Surgery of primary spontaneous pneumothorax via single incision
Eun gu HWANG, Sun Kyung Min, Yong In Kim.
Inje University Seoul Paik Hospital, Seoul, Korea, Republic of.
OBJECTIVE: Thoracoscopic operation is common in primary spontaneous pneumothorax. Recently, single incision approach is widely
used. This study is aimed to evaluate the effectiveness of operation via single incision in primary spontaneous pneumothorax compare with conventional thoracoscopic operation
METHODS: We reviewed medical record of primary spontaneous pneumothorax operated by thoracoscopic approach from Jan 2011 to Nov 2012 retrospectively .Groups were divided into two groups according to approach as one camera port and another port on anterior chest wall (2-ports ) and single incision via 7th ICS- MXL (SITS). Operative method was common in two groups as wedge resection and reinforcement of stapled line with polyglycolic acid sheet and fibrin glue. Various parameters were compared with two groups including age,sex, op. time,numbers of staples,complications (Wound infection, postop.CTD > 5days, respiratory complication), postop. CTD days, postop.recurrence, and need of additional opioid. Statistical analysis was done by χ2-test, and
statistical significance was p-value < 0.05
RESULTS: 32 cases were collected. 2-ports group were 16 cases, SITS were 16 cases. Men were 29, women were 3 . Age was mean 24.75 yrs
(15-66) (p=0.108). Operative time was mean 59.37 minutes (p=0.176), Mean numbers of staples were 5.50 in 2-ports and 3.87 in SITS (p=0.163). Complications were occurred 12 cases, 6 cases (all postop. CTD > 5 days) in 2-ports and 6 cases (Wound infection 2, postop. CTD > 5 days 3, respiratory cx. 1) in SITS(p=0.261).Mean postop. CTD were 4.69 in 2-ports and 3.38 in SITS (p=0.69).Postop.recurrence were occurred 4 cases (13.3%), 3 cases in 2-ports group (18.7%) and a case in SITS group (6.2%) (p=.600). Additional opioid needed in 19 cases, 11 cases needed in 2-ports group (69%) and 8 cases in SITS group (50%) (p=0.473)
CONCLUSIONS: There were no significant differences between 2-ports approach and single incision approach. So, we could suggest that single incision approach can be a substitute to conventional approach. Surgical technique and postoperative pain management should be refined to reduce postoperative pain. More cases and randomized controlled study are essential to evaluate the efficacy of single incision approach
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