Comparison Of Uniportal And Three Portal Video-assisted Thoracic Surgery In Benign Pulmonary Diseases

Objective To compare the application of uniportal video-assisted thoracoscopic surgery(VATS)with the conventional three portal VATS in the treatment of benign pulmonary diseases,so as to provide a theoretical base for the clinical promotion of uniportal VATS in benign pulmonary disease.Methods The clinical data collected from 66 VATS-treated patients with benign pulmonary disease,whose treatments were conducted by the same team from 2015 June to 2016 October in the thoracic surgery department of Anhui Provincial Chest Hospital,were retrospectively analyzed.The patients were divided into two groups: uniportal VATS group,32 patients with 18 males and 14 females,aged from 12 to 77(42.72±16.94 in average);three portal VATS group,34 patients with 18 males and 16 females,aged from 16 to 74(41.88±16.90 in average).The operation time,intraoperative blood loss,thoracic drainage volume 24 hours after operation,incision length,retention time of postoperative drainage tube,pain score three days after the operation,and complication rate were then compared between the two groups.Results The surgeries for both groups of patients corresponding to the two different operation approaches were performed successfully.The intraoperative blood loss,thoracic drainage volume 24 hours after operation and retention time of postoperative drainage tube in the uniportal VATS group(40.9±54.60 ml,56.65±33.72 ml,5.16±1.83 d respectively)showed no significant difference(p>0.05)when compared to those in the three portal VATS group(60.44±120.02 ml,75.38±24.75 ml,5.00±1.51 d respectively).The incision length and pain score three days after the operation in the uniportal VATS group(3.80±0.37 cm,2.31±0.74 respectively)were statistically less(p<0.05)than that of the three portal VATS group(5.83±0.54 cm,3.00±0.95 respectively).Yet,the operation time of uniportal VATS group(54.69±27.12min)was significantly longer(p<0.05)than that of three portal VATS group(40.44±14.88min).No death case or serious complications were found in the two groups during the perioperative period.One case of lung infection and arrhythmia occurred in the group of uniportal VATS,whereas three cases of arrhythmia and one case of lung infection and incision fat liquefaction,which were then cured through conservative treatment,were found in the group of three portal VATS.No recurrence or other serious complications occurred over the 2 to 14 months of follow-up consultation.Conclusion Uniportal VATS is safe and feasible for the treatment of benign lung diseases.It does not increase the blood loss intraoperatively or the complication rate postoperatively yet still can achieve similar surgical efficacy.Although the operation time of uniportal VATS is longer than that of three portal VATS,it can be improved hopefully by the accumulated clinical experience and further optimized surgical process.The postoperative pain of uniportal VATS,which is more minimally invasive and elegant,is lighter than that of the conventional three portal VATS,which makes it worth of promotion and broader prospects.