Uniportal Thoracoscopic Surgery Is A Standard Approach For Primary Spontaneous Pneumothorax
Ryohei Yoshikawa, Hitoshi Igai, Fumi Ohsawa, Tomohiro Yazawa, Mitsuhiro Kamiyoshihara.
Maebashi Red Cross Hospital, Maebashi, Japan.
Background: We have adopted uniportal thoracoscopic surgery (UTS) for young patients with primary spontaneous pneumothorax (PSP) as the standard approach in our department. In this study, we analyzed the long-term results of UTS for PSP. Method: A total of 232 patients with PSP undergoing surgical treatment were enrolled from October 2010 to February 2017 and reviewed retrospectively. Patients who were > 40 years old or undergoing a re-operation simultaneous with bilateral surgery were excluded. All patients were classified into two groups: UTS and three-port thoracoscopic surgery (3P) groups. We compared the perioperative results of the two groups using a univariate analysis. Independent risk factors for recurrence, including age (≥ 17 vs. < 17 years), affected side (right/left), sex (male/female), and the number of bullae (single/multiple) were investigated after the surgical procedure (UTS/3P). The median observational period was 1,917 days (range: 457-2,970 days). Results: The patients’ characteristics and perioperative results are listed in Table 1. No significant difference in recurrence was observed between the two groups. Multivariate analysis indicated that age < 17 years old (hazard ratio: 9.37, 95% confidence interval: 0.02-0.56, p = 0.008) was the only independent risk factor for recurrence. Conclusions: UTS is a standard approach for young patients with PSP. 
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