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OBJECTIVE: Currently, SITS (single-incision thoracoscopic surgery) is a potential alternative procedure in primary spontaneous pneumothorax compared with conventional multi-ports thoracoscopic surgery. But SITS is not yet a widespread procedure for primary spontaneous pneumothorax because of an increased likelihood of collision between the instruments during surgery, and the use of all instruments through one incision means that a relatively large incision is required, leading to less satisfactory cosmetic outcomes. The purpose of this study is to confirm that our surgical method can be safe and an alternative procedure for the treatment of primary spontaneous pneumothorax.
METHODS: From October 1st, 2012 to August 31, 2013, a total of 33 patients were enrolled and had surgery for primary spontaneous pneumothorax. Total 35 surgeries were performed because 2 patients had a contralateral recurrence of pneumothorax. Our surgical technique is illustrated in the figures below. All of the clinical data were analyzed retrospectively.
RESULTS: The mean age of the 33 patients was 22.9±7.5 years. 32 patients were men and 1 patients were women. The mean operative time was 52.3±11.4 minutes. The mean duration of thoracic catheter insertion was 3.1±1.3 days. The patients with the postoperative air leak were 19 and the mean duration of the air leak was 1.6±1.2 days. No complications were recorded. The Wong-baker pain scale of the postoperative day 0, 1, 2, discharge were 3.2±1.5, 2.6±1.3, 1.7±0.9, 1.2±0.8 respectively. The mean duration of the hospital stay and the postoperative hospital stay were 7.8±2.9 and 4.9±2.5 days respectively. The mean follow-up period was 5.9±2.9 months. There were 2 ipsilateral recurrent pneumothorax case during this period.
CONCLUSIONS: Small single-incision (less than 2cm) thoracoscopic surgery using wound protector and bidirectional anchoring suture is safe and feasible method has acceptable outcomes for primary spontaneous pneumothorax. Our operative technique can be an alternative method of the treatment for primary spontaneous pneumothorax.