Fiorelli A, Cascone R, Carlucci A, Natale G, Freda C, Bove M, Messina G, Liguori G, Santini M. Uniportal thoracoscopic surgical management using a suture traction for primary pneumothorax.
Asian Cardiovasc Thorac Ann 2020;
29:195-202. [PMID:
33183063 DOI:
10.1177/0218492320974184]
[Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND
We devised a new strategy using suture traction to facilitate the management of primary spontaneous pneumothorax during uniportal thoracoscopy. To test its validity, we compared the outcomes of our modified technique with those of conventional three-port thoracoscopy.
METHODS
This retrospective study included all 43 consecutive patients with primary spontaneous pneumothorax undergoing thoracoscopy between January 2017 and December 2019. They were divided within two groups: uniportal thoracoscopy using suture traction (n = 21) and conventional 3-port thoracoscopy (n = 22). Postoperative pain, paresthesia, patient satisfaction, and surgical outcomes were compared to test the validity of our technique.
RESULTS
There were no significant differences in operative time (47 ± 4.8 vs. 43 ± 7.9 min), number of staples used (2.5 ± 0.9 vs. 2.3 ± 0.6), postoperative drainage (235 ± 15 vs. 240 ± 19 mL), chest tube drainage time (3.2 ± 0.8 vs. 3.4 ± 1.8 days), and hospital stay (4.2 ± 1.2 vs. 4.3 ± 0.9 days). However, uniportal thoracoscopy was associated with less pain at 24 (p = 0.01), 48 (p = 0.02), and 72 h (p = 0.03) postoperatively, less paresthesia at 24 (p = 0.03), 48 (p = 0.02), and 72 h (p = 0.02) postoperatively, and greater patient satisfaction at 24 (p = 0.04), 48 (p = 0.02), and 72 h (p = 0.02) postoperatively.
CONCLUSIONS
Our technique may facilitate the use of uniportal thoracoscopy for treatment of primary spontaneous pneumothorax, reducing neurological sequelae and improving patient satisfaction compared to the traditional three-port thoracoscopy.
Collapse