Comparision Of Uniportal Video-assisted Thoracoscopic Surgery Versus Subaxillary Small Incision Thoracotomy In The Treatment Of Primary Spontaneous Pneumothorax

Objective:To compare the clinical efficiency of uniportal video-assisted thoracoscopic surgery and subaxillary small incision thoracotomy in the treatment of primary spontaneous pneumothorax.Methods:77 patients with primary spontaneous pneumothorax who underwent bullectomy of cardiothoracic surgery in our Hospitalfrom September2016 to December 2018were enrolled.According to the surgical methods accepted by the patients,they were divided into two groups,A and B.Among them,45 patients in group A underwent uniportal video-assisted thoracoscopic surgery,and 32 patients in group B underwent subaxillary small incision thoracotomy.The relevant clinical data of the two groups were collected and statistically analyzed.Results:All patients completed the procedure successfully,with no transfer to thoracotomy.There were no significant difference in the operation time(1.15±0.33)h vs(1.19±0.23)h,betweengroup A and group B,respectively(P>0.05).There were significantdifferenceinIntraoperativebloodloss[(21.49±4.62)mlvs(23.59±2.49)ml],Chest drainage duration[(2.02±0.62)d vs(2.41±0.80)d],postoperative drainage[(209.33±79.64)mlvs(250.63±90.41)ml],postoperativehospital stay[(5.51±1.33)d vs(6.22±1.31)d],and paresthesia of chest wall[(9 cases)vs(14cases)],between group A and group B,respectively(P<0.05).There were significant differenceinhospitalizationexpenses[(26024.60±1909.87)RMBvs(17346.09±1343.16)RMB],between the groups,respectively(P<0.001).There were no significant difference in postoperative recurrence[(1 cases)vs(1 cases)],between the groups,respectively(P>0.05).There were no significant difference in the postoperative 2h、24h、48h resting visual pain score(R-VAS score)[(3.07±1.94,3.11±2.06,2.36±1.35)pointsvs(3.28±2.08,3.52±1.57,2.09±1.28)points],betweenthe groups,respectively(P>0.05).There were significant difference in the postoperative 2h、24h、48h visual pain score in cough(C-VAS score)[(5.02±2.45,3.56±2.08,2.82±1.48)points vs(6.31±1.73,4.72±2.05,3.66±1.47)points],and additional use of pain killer[(7cases)vs(11cases)],between the groups,respectively(P<0.05).There were significant difference in postoperative(day 1,day 3,day 5)C-reactive protein levels[(61.60±19.27,42.24±11.14,15.51±4.96)mg/L vs(71.78±11.46,48.22±7.82,18.16±4.65)mg/L],between the groups,respectively(P<0.05).There were significant difference in postoperative(day 1,day 3,day 7)white blood cell counts[(11.81±1.60,10.29±1.55,6.77±1.08)×10~9/L vs(16.98±1.55,11.22±1.56,7.38±1.10)×10~9/L],between the groups,respectively(P<0.05).Conclusion:The uniportal video-assisted thoracoscopic surgery for spontaneous pneumothorax is worthy of clinical application,because of mild chest pain after surgery,light inflammatory reaction,short hospital stay,and more in line with the minimally invasive concept of surgery。...