Single-port Versus Two-port Video-assisted Thoracoscopic Surgery For Primary Spontaneous Pneumothorax: Single Center's Experience
Yun Li1, Chun Tang2, Jinyuan He3, Peijie Wang1, Junhang Zhang1.
1Department of Cardiothoracic and Vascular Surgery, the 7th Affiliated Hospital of SUN Yat-sen University, Shenzhen, Guangdong, China, 2Department of Nephrology, the 7th Affiliated Hospital of SUN Yat-sen University, Shenzhen, Guangdong, China, 3Department of Cardiothoracic Surgery, the 3rd Affiliated Hospital of SUN Yat-sen University, Guangzhou, Guangdong, China.
Background: Video-assisted thoracoscopic surgery (VATS) blebectomy or bullectomy was the conventional treatment for primary spontaneous pneumothorax (PSP). However, the procedure has been shown to have neurological complications related to port sites. Since single-port VATS was reported less chest wall paresthesia and pain after operation. This research is to compared the results of our single centerís experience with single-port and two-port VATS for PSP. Methods: This is a non-randomized retrospective study. 104 patients with PSP underwent VATS from January 2013 to December 2014 in our center. 56 patients received single-port VATS and 48 patients received two-port VATS. Operation time, blood loss, number of stapler used, drainage time, postoperative hospital stay, complications, chest wall paresthesia, visual analog scale (VAS) pain scores and patient satisfaction scale scores were compared between two groups. Results: There was no difference in age, gender, BMI, smoking status, surgical indication and involved side between two groups. The procedures performed in the single-port group were similar to those performed in the two-port group. No significant difference was found in operation time, blood loss, number of stapler used, drainage time, and recurrence rate. The rate of chest wall paresthesia was obviously lower in the single-port group than in the two-port group (28.5% vs 52.1%, p = 0.032). The VAS scores in single-port group were obviously lower than that in two-port group at 24 and 48 hour (p = 0.032, p = 0.004). Conclusion: Compared with two-port VATS, single-port VATS for PSP appeared to be more tolerable in terms of postoperative paresthesia and pain. Single-port procedure can be considered as a first-line choice for PSP.
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