Uniportal Versus Needlescopic Video-Assisted Thoracoscopic Surgery for Primary Spontaneous Pneumothorax: A Comparable Study

Abstract Objectives:Primary spontaneous pneumothorax (PSP) is a common disease in young and thin male. Operation has been regarded as definitive treatment for it. However, the operative methods for those patients are under dispute. Our study is aimed to compare the uniportal VATS versus needlescopic VATS for PSP patients in our institute.Methods:From July 2013 to December 2017, the patients who underwent video-assisted thoracic surgery for pneumothorax in National Taiwan University Hospital were retrospectively collected. The preoperative condition, surgical results, and postoperative outcomes was analyzed.Results:There were 60 patients undergoing needlescopic VATS and 91 undergoing uniportal VATS during the study period. There was no significant difference between the patients who underwent needlescopic VATS and those who underwent uniportal VATS in their demorgraphic and clinical characteristics. The post-operative pain score was significantly lower in the uniportal VATS group compared to the mini VATS group at day 1 (2.65 ± 1.59 vs. 1.74 ± 1.35, p = 0.001).Conclusion:We have shown that uniportal VATS is an effective and a safe treatment for PSP patients, and it is comparable to needlescopic VATS. Based on these results, we believe that uniportal VATS using a wound protector can be used as an alternative approach for PSP.

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The advantages of video-assisted thoracoscopic surgery compared to thoracic drainage in the treatment of primary spontaneous pneumothorax

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh180504055r ◽

2019 ◽

Vol 147 (3-4) ◽

pp. 181-184

Author(s):

Aleksandar Ristanovic ◽

Dejan Stojkovic ◽

Vanja Kostovski ◽

Nebojsa Maric ◽

Natasa Vesovic ◽

...

Keyword(s):

Spontaneous Pneumothorax ◽

Thoracoscopic Surgery ◽

Intraoperative Complications ◽

Video Assisted ◽

Military Medical Academy ◽

Thoracic Drainage ◽

Significant Difference ◽

Duration Of Surgery ◽

The Military ◽

Video Assisted Thoracoscopic Surgery

Introduction/Objective. The aim of the study is to analyze the treatment of spontaneous pneumothorax (PSP) through our 10-year experience. Methods. The study included 67 patients with PSP treated with video-assisted thoracoscopic surgery (VATS) or with thoracic drainage (TD) in the Clinic for Chest Surgery at the Military Medical Academy in Belgrade, Serbia in the 2008?2017 period. Results. PSP patients with VATS were younger (33.2 ? 16.4 vs. 45.5 ? 21.5 years, p = 0.010), and both groups consisted mainly of males (69.2% vs. 78%). VATS-treated patients were hospitalized shorter and wore drains (p < 0.001, p < 0.002). Recurrence after treatment was more common after TD (61% vs. 3.8%) and in most cases it was treated with VATS (92%). The incidence of intraoperative complications is similar between groups (p = 0.599, p = 0.636, p = 0.311, p = 0.388, p = 0.388, respectively). Pain was more common in TD (p < 0.001). The early complications in the group of patients treated with TD occurred more often (p < 0.001, p < 0.001), without significant difference in the incidence of pleura infections and intercostal blockade between groups (p = 0.388, p = 0.388, respectively). Patients treated for PSP with the VATS method came to the control follow-up later, compared to patients treated with TD (p < 0.001). Conclusion. VATS proved to be efficient, which was reflected in the optimal duration of surgery, length of hospitalization, tolerable postoperative pain and satisfactory cosmetic effect, and postsurgical relapse in only one case.

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