Single-port Video-assisted Thoracic Surgery For Primary Spontaneous Pneumothorax

Objective To analyse the application of video-assisted thoracicsurgery (VATS) in the treatment of primary spontaneous pneumothorax(PSP), and investigate the clinical applied value and advantages ofSingle-port video-assisted thoracic surgery in the treatment of primaryspontaneous pneumothorax.Materials and methods A retrospective analysis was performed onthe clinical data of74patients with primary spontaneous pneumothorax indepartment of thoracic surgery of China-Japan Union Hospital of JilinUniversity from March2012to August2014, including66males and8females aged from16to60years. According to the different surgicalmethods, all patients were divided into the single-port video-assistedthoracoscopic surgery group (33cases) and two-port video-assistedthoracic surgery group (41cases). The preoperative general information ofthe patients such as age, sex, and the seizure frequency in both groups wasnot statistically significant. The groups were compared by the meanoperation time, mean intraoperative blood loss, chest drainage tubeindwelling time, surgery cost, average postoperative length of stay andpostoperative visual analogue scales(VAS). All cases were diagnosed asunilateral primary spontaneous pneumothorax by chest radiography andchest CT preoperatively without other complications and obvious othersystem disfunction and could tolerate surgery. All surgeries were voluntary. Patients in both groups were taken care postoperatively in the ICU for24hours, receiving routine treatment and related indices were recorded. Allcases were followed up postoperatively for6months to observe relapse.Results The anesthesia effects were satisfied and mini-invasive effectswere achieved in both groups. Compared with two-port video-assistedthoracic surgery group, the total length of incision of single-portvideo-assisted thoracoscopic surgery group was significantly shorterbecause of avoiding the observation port. Patients in single-portvideo-assisted thoracoscopic surgery group achived higher incisionsatisfaction score. No intraoperative hemorrhage or blood transfusionoccurred. There was no statistical significance between single-portvideo-assisted thoracic surgery group and two-port video-assisted thoracicsurgery group in intraoperative blood loss, chest drainage tube indwellingtime, mean operation time, surgery cost and average postoperative length ofstay. The postoperative visual analogue scales in Single-port video-assistedthoracoscopic surgery group were （4.02±0.87）、（3.51±0.89）、（2.45±0.67）at6hours、24hours and48hours respectively, which were muchlower than the VAS in two-port video-assisted thoracic surgery group（5.14±0.97）、（4.67±0.94）、（3.51±0.69）, but no statistical significance wasfound at72hours and1week. Analgesic was used postoperatively in26cases in two-port video-assisted thoracic surgery group, while only11cases in Single-port video-assisted thoracoscopic surgery group, which suggusted that two-port video-assisted thoracic surgery could significantlyalleviate pain（P<0.05）.Conclusion Compared to two-port video-assisted thoracic surgery,single-port video-assisted thoracoscopic surgery could achieve the sametherapy effects, with shorter incision length and less postoperative pain,which deserves to be used widely in clinical practice.