Video-Assisted Thoracoscopic Surgery for Postoperative Hemothorax

BACKGROUND: The aim of this study was to evaluate the role of video-assisted thoracoscopic surgery (VATS) in the treatment of postoperative bleeding after thoracic surgery. METHODS: We retrospectively analyzed data from our institution on the use of a video-assisted approach in patients requiring reexploration for hemorrhage occurring after open or VATS procedures. RESULTS: Seventeen surgical reexplorations were performed in 16 patients: 7 after VATS and 9 after prior open procedures. The interval between the end of the first procedure and reexploration was 6-36 hours after VATS and 15-120 hours after thoracotomy. The source of bleeding was identified in 82.4 % of cases. No deaths occurred. The postoperative course was uneventful for all patients except one, who underwent extrapleural pneumonectomy and required a second VATS reexploration for uncontrolled bleeding 10 hours after the first reoperation. CONCLUSIONS: The videothoracoscopic approach for postoperative hemothorax requiring surgical reexploration seems to be safe and effective and guarantees the benefits of minimally invasive surgery: it allows the surgeon to evacuate the hemothorax, to accurately explore the operating field, and to achieve adequate hemostasis.