The Study Of The Safety And Feasibility Of Uniportal Video-assisted Thoracoscopic Surgey For The Treatment Of Thoracic Diseases

Objective:Objective to summarize the clinical effect of uniportal video-assisted thoracoscopic surgey(VATS)in the treatment of thoracic diseases,and to evaluate the safety and feasibility of its clinical application by means of comparing the differences of every clinical indices during perioperative period with 3-port VATS in the surgical treatment of lung cancer.Methods:We retrospectively analyzed the clinical data of 326 cases who had accepted the uniportal video-assisted thoracoscopic surgey from June 2010 to June 2017 in The Second Hospital of Shanxi Medical University and Shanxi Provincial Hospital of traditional Chinese Medicine,and compared the clinical indices including operation time,intraoperative blood loss,intraoperative lymph node dissection number,degree of chest pain,postoperative chest drainage in initial 3 days,chest drainage duration,postoperative hospital stay,postoperative complications during perioperative period of 39 cases among them who with lung cancer and completed the lung cancer radical operation underwent 2-ports VATS with those clinical indices of 40 cases who with lung cancer and completed the lung cancer radical operation underwent 3-ports VATS in the same period.Results:No perioperative death was observed,except 2 cases with assisted small incision and9 cases were transferred to open-thorax operation,the other 315 cases received total uniportal video-assisted thoracoscopic surgey.Postoperative complications: pleural effusion in 3,pneumonia and atelectasis in 9,pulmonary air leakage in 12,arhythmia in7,wound infection in 3,pleural active hemorrhage in 2,for the above-mentione postoperative complications,except 2 pleural active hemorrhage were cured with reoperation,the rest were cured by encouraging coughing and expectoration,giving thoracic closed drainage or changing dressings of incision frequently.Compared the clinical indices during perioperative period of 39 cases among them who with lung cancer and completed the lung cancer radical operation underwent2-ports VATS with the clinical indices of 40 cases who with lung cancer and completed the lung cancer radical operation underwent 3-ports VATS in the same period,we get the following results:The two groups were similar in operation time(180.28±29.99 min vs173.10±35.63min),intraoperative blood loss(189.39±58.81 mL vs180.63±59.41mL),lymph nodes dissection(13.74±2.09 vs 14.00±2.07),and postoperative complications(6/39 vs 7/40)(P>0.05).There were differences in degree of chest pain(4.31±1.54 score vs 5.48±1.24score),postoperative chest drainage in initial 3days(785.31±206.47 ml vs 964.85±294.88ml),chest drainage duration(4.01±1.21 d vs5.78±1.64d),and postoperative hospital stay(6.59±1.25 d vs 7.43±1.41d)between the two groups(P<0.05).Conclusion:Uniportal video-assisted thoracoscopic surgey is valuable in the treatment of thoracic diseases,and it has the advantages of less traumatic,light pain,rapid recovery,short time in hospital compared with 3-ports VATS in the use of lung cancer radical operation,and it has high safety and feasibility in the clinical application.