Minimal-single-operating-port Thoracoscopic Treatment Of Primary Spontaneous Pneumothorax

Objective：To investigate minimal-single-operating-port video assistedthoracic surgery (VATS) treatment of primary spontaneous pneumothorax anddiscuss its clinical advantages.Materials and methods：Retrospective analysis of96cases of primaryspontaneous pneumothorax treatment from August2010to September2012inChina-Japan Union Hospital, Jilin University of Thoracic Surgery.Collection ofgenerally information including age, gender, seizure frequency, and to evaluatethe comparability of the two groups of patients.Clinical evaluation indicatorsinclude the mean operation time, mean intraoperative blood loss,averagepostoperative hospital stay, average postoperative chest tube duration andpostoperative pain scores of the two groups.The postoperative pain scoresusing the World Health Organization VRS grading.Depending on the caseswhere the medical group and operation mode divided into twogroups.Minimal-single-operating-port VATS group consists of23cases treatedby Minimal-single-operating-port VATS.Conventional VATS group consistsof73cases treated by two-operating-port VATS or conventionalsingle-operating-port VATS.All cases underwent preoperative diagnosis ofprimary spontaneous pneumothorax by chest radiography or chest CT,and,noserious complications, the various functions of abnormal tolerate operation.Fedinto the ICU24hours in the two groups of patients after surgery, routineinfection prevention, phlegm and symptomatic treatment.One day after surgeryinto the flow of food and review bedside chest radiography observation lungreexpansion.Observe and record the operation, thoracic drainage tubedrainage.If daily chest tube drainage less than100ml,and it no leakage of gas,the vases could be discharged after the removal of the chest tube by thechest radiographs proof of lung reexpansion well.All cases were followed upfor6months after operation for observed relapse.Results：Two groups of patients were successfully completed according toplan surgical operation,and no conversion to thoracotomy cases.Minimal-single-operating-port VATS group of cases had none extension of the incisionor increase the auxiliary operation holes.All cases postoperative pathologicalreturn support bullae change.Only two of the Minimal-single-operating-portVATS group of cases have chest tube leakage of gas,and without specialtreatment natural recovery in3days.Eight of the Conventional VATS group ofcases have chest tube leakage of gas,and4of them use lasting vacuumaspiration and recovery in4days.All cases had no hemothorax, empyema, andatelectasis related complications.Postoperative follow6months and norecurrent cases.In Minimal-single-operating-port VATS group, the meanoperation time was50.0±4.1min, mean intraoperative blood loss was43.2±6.7ml, average postoperative hospital stay was6.0±1.4d, average postoperativechest tube duration was4.5±1.1d.In Conventional VATS group,the meanoperation time was51.4±4.0min, mean intraoperative blood loss was46.4±6.9ml, average postoperative hospital stay was6.0±1.4d, average postoperativechest tube duration was4.8±1.1d,the difference of these indicators was notstatistically significant (P>0.05).Minimal-single-operating-port VATS groupwas lower than Conventional VATS group in the incidence of post-operativepain,the difference of these indicators had statistically significant（P<0.05）.Conclusions：With the surgical technique, the instrument conditionssufficient premise,Minimal-single-operating-port thoracoscopic compared withConventional VATS treatment of primary spontaneouspneumothorax,Minimal-single-operating-port thoracoscopic have smallersurgical trauma, lighter postoperative pain reaction,more beautiful incision,clinical effect certainly, so it is worthy of clinical promotion.