Abstract
Background
Video-assisted thoracoscopic surgery is a widespread used procedure for treatment of primary spontaneous pneumothorax patients. In this study, the adaptation of single-port video-assisted thoracoscopic surgery approach to primary spontaneous pneumothorax patients necessitating surgical treatment, with its pros and cons over the traditional two- or three-port approaches are examined.
Methods
Between January 2011 and August 2013, 146 primary spontaneous pneumothorax patients suitable for surgical treatment are evaluated prospectively. Indications for surgery included prolonged air leak, recurrent pneumothorax, or abnormal findings on radiological examinations. Visual analog scale and patient satisfaction scale score were utilized.
Results
Forty triple-port, 69 double-port, and 37 single-port operations were performed. Mean age of 146 (126 male, 20 female) patients was 27.1 ± 16.4 (range 15–42). Mean operation duration was 63.59 ± 26 min; 61.7 for single, 64.2 for double, and 63.8 min for triple-port approaches. Total drainage was lower in the single-port group than the multi-port groups (P = 0.001). No conversion to open thoracotomy or 30-day hospital mortality was seen in our group. No recurrence was seen in single-port group on follow-up period. Visual analog scale scores on postoperative 24th, 48th, and 72nd hours were 3.42 ± 0.94, 2.46 ± 0.81, 1.96 ± 0.59 in the single-port group; significantly lower than the other groups (P = 0.011, P = 0.014, and P = 0.042, respectively). Patient satisfaction scale scores of patients in the single-port group on 24th and 48th hours were 1.90 ± 0.71 and 2.36 ± 0.62, respectively, indicating a significantly better score than the other two groups (P = 0.038 and P = 0.046).
Conclusions
This study confirms the competency of single-port procedure in first-line surgical treatment of primary spontaneous pneumothorax.
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References
Light RW (1995) Pneumothorax. In: Light RW (ed) Pleural diseases, 3rd edn. Williams & Wilkins, Baltimore, pp 242–277
Henry M, Arnold T, Harvey J, Pleural Diseases Group, Standards of Care Committee, British Thoracic Society (2003) BTS guidelines for the management of spontaneous pneumothorax. Thorax 58(Suppl 2):ii39–ii52
Duncan JA, Bond JS, Mason T, Ludlow A, Cridland P, O’Kane S, Ferguson MW (2006) Visual analogue scale scoring and ranking: a suitable and sensitive method for assessing scar quality? Plast Reconstr Surg 118:909–918
Bird HA, Dixon JS (1987) The measurement of pain. Bailliere’s Clin Rheumatol 1:71
de Vos B, Hendriks J, Van Schil P, Van Hee R, Hendrickx L (2002) Long-term results after video-assisted thoracic surgery for spontaneous pneumothorax. Acta Chir Belg 102:439–444
Passlick B, Born C, Haussinger K, Thetter O (1998) Efficiency of video-assisted thoracic surgery for primary and secondary spontaneous pneumothorax. Ann Thorac Surg 65:324–327
Rocco G, Martin-Ucar A, Passera E (2004) Uniportal VATS wedge pulmonary resections. Ann Thorac Surg 77(2):726–728
Chen PR, Chen CK, Lin YS, Huang HC, Tsai JS, Chen CY, Fang HY (2011) Single-incision thoracoscopic surgery for primary spontaneous pneumothorax. J Cardiothorac Surg 6:58
Young R, McElnay P, Leslie R, West D (2015) Is uniport thoracoscopic surgery less painful than multiple port approaches? Interact Cardiovasc Thorac Surg 20:409–414
Chen CH, Lee SY, Chang H, Liu HC, Hung TT, Chen CH (2012) The adequacy of single-incisional thoracoscopic surgery as a first-line endoscopic approach for the management of recurrent primary spontaneous pneumothorax: a retrospective study. J Cardiothorac Surg 7:99
Byun CS, Hwang JJ, Choi JH (2013) Single-incision VATS bullectomy with suture-lift method in primary spontaneous pneumothorax. Conference: 2013 Annual Scientific Meeting of the International Society for Minimally Invasive Cardiothoracic Surgery. ISMICS 2013 Prague Czech Republic, Conference Publication: (var.pagings) 8:45–146
Chen CH, Chang H, Tseng PY, Hung TT, Wu HH (2012) A rare case of dysphagia and palpitation caused by the compression exerted by an enormous mediastinal lipoma. Rev Port Pneumol 18:149–152
Berlanga LA, Gigirey O (2011) Uniportal video-assisted thoracic surgery for primary spontaneous pneumothorax using a single-incision laparoscopic surgery port: a feasible and safe procedure. Surg Endosc 25:2044–2047
Horio H, Nomori H, Kobayashi R, Naruke T, Suemasu K (2002) Impact of additional pleurodesis in video-assisted thoracoscopic bullectomy for primary spontaneous pneumothorax. Surg Endosc 16:630–634
Chen CH, Chang H, Yang LY, Liu HC, Tsung TT, Hung TT (2012) A preliminary report of a disposable electrical non-fiberoptic endoscope in thoracoscopic surgery. Int J Surg 10:20–24
Disclosures
Drs. Ilhan Ocakcioglu, Levent Alpay, Mine Demir, Hakan Kiral, Mustafa Akyil, Talha Dogruyol, Cagatay Tezel, Volkan Baysungur, Irfan Yalcinkaya have no conflicts of interest or financial ties to disclose.
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Ocakcioglu, I., Alpay, L., Demir, M. et al. Is single port enough in minimally surgery for pneumothorax?. Surg Endosc 30, 59–64 (2016). https://doi.org/10.1007/s00464-015-4161-6
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DOI: https://doi.org/10.1007/s00464-015-4161-6