Observational Study of Curative Effects Between Complete Video-Assisted Thoracoscopic Surgery and Conservative Treatment for Multiple Rib Fractures in Non-Frail Chests.

Background: Multiple rib fractures (MRFs) are common injuries and result in serious morbidity and mortality after trauma. Complete video-assisted thoracoscopic surgery (c-VATS) has been increasingly used in the treatment of MRFs. This study was to compare the clinical effects of c-VATS and conservative treatment for MRFs.

Methods: 60 patients with MRFs without flail chest were selected. Patients were divided into a c-VATS group (30 cases) and a conservative treatment group (30 cases). In the c-VATS group, patients were operated on with the internal fixation of rib fracture with complete video-assisted thoracoscopic surgery. Patients in the conservative treatment group were given symptomatic treatment measures such as oxygen therapy, fluid replacement, pain relief, rib band fixation, closed chest drainage, and drug anti-infection therapy. These treatment-related indexes were retrospectively analyzed, including abbreviated injury scale (AIS) score, visual analog scale (VAS) of pain score, blood gas analysis, lung function, hospitalization cost, and fracture healing after discharge.

Results: There were no significant differences in age, sex, number of fractures, or AIS score between the two groups. Blood gas analysis and pulmonary function indices showed better improvement in the c-VATS group (p < 0.05). The VAS pain score was 3.42 ± 0.54 in the c-VATS group and 4.98 ± 1.01 in the conservative group, indicating better pain control in the c-VATS group (p < 0.05). Hospitalization time was shorter in the c-VATS group (9.54 ± 2.61 days) compared to the conservative group (12.64 ± 3.54 days) (p < 0.05). Three months after discharge, follow-up evaluations revealed that the c-VATS group exhibited significantly better fracture healing (96.67%) compared to the conservative treatment group (80%) (p < 0.05). The average hospitalization cost in the c-VATS group (35,689 ± 7361) was significantly higher than that in the conservative treatment group (12,624 ± 3638) (p < 0.05).

Conclusion: In treating MRFs, c-VATS with internal fixation resulted in significant improvements in lung function, shorter pain duration, and a lower rate of fracture malunion. c-VATS with internal fixation represents a feasible, safe, and minimally invasive surgical approach for the treatment of MRFs, which is worthy of clinical promotion.