Clinical Effect Analysis Of Single-port Vats For Treatment Of Spontaneous Pneumothorax With Pulmonary Bulla

Objective:Through the clinical observation on Single-port Video-assisted Thoracoscopic Surgery(VATS)and traditional thoracotomy of transaxilary minithoracotomy conducted by Department of thoracic surgery in Dandong No.1 Hospital for the past 2 years,the study compares and analyzes the clinical advantage of Single-port VATS for treatment of spontaneous pneumothorax with pulmonary bulla.Methods:Firstly,by revisit and analyzes 40 patients suffering a second attack of spontaneous pneumothorax with pulmonary bulla who checked in the Department of Thoracic Surgery in Dandong No.1 Hospital during January,2014 and November,2015,and divides them into 2 groups.20 patients treated by Single-port(operating and observing by the same hole)VATS are drawn into Group A and the other 20 treated by traditional thoracotomy of transaxilary minithoracotomy are drawn into Group B.Secondly,the study gathers general information of the patients,such as age and gender,and compares clinical indicators,such as duration of surgery,amount of bleeding during surgery,indwelling time of closed thoracic drainage tube,post-surgery hospitalization days,post-surgery complication and total hospitalization expenses.Finally,the study conducts statistical analysis by SPSS20,T test by measurement data,and chi-square test by enumeration data.Result:For general information,the male to female ratio of Group A is 13:7 and Group B is 12:8,so sex ratio difference is not statistically significant(P>0.05).Average age of Group A is 32.45±16.40 and Group B is 39.15±16.16,so age difference is not statistically significant(P>0.05).For average duration of surgery,Group A is 78.25±17.79min and Group B is 98.25±19.11 min,and difference is statistically significant(P<0.05).For average bleeding during surgery,Group A is 42.25±14.46ml and Group B is 58.00±13.21ml,and difference is statistically significant(P<0.05).For average post-surgery hospitalization days,Group A is 7.40±3.31 and Group B is 9.40±1.23,and difference is statistically significant(P<0.05).For average indwelling time of closed thoracic drainage tube,Group A is 4.55±2.56 days and Group B is 6.05±1.96 days,and difference is not statistically significant(P>0.05).For average total hospitalization expenses,Group A is 19722.30±3295.06 Yuan and Group B is 19029.32±2803.46 Yuan,and difference is not statistically significant(P>0.05).There are 3 patients suffering postoperative complications,2 of which suffer postoperative air leak and the other one suffers postoperative atelectasis,so complication rate is 15%;there are 9 patients suffering postoperative complications,5 of which suffer postoperative air leak,3 of which suffer postoperative atelectasis and one suffers Delayed healing of incision,so complication rate is 45%,so the difference is statistically significant(P<0.05).All complications are healed.Every patient suffers second attack of pneumothorax,and there are pulmonary bulla found by CT scan of the Lung.All of patients are cured when leaving hospital and none of them suffers pneumothorax or other complications during follow-up visit in 6 months.Conclusion:When treating the patient suffers second attack of spontaneous pneumothorax with pulmonary bulla,Single-port VATS,comparing with traditional thoracotomy of transaxilary minithoracotomy,has advantages on duration of surgery,amount of bleeding during surgery,post-surgery hospitalization days,indwelling time of closed thoracic drainage tube and post-surgery complication rate,and at the same time,total hospitalization expenses doesn’t increase markedly.With the feature of little trauma and rapid recovery,VATS conforms to the concept of minimally invasive surgery and is worthy of popularizing.