Clinical Application Of Uniportal Video-assisted Thoracoscopic Surgery In Pulmonary Diseases

Objective:To explore the feasibility and safety of uniportal VATS in the treatment of lung diseases,and to provide evidence for its clinical application.Methods:To collect the patients who had pulmonary diseases were underwent the uniportal video-assisted thoracoscopic surgery in our department from January 2015 to February 2016,and statistical analysis of the perioperative clinical indicators,such as the operation time,intraoperative bleeding,postoperative thoracic drainage time,postoperative hospital stay,postoperative complications,and follow-up of all patients after operation.Result:69 patients with pulmonary diseases were underwent uni-VATS from January 2015 to February 2016,including 8 kinds of diseases,such as lung cancer,pulmonary sequestration,bronchiectasis.Lobectomy in 29 cases,partial lung resection in 40 cases.Lung partial resection including 28 cases of pulmonary bullae resection and 12 cases of pulmonary wedge resection.Lobectomy in 29 cases,the average of operation time was 170±32min,the average of intraoperative bleeding was 205 ±145ml,,the average of postoperative thoracic drainage time was 3.7±2.1 days,the average of postoperative hospital stay was 8.3±3.1 days.Only one converted to open approach,The conversion rate is 1/29(3.4%),8 patients needed to be treated again with pleural effusion.The mean partial lung resection surgery time was 64±32 mins,the mean intraoperative bleeding was 68±23ml,the mean thoracic drainage time was 3.0±1.9 days,the mean postoperative hospital stay was 5.7±1.8 days.1 case of persistent postoperative leakage through good recovered after conservative treatment,other patients recovered smoothly.There were no other complications and perioperative death occurred.Followed up for 3 ~ 12 months,all patients recovered well and no recurrence of pneumothorax.Conclusion: According to the statistics,can be found that the uniportal video-assisted thoracoscopy is safe and feasible in the treatment of lung diseases,69 cases underwent surgery,only 1 cases of transit,the rest of the operations were completed successfully.In terms of disease,the whole group of 8 lung diseases,including benign lung disease and malignant tumor,were successfully performed in uniportal VATS,so the surgery can be used to treat various lung diseases.In terms of surgical methods,including two kinds of operation,simple partial lung resection did not transfer,and achieved satisfactory results.however,the complex lobectomy relatively also can be performed successfully,so it can carry out the operation in a variety of ways.In our experience,it’s the best way to achieve the operation from easy to difficult,because of the requirement of uniportal VATS operation higher than the traditional.This can effectively improve the safety of the operation.If the surgeon mastered traditional thoracoscopic technique,the new technology learning process will become easier.In terms of the effect of surgery,the uniportal VATS operation achieved satisfactory results,all patients in the perioperative and postoperative follow-up showed no serious complications,and compared with c-VATS,the uniportal VATS has less trauma,less postoperative pain,more beautiful,is a minimally invasive type of surgery.Therefore,the uniportal VATS is worthy of clinical promotion.