Minimally invasive approaches for thoracoabdominal injuries

Introduction:
Thoracoabdominal injuries are associated with significant morbidity and mortality, and their diagnosis and treatment remain complex and controversial.

Aim:
This study evaluated the effectiveness of endovideosurgery and enhanced surgical techniques for the diagnosis and treatment of hemodynamically stable and unstable patients with thoracoabdominal injuries.

Material and methods:
This study included 190 cases of thoracoabdominal injuries treated between June 2017 and June 2022. Patients were divided into three groups: those with thoracic injuries, abdominal injuries, and combined thoracoabdominal injuries. The main group underwent endovideosurgery and improved surgical techniques, while the comparison group was treated with traditional methods. The outcomes of the advanced surgical approach and endovideosurgery were assessed and compared with traditional methods to evaluate their clinical significance.

Results:
The use of endovideosurgery and enhanced surgical techniques reduced the rate of exploratory surgery for abdominal injuries from 25.4% to 3.6% (a sevenfold reduction) and for combined thoracic and abdominal injuries from 28.2% to 5.0%. Postoperative complications also showed a significant decrease: in thoracic injuries, from 29.0% to 5.0%; in abdominal injuries, from 30.5% to 7.1%; and in combined thoracoabdominal injuries, from 37.5% to 10.0%.

Conclusions:
Dividing patients based on hemodynamic stability is crucial in the surgical management of thoracoabdominal injuries, facilitating the effective use of endovideosurgical techniques in appropriate patient categories.