The Clinical Application Of Tubeless VATS In The Treatment Of Spontaneous Pneumothorax

Objective: To explore the safety,feasibility and superiority of Tubeless VATS in the treatment of spontaneous pneumothorax.Methods: The clinical data of 38 patients with primary spontaneous pneumothorax treated in our hospital from February 2017 to July 2018 were retrospectively analyzed.Tubeless bullectomy was performed in 18 patients,including 11 males and 7 females,aged(14.3±1.5)years.20 patients underwent conventional thoracoscopic bullae resection,including 12 males and 8 females,aged(14.5±1.7)years.The operative time,preoperative anesthesia time,intraoperative blood loss,postoperative anesthesia resuscitation time,postoperative visual analogue score for pain(VAS),postoperative complete pulmonary retraction time,postoperative activity time,postoperative hospitalization time,and hospitalization cost were compared.Results: All the 38 cases completed the operation successfully under the single-hole thoracoscopy,without the transfer of intubation and secondary surgery.Postoperative operation time [(67.3±13.3)min vs.(81.4±13.4)min,P=0.002],preoperative anesthesia time [(14.2±2.6)min vs.(18.5±2.6)min,P=0.000],postoperative anesthesia recovery time [(17.1±2.6)min vs.(26.5±5.0)min,P=0.000],Visual simulation score of postoperative pain [(2.3±0.9)vs.(5.2±1.0),P=0.000],postoperative activity time [(1.3±0.4)d vs.(2.9±0.6)d,P=0.000],postoperative hospitalization time [(2.9±0.8)d vs.(5.6±1.3)d,P=0.000],hospitalization cost[(3.5±0.6)kRMB vs.(5.9±1.0)kRMB,P=0.000] were better than the control group.There was no significant difference in intraoperative blood loss [(73.2±4.6)ml vs.(73.9±4.1)ml] and postoperative lung revascularization time [(29.3±2.4)h vs.(29.7±2.5)h] between the two groups(P > 0.05).Conclusion: Compared with traditional thoracoscopic bullectomy,tubeless VATS technique is safe and reliable in the treatment of spontaneous pneumothorax,with mild pain and quick recovery,in line with the concept of accelerated rehabilitation surgery and worthy of clinical promotion.