Abstract:
:Thoracic damage control surgery (TDCS) is a decision making tool and derivate of the damage control concept (DCC), where physiological stabilization has a priority over anatomical reconstruction under the pressure of time. Intrathoracic haemorrhage control and pleural decompression are the two main immediate tasks of TDCS, while definitive procedures follow when the patient is stabilised in 24-48 hours. The focus of the thoracic surgeon is on the prevention of the haemorrhage induced coagulopathy, metabolic acidosis and hypothermy formed triad of death. Surgical haemorrhage control and pleural space decompression are to be performed. The individual patients benefit from TDCS procedures whose condition is too severe for a complex immediate reconstruction (polytrauma). Life threatening chest injuries in multiple/mass casualty scenarios in civilian and military environment alike are triaged and treated accordingly. Onset of acute mismatch between the resources (available hands, OP theaters, resources, hardware) and the needs (number and severity of chest trauma cases), a mindset shift should take place, where time and space the two main limiting factors. Airway obstruction, tension haemo/pneumothorax falls into the preventable death category. Chest drainage and emergency thoracotomy are the two main procedures offered by TDCS. An intervention structured organ/injury specific list of procedures is detailed. This is a mix of emergency surgery and cardiothoracic surgery, where less is more. TDSC is not the Holy Grail found to solve all complex thoracic trauma cases, but is a good tool to increase the chance for survival in challenging, and frequently quite hopeless situations.
journal_name
J Thorac Disjournal_title
Journal of thoracic diseaseauthors
Molnar TFdoi
10.21037/jtd.2018.11.32subject
Has Abstractpub_date
2019-02-01 00:00:00pages
S158-S166issue
Suppl 2eissn
2072-1439issn
2077-6624pii
jtd-11-S2-S158journal_volume
11pub_type
杂志文章,评审abstract:Background:Anterior mediastinal tumours account for 50% of all mediastinal masses. Surgical intervention is the standard approach for their diagnosis or treatment. Minimally invasive techniques have gained significant popularity in the last few decades due to the obvious advantages that they offer. We will describe a s...
journal_title:Journal of thoracic disease
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journal_title:Journal of thoracic disease
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更新日期:2013-06-01 00:00:00
abstract::The criteria that define acceptable physiologic and social parameters for lung donation have remained constant since their empiric determination in the 1980s. These criteria include a donor age between 25-40, a arterial partial pressure of oxygen (PaO2)/FiO2 ratio greater than 350, no smoking history, a clear chest X-...
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journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
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journal_title:Journal of thoracic disease
pub_type: 杂志文章
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journal_title:Journal of thoracic disease
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pub_type: 杂志文章
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更新日期:2018-06-01 00:00:00
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journal_title:Journal of thoracic disease
pub_type: 杂志文章
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更新日期:2019-12-01 00:00:00
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journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
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更新日期:2015-09-01 00:00:00
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journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
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journal_title:Journal of thoracic disease
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journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
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journal_title:Journal of thoracic disease
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journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
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journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
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journal_title:Journal of thoracic disease
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journal_title:Journal of thoracic disease
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journal_title:Journal of thoracic disease
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journal_title:Journal of thoracic disease
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journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2019.11.32
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