The aim of this study was to evaluate the diagnostic and therapotic effectiveness of video-assisted thoracoscopy (VAT) in chest injury patients.

We reported our experience of VAT in chest injury patients between November 1995 and October 1997. Thirty-eight hemodynamically stable patients sustaining chest injury were reviewed (29 blunt and 9 penetrating injunes). Indications for VAT included clotted hemothorax (17 patients), suspected diaphragmatic injury (7 patients), persistent pneumothorax (6 patients), continued hemothorax (5 patients), posttraumatic empyema (2 patients) and intrathoracic foreign body (1 one patient).

Two of 5 patients with continued hemothorax were successfully treated by VAT. Two of 3 diaphragmatic injuries were confirmed by VAT, but all of these were repaired via thoracotomic approach. Fourteen of 17 patients with clotted hemothoraces, four with pneumothorax, one with a foreign body were treated succesfully using VAT.There was no VAT-related complication.

VAT appears to be a safe, accurate, expeditious, minimally invasive and potentially cost-effective method for the diagnosis and treatment of hemodynamically stable patients with chest injuries, for evacuation of clotted hemothorax and empyema, for treatment of persistent air leak, for control of continued hemothorax, and for removal of foreign body.

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