Cryoablation for Chest Wall Trauma: A Brief Report

Am Surg. 2022 May;88(5):984-985. doi: 10.1177/00031348211058630. Epub 2022 Jan 2.

Abstract

Respiratory failure secondary to rib fractures is a major source of morbidity and mortality in trauma patients, particularly in older populations. Management of pain in these patients is complex due to the nature of the injuries. We present 3 patients who underwent a video-assisted thoracoscopic cryoablation of intercostal nerves for pain control after chest trauma. None of the patients developed post-operative complications related to poor respiratory status such as pneumonia or atelectasis. At one-month clinic follow-up, all patients reported no chest pain and were not using opiate analgesics. In patients for whom there is a contraindication to rib fixation in the setting of unstable rib fractures, cryoablation may be a method by which to improve respiratory status and decrease ventilator dependency due to pain. Cryoablation of intercostal nerves may provide a more durable and clinically feasible solution to aid in the healing process of these patients.

Keywords: Trauma; pain; rib fractures.

MeSH terms

  • Aged
  • Cryosurgery*
  • Flail Chest* / complications
  • Humans
  • Length of Stay
  • Pain
  • Rib Fractures* / complications
  • Rib Fractures* / surgery
  • Thoracic Injuries* / complications
  • Thoracic Wall* / surgery