Lung-Sparing Surgery After Penetrating Trauma Using Tractotomy, Partial Lobectomy, and Pneumonorrhaphy

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Abstract
THE MAJORITY of injuries to the lung are managed by tubal thoracostomy.1 The combination of lung expansion, low intravascular pressures, and high concentration of tissue thromboplastin provides adequate hemostasis in most instances.2 Thoracotomy to control bleeding is reserved for approximately 10% to 15% of penetrating thoracic injuries.1,2 In contrast with the abdominal cavity, where surgical exploration is frequently mandated by abdominal tenderness even in the presence of hemodynamic stability, operations in the chest are almost exclusively done for severe intrathoracic blood loss affecting the vital signs. Therefore, rapid bleeding control with the least possible physiologic insult is highly desirable.