engleski

Brachial Plexus Injuries Complicating Video Assisted Thoracic Surgery

Background of the study. Video-assisted thoracic surgery (VATS) is less invasive alternative to open thoracotomy commonly used in the spinal surgery. According to Evidence Based Medicine (EBM) methodology VATS is associated with better outcomes and the same complication rate as open thoracotomy. Methods. Two girls (19, 21) underwent VATS for the treatment of pneumothorax. In an attempt to perform hemostasis, the subclavian arteries had to be occluded. Total sensomotor deficit in both patients on the side surgery was performed was noticed postoperatively. In the first patient nerve roots C5 and C6 were neurolyzed. Neuromas of roots C7, C8 and T1 were resected and graft repair with sural nerves was performed with medial and lateral fascicles. In the second patient the entire plexus was in severe fibrosis. Following neurolysis positive nerve action potentials were recorded. Results. The first patient after the 4- year follow-up and the second patient after the 1-year follow- up had full range of motion of the shoulder and elbow. Extension and flexion in the wrist and fingers recovered to M4/5. Pain sensation and 2 point discrimination recovered in all fingers. Conclusion. Presented cases showed that VATS is not without severe complications as EMB methodology suggests. Surgical findings of our patients imply that if this type of complication happened, early surgical exploration could be the best option for the patients.

brachial plexus ; video assiested thoracic surgery ; complication

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