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Nonintubated minimally invasive chest wall stabilization for multiple rib fractures: a prospective, single-arm study.

ABSTRACT: BACKGROUND:Nonintubated video-assisted thoracoscopic surgery has been widely reported in the past decade, while nonintubated chest wall stabilization has not been reported previously. The aim of this study was to evaluate the safety and feasibility of nonintubated minimally invasive chest wall stabilization in patients with multiple rib fractures. METHODS:We conducted a prospective, single-arm, observational study. In this prospective study, 20 consecutive patients with multiple rib fractures were treated using nonintubated minimally invasive chest wall stabilization. RESULTS:Minimally invasive chest wall stabilization was mostly performed for lateral rib fractures in this study (n = 8). The mean operation time was 92.5?min, and the mean blood loss was 49?ml. No patient required conversion to tracheal intubation. The mean extubation time of the laryngeal mask was 8.9?min; the mean postoperative fasting time was 6.1?h; the mean postoperative hospital stay was 6.2?days; the mean amount of postoperative drainage was 97.5?ml; the mean postoperative pain score was 2.9 points at 6?h, 2.8 points at 12?h, and 3.0 points at 24?h; and the mean postoperative nausea and vomiting score was 1.9 points at 6?h, 1.8 points at 12?h, and 1.7 points at 24?h. CONCLUSIONS:Nonintubated minimally invasive chest wall stabilization is safe and feasible in carefully selected patients. Further studies with a large sample size are warranted. TRIAL REGISTRATION:ChiCTR1900025698 . Registered on 5 September 2019.

SUBMITTER: Zhao W

PROVIDER: S-EPMC7513522 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Nonintubated minimally invasive chest wall stabilization for multiple rib fractures: a prospective, single-arm study.

Zhao Weigang W Chen Yonglin Y He Weiwei W Zhao Yonghong Y Yang Yi Y Yang Yi Y

World journal of emergency surgery : WJES 20200923 1

<h4>Background</h4>Nonintubated video-assisted thoracoscopic surgery has been widely reported in the past decade, while nonintubated chest wall stabilization has not been reported previously. The aim of this study was to evaluate the safety and feasibility of nonintubated minimally invasive chest wall stabilization in patients with multiple rib fractures.<h4>Methods</h4>We conducted a prospective, single-arm, observational study. In this prospective study, 20 consecutive patients with multiple r ...[more]

PMID: 32967702

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Project description:BackgroundTo evaluate therapeutic efficacy of minimally invasive and small incision surgery [minimally invasive surgery (MIS)] in patients with non-flail chest rib fractures through a prospective cohort study.MethodsThis study included 98 patients with non-flail chest rib fractures (≥3 displaced fractures) and 66 patients undergoing MIS served as the experimental group and 32 patients receiving conservative treatment served as the matched control group. Pain index and indicators of pulmonary function [vital capacity (VC); forced expiratory volume in one second (FEV1); peak expiratory flow (PEF)] for the two groups were assessed and compared at the time of admission and before discharge. In addition, duration of pain, time required for the patient to regain the ability to perform daily self-care, mental labor, and moderate-to-severe physical labor, and duration of chest discomfort were measured during long-term follow-up and compared between the two groups.ResultsThere were also no significant differences (P>0.05) in pain index (8 vs. 8) or indicators of pulmonary function (VC: 31.0% vs. 26.5%; FEV1: 29.9% vs. 26.7%; PEF: 15.2% vs. 12.0%) were found between the MIS and conservative treatment groups at the time of admission; while pain index (3 vs. 6), VC (42.1% vs. 35.3%), and FEV1 (44.2% vs. 35.9%) were significantly different between the two groups (P<0.05) but not in PEF (21.2% vs. 19.6%) before discharge. Long-term follow-up showed that duration of pain, time required for the patient to regain the ability to engage in daily self-care, mental labor, and moderate-to-severe physical labor, and duration of chest discomfort in the MIS group were significantly more improved than in the conservative treatment group (P<0.05).ConclusionsMIS was a simple and safe treatment that significantly relieved chest pain and rapidly restored pulmonary function and improved the long-term quality of life of patients with non-flail chest rib fractures of ≥3 ribs with displacement.

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Nonintubated minimally invasive chest wall stabilization for multiple rib fractures: a prospective, single-arm study.

Publications

Nonintubated minimally invasive chest wall stabilization for multiple rib fractures: a prospective, single-arm study.

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