Experience of pulmonary surgery for thoracic trauma in Iraq

Abstract

The aim of this study was to analyze the surgical outcome of lung injuries in the Department of thoracic surgery of Alhakeem and Alsader teaching hospital in Najaf city which drained patients from middle euphrates region of Iraq. Medical records of 820 patients with thoracic trauma were analyzed, during the period from September 2001 to September 2007. The analysis includes The following variables: Age and gender of patients, mechanism and scale of injury, diagnostic technique, the performed surgical procedure, and mortality. All cases were classified according to the scale of lung injury. Most patients were male 802 (97.8%) and only 18 (2.2%) were female, average age of the patients were 25 years (range: three months to 70 years). The Mechanism of injury was gun shot in 315 (382.41%) patients, missiles and shell injuries in 275 (33.53%), stabbing by knife and other similar objects in 125 patients(15.24%), and by blunt chest trauma in 105 (12.80%) patients. fourth degree thoracic injury was the most frequent as it involved 410 patients (50.00%), followed by The Grade III in 265 (32.32%) patients, grade II and V in 65 (7.93%) and 62 (7.56%) cases respectively, and the grade I in 18 (2.19%) cases. Ten thoracotomies were done urgently in emergency unit and 510 thoracotomy operations in the main operating room. The most frequent surgical technique was simple suture of injured pulmonary parenchyma as It was practiced in 432 (52.68%). The average intra-hospital stay was seven days (range: 2 to 17 days). Mortality and morbidity were reported as (1.58%) 13 and ( 2.80%) 23 respectively. Time factor in the diagnosis and specific surgical treatment in thoracic trauma were considered an important elements in decreasing post-operative mortality and morbidity from lung injury.