Pneumonectomy for trauma and war casualties

João Santos Silva, Paulo Almeida Calvinho, Anne Olland, Pierre-Emmanuel Falcoz

Abstract

Chest trauma has been described in the literature since 3000 bc. This trauma is usually not isolated and associated with high mortality and morbidity. The majority of the patients with thoracic trauma are not operated, being reported emergent thoracotomies between 1–12% of all chest traumas and of this only 1% to 2% of thoracic trauma patients need a pneumonectomy with mortality rates from 50% to 100%, with a slight improvement tendency, having worst results those with blunt trauma. In a war scenario around 25% of the casualties have thoracic trauma associated, but there is no data available related to the pneumonectomy itself. Has been shown that victim stabilization, eventually with hilar control and quick referral to the central hospital improved patient survival and outcomes. Outcomes in war victims have been improving over time and Medicine has evolved much to the learnings during war times. The presence of a cardiothoracic surgeon in an emergency scenario improves the outcome not only due to their technical skills but also to their soft skills. It is written that the presence of these professional can induce a sense of confidence and security.