The first video-assisted thoracoscopic surgical interventions for chest wounds at a level 3 military medical organization in a special military operation zone

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Abstract

Two clinical cases of successful surgical treatment of patients with gunshot penetrating shrapnel wounds to the chest using video-assisted thoracoscopic surgery in the area of a special military operation are presented. For the performance, an endovideosurgical complex manufactured by Karl Storz with a thoracoscope with a 30° optical system and a set of endosurgical instruments were used. Intraoperative fluoroscopy was performed using a Siemens Cios Alpha C-Arm X-ray machine. During this procedure were shown the possibilities, safety, and efficiency of rendering specialized and high-tech medical care in the military medical organization of the 3rd level. This helps to eliminate life-threatening consequences and prevent complications in victims with penetrating gunshot wounds to the chest.

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About the authors

I. V. Dmitrochenko

The S.M.Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation

Author for correspondence.
Email: vmeda-na@mil.ru

кандидат медицинских наук, майор медицинской службы 

Russian Federation, Saint Petersburg

I. Yu. Kim

Branch No.1 of the National Medical Research Center for High Medical Technologies – The A.A.Vishnevsky Central Military Clinical Hospital of the Ministry of Defense of the Russian Federation

Email: vmeda-na@mil.ru

подполковник медицинской службы

Russian Federation, Krasnogorsk, Moscow Region

Kh. M. Makoev

Branch No. 4 of the 1602nd Military Clinical Hospital of the Ministry of Defense of the Russian Federation

Email: vmeda-na@mil.ru

подполковник медицинской службы

Russian Federation, Lugansk

M. M. Rabdanov

Branch No. 4 of the 1602nd Military Clinical Hospital of the Ministry of Defense of the Russian Federation

Email: vmeda-na@mil.ru

майор медицинской службы

Russian Federation, Lugansk

N. S. Sharshukova

Branch No. 4 of the 1602nd Military Clinical Hospital of the Ministry of Defense of the Russian Federation

Email: vmeda-na@mil.ru
Russian Federation, Lugansk

References

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  2. Гончаров А.В., Маркевич В.Ю., Носов А.М. и др. Характеристика ранений груди в медицинских организациях III уровня в современных вооруженных конфликтах / К 100-летию со дня рожд. чл-корр. АМН СССР С.С.Ткаченко: Сб. тез. VIII Всерос. конгр. с междунар. участием. – СПб, 2023. – С. 43–44.
  3. Серговенцев А.А., Дацко А.В., Котив Б.Н. и др. Инородные тела после ранений и травм / Временные указания по лечению и военно-врачебной экспертизе. – 2023. – 60 с.
  4. Тришкин Д.В., Крюков Е.В., Чуприна А.П. и др. Методические рекомендации по лечению боевой хирургической травмы. – 2022. – 373 с.
  5. Фуфаев Е.Е., Дмитроченко И.В., Дзидзава И.И. и др. Способ идентификации, фиксации и удаления ферромагнитных инородных тел при огнестрельных проникающих ранениях груди / Патент на изобрет. № 2825952 от 29.09.2023 г.: опубл. 02.09.2024 г. // Бюл. № 25. https://www.elibrary.ru/item.asp?id=69737784

Supplementary files

Supplementary Files
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2. Fig. 1. Computed tomography of patient S. Consolidation of pulmonary parenchyma of the lower lobe of the left lung, heterogeneous fluid content in the left pleural cavity, metallic foreign body in the S8 projection of the left lung are determined

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3. Fig. 2. Intraoperative photo, patient C. A metal fragment on the IX thoracic vertebra under fluoroscopic navigation fixed with a neodymium extractor for metallic ferropositive foreign bodies

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4. Fig. 3. Intraoperative photo, patient C. Metal fragment extracted from the left pleural cavity

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5. Fig. 4. Computed tomography of patient K. Right-sided hemopneumothorax, drainage in the right pleural cavity, mediastinal displacement to the opposite side, interstitial emphysema are determined

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6. Fig. 5. Computed tomography of patient K. A large metal-dense foreign body is detected in the I intercostal space on the right side, near the subclavian vessels

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7. Fig. 6. Patient K. Intraoperative photo. I intercostal wound and metal fragment extracted

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Copyright (c) 2024 Dmitrochenko I.V., Kim I.Y., Makoev K.M., Rabdanov M.M., Sharshukova N.S.



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