Feasibility and efficacy of video-assisted thoracoscopic surgery for the surgical stabilization of rib fractures: a single-center retrospective cohort study.

Purpose: Surgical fixation of traumatic multiple rib fractures is becoming more common; video-assisted thoracoscopic surgery (VATS) is reportedly useful in such cases. Therefore, we aimed to explore the feasibility and effectiveness of VATS for surgical stabilization of rib fractures (SSRF).

Methods: We conducted a single-center, medical record-based retrospective cohort study including 52 patients with traumatic multiple rib fractures who underwent SSRF with or without VATS. All patients were admitted to our hospital between January 2017 and March 2024. Patient characteristics and perioperative outcomes were compared between the groups, and the frequencies of relevant VATS outcomes were investigated.

Results: VATS was performed in 42 patients. The with-VATS group had significantly more isolated thoracic trauma (p =.04) and lower thoracic Abbreviated Injury Scale and Injury Severity Score (p =.015, p =.017) than the without-VATS group, albeit no differences in perioperative outcomes were found. In the VATS group, common intraoperative findings included sharp bone fragments protruding into the thoracic cavity, lung entrapment at fracture site, lung and diaphragm injuries, and intrathoracic hematomas. These injuries were managed through repair, as well as hematoma irrigation and evacuation.

Conclusions: VATS was feasible in 80% cases and was not associated with adverse outcomes. The addition of VATS to SSRF facilitated missed-injury identification and repair, enhanced intrathoracic visualization during fixation, and enabled hematoma evacuation, potentially reducing perioperative complications.