition of Thoracostomy
Thoracostomy refers to a surgical incision into the chest cavity, which can be performed to gain access to the thoracic organs, such as the heart, lungs, or esophagus 4. It is a major surgical maneuver that requires general anesthesia and can be used to treat various conditions, including pneumothorax, hemothorax, and lung cancer.
Types of Thoracostomy
There are different types of thoracostomy, including:
- Tube thoracostomy, which involves the insertion of a tube into the chest cavity to drain air or fluid 5, 6, 7, 8
- Open thoracotomy, which involves a surgical incision into the chest cavity to access the thoracic organs 4
Indications and Uses
Thoracostomy can be used to treat various conditions, including:
- Pneumothorax, which is the presence of air in the chest cavity 4
- Hemothorax, which is the presence of blood in the chest cavity 6, 7
- Lung cancer, which may require surgical removal of the tumor 4
- Traumatic injuries to the chest, which may require surgical intervention to repair damaged organs or tissues 6, 7
Complications and Risks
Thoracostomy can be associated with various complications and risks, including: