Minimally invasive approach in diaphragmatic injuries due to stab wounds: 10 years of experience

Abstract

Objective: We aimed to evaluate minimally invasive methods in the diagnosis and treatment of stabbing diaphragmatic injuries.
 Methods: Between January 2013 and January 2023, 66 patients with suspected diaphragmatic injury (DI) due to stab wounds, were diagnosed and treated with video assisted thoracoscopic surgery (VATS). The records of age, gender, concomitant injuries, surgical approach, morbidity and length of hospital stay were reviewed retrospectively.
 Results: The mean age of the patients was 26.39 years and they were 59 males and 7 females. Of the patients, 42 (63.4%) were on the left side and 24 (36.4%) were on the right side. According to the sites, The wounds were anterior in 32 (48.5%) of the cases and posterior in 34 (51.5%). Concomitant injuries were seen in 47 cases. DI was confirmed in 30 (45.5%) cases. Of these, 18 (60%) were on the left and 12 (40%) were on the right. The surgeries were VATS alone in 36 (54.5%), VATS via stab wounds in 22 (33.3%), and mini-thoracotomies in 8 (12.1%) of the cases, respectively. DI was confirmed in 30 (45.5%) cases. Eighteen (60%) of them were on the left, and 12 (40%) were on the right (p0.05). The mean duration of hospital stay was 4.58 days in anterior injuries and 6.11 days in posterior injuries. No patient died.
 Conclusıon: As a minimally invasive method, VATS is the method of choice for the detection and treatment of DI in thoracoabdominal injuries caused by stabbing.