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Background <p>Penetrating lung injuries are rare but potentially life-threatening. Pulmonary tractotomy (PT) allows for repair while preserving lung parenchyma. This case demonstrates the effectiveness of thoracoscopic PT.</p> Case report <p>An 81-year-old woman sustained a right chest stab wound with a gardening stake. Imaging revealed a right pneumothorax without cardiac or major vascular injury. A chest tube was inserted, draining blood-stained fluid and revealing a persistent air leak. Progressive anemia necessitated transfusion, and surgery was planned due to suspected contamination. Thoracoscopy identified a 1.5&#xa0;cm fistula in the S3 segment of the right upper lobe extending toward S2. A stapler was inserted to perform tractotomy, revealing a bronchial injury, which was sutured. The air leak resolved completely. The postoperative course was uneventful. Empirical antibiotics were administered for 5&#xa0;days. The chest tube was removed on day 5, and the patient was discharged on day 13.</p> Conclusion <p>Thoracoscopic PT is considered a safe and effective option for selected penetrating lung injuries, preserving lung function and reducing surgical trauma. Careful preoperative imaging and intraoperative bronchial evaluation are essential for safe and effective thoracoscopic PT.</p>

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Thoracoscopic repair of penetrating lung trauma with pulmonary tractotomy: a case report

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年5月26日

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  • Hiroyasu Koga,
  • Katsuya Watanabe,
  • Aya Saito

摘要

Background

Penetrating lung injuries are rare but potentially life-threatening. Pulmonary tractotomy (PT) allows for repair while preserving lung parenchyma. This case demonstrates the effectiveness of thoracoscopic PT.

Case report

An 81-year-old woman sustained a right chest stab wound with a gardening stake. Imaging revealed a right pneumothorax without cardiac or major vascular injury. A chest tube was inserted, draining blood-stained fluid and revealing a persistent air leak. Progressive anemia necessitated transfusion, and surgery was planned due to suspected contamination. Thoracoscopy identified a 1.5 cm fistula in the S3 segment of the right upper lobe extending toward S2. A stapler was inserted to perform tractotomy, revealing a bronchial injury, which was sutured. The air leak resolved completely. The postoperative course was uneventful. Empirical antibiotics were administered for 5 days. The chest tube was removed on day 5, and the patient was discharged on day 13.

Conclusion

Thoracoscopic PT is considered a safe and effective option for selected penetrating lung injuries, preserving lung function and reducing surgical trauma. Careful preoperative imaging and intraoperative bronchial evaluation are essential for safe and effective thoracoscopic PT.