A Comparative Study Of Single-Port Video-Assisted Thoracic Surgery Versus Two-Port Video-Assisted Thoracic Surgery Technique For Spontaneous Pneumothorax

Objective: To analyze and compare the clinical effectiveness of single-port video-assisted thoracic surgery(SPVATS) and two-port video-assisted thoracic surgery(TPVATS) for the treatment of spontaneous pneumothorax, and provide clinical data for supporting the chest disease of minimally invasive treatment.Methods: 133 cases of VATS treatment for spontaneous pneumothorax cases in our hospital were collected from January 2014 to June 2015, including the single-port VATS group(n=47) and the two-port VATS group(n=86). The two groups were compared with the clinical data, including the surgical incision length, staple-using number, operation time, intraoperative blood loss, postoperative chest tube drainage time, postoperative visual pain score, incision satisfaction, hospital days and hospitalization expenses. All the patients’ pneumothorax relapse rates were followed-up in half a year postoperatively.Results: Two groups of patients were successfully completed by surgery, without operative death or converting to thoracotomy, and no one relapsed again in half a year postoperatively.(1) Intraoperative indexes: the length of incision, the single-port VATS group was 3.07±0.77 cm; the operation incision in the two-port VATS group was 2.58±0.33 cm, and the endoscopic incision was 1.53±0.11 cm. There was a statistically significant difference between the two groups(P<0.01). However, there were no statistically significant differences on the staple-using number(2.55±1.18 vs 2.51±1.19, P=0.846), the operation time(79.50±34.37 minutes vs 86.60±36.36 minutes, P=0.267) and blood loss(20.53±4.92 ml vs 24.53±14.90 ml, P=0.076).(2) Postoperative indexes: there were statistically significant differences between the two groups regarding postoperative visual pain score(5.21±2.03 vs 6.07±2.46, P=0.033) and incision satisfaction(1.70±0.75 vs 2.49±0.63, P<0.01). However, there were no statistically significant differences on postoperative chest tube drainage time(4.32±1.46 days vs 4.53±1.57 days, P=0.430) and postoperative complications(P>0.05). Regarding with the postoperative complications, there were two cases complicated with air leak, one case with pleural effusion and no one with lung infection in the single-port VATS group. However, there were four cases complicated with air leak, three cases with pleural effusion and one case with lung infection in the two-port VATS group.(3) Other indexes: there were no statistically significant differences on hospital days(6.26±1.86 days vs 6.88±2.26 days, P=0.195) and hospitalization expenses(￥28643.45±6103.06 vs ￥27716.58±6080.60, P=0.404).Conclusion:The single-port VATS technology had the similar clinical effects with the two-port VATS technology on the treatment of spontaneous pneumothorax. And the patients undergoing the single-port VATS had shorter incision、less pain and higher satisfaction on the appearance of incision after operation yet. It is worthwhile to promote the single-port VATS technology in the treatment of spontaneous pneumothorax.