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Feasibility of single-incision thoracoscopic surgery using a modified chest wall pulley for primary spontaneous pneumothorax: a propensity score matching analysis

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Abstract

Purpose

Recently, single-incision thoracoscopic surgery (SITS) has been recognized as a favorable treatment choice for primary spontaneous pneumothorax (PSP) compared with conventional three-port video-assisted thoracoscopic surgery (VATS). However, conventional SITS bullectomy often results in collisions with surgical devices. Therefore, we devised a method of SITS using a chest wall pulley for lung excision (PulLE) and modified PulLE (mPulLE) system, which substitutes threads to eliminate such collisions. We compared the mPulLE system with conventional procedures using propensity score matching (PSM) to adjust for patient backgrounds.

Methods

Using PSM, we evaluated the surgical results of 210 PSP patients who underwent VATS, including mPulLE (n = 23) and three-port VATS (n = 102), at our institution between January 2010 and August 2016.

Results

We selected 17 mPulLE cases and 17 three-port VATS. There were no marked differences between the groups in the patient backgrounds or surgical results. However, there was a significant difference between the mPulLE cases and the three-port VATS cases in the operative time (71.7 ± 15.7 vs. 85.9 ± 25.5 min, respectively, P = 0.0388) and the number of autosutures used (3.6 ± 1.2 vs. 4.5 ± 1.2, respectively, P = 0.0178).

Conclusion

The surgical results of mPulLE in patients with PSP with multiple lesions were equivalent to those achieved with three-port VATS under the same conditions.

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Authors and Affiliations

  1. Department of Thoracic Surgery, Takasago Municipal Hospital, 33-1 Kamimachi, Arai Town, Takasago, Hyogo, 676-8585, Japan

    Kenji Tsuboshima, Machiko Nagata, Teppei Wakahara & Yasumi Matoba

  2. Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan

    Yoshimasa Maniwa

Authors
  1. Kenji Tsuboshima
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  2. Machiko Nagata
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  3. Teppei Wakahara
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  4. Yasumi Matoba
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  5. Yoshimasa Maniwa
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Corresponding author

Correspondence to Kenji Tsuboshima.

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Tsuboshima, K., Nagata, M., Wakahara, T. et al. Feasibility of single-incision thoracoscopic surgery using a modified chest wall pulley for primary spontaneous pneumothorax: a propensity score matching analysis. Surg Today 47, 1129–1134 (2017). https://doi.org/10.1007/s00595-017-1483-0

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  • DOI: https://doi.org/10.1007/s00595-017-1483-0

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