Experience with removal of foreign bodies from the lungs, pleura and mediastinum in patients with penetrating gunshot wounds of the chest

The OBJECTIVE was to evaluate the effectiveness of modern surgical methods for removing intrathoracic foreign bodies in patients with penetrating gunshot chest wounds. METHODS AND MATERIALS . The study included 207 patients with intrathoracic foreign bodies (FBs) after penetrating gunshot chest wounds. Depending on the size and location of the FBs, the choice of surgical access and method of their removal was determined. RESULTS . FBs were large in 35 (17 %), medium – in 113 (54.6 %), small – in 59 (28.4 %) patients. Localization of FBs was noted in: lung parenchyma – 76 (36.7 %), mediastinum – 28 (13.5 %), pleural cavity – 103 (49.7 %) patients. In 197 (95.2 %) cases, the FBs were removed using videothoracoscopic methods, «open» surgical procedures were undertaken only in 3.4 % (n=7) of observations, and intraluminal endoscopic interventions were performed in 3 (1.4 %) cases. Postoperative complications developed in 14 (6.7 %) patients. There were no fatal outcomes. CONCLUSION. In specialized thoracic surgery departments, minimally invasive video-assisted thoracoscopic surgical procedures are used in most cases to remove FBs from the pleura, lungs and mediastinum. Indications for performing thoracotomy and sternotomy are limited to cases of removing FBs from dangerous locations (heart, main vessels).