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Single incision thoracoscopic surgery for primary spontaneous pneumothorax: Experience in single institution

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SINGLE INCISION THORACOSCOPIC SURGERY FOR PRIMARY SPONTANEOUS PNEUMOTHORAX: EXPERIENCE IN SINGLE INSTITUTION

Department of Thoracic and Cardiovascular Surgery, Pusan National School of Medicine, Medical Research Institute, Busan, KoreaJeong Su Cho,Hyo Yeong Ahn, YeongDae Kim, Hoseok I

Introduction

Single incision thoracoscopic surgery (SITS) has been recently highlighted as alternative surgical option of conventional three ports Video-assisted thoracoscopic surgery (VATS). The outcome of SITS for primary spontaneous pneumothorax (PSP) was investigated to evaluate the possibility of as the first-line approach in operative cases with PSP.

Method

From  January 2012 to March 2014, 55 patients underwent operation via SITS and 56 received conventional VATS in Pusan National University Hospital.
Retrospective review of the medical records
•the operative time
•the postoperative pain scale
•the mean length of chest tube drainage
•the postoperative hospital stay
Our preference in procedure of SITS
•Position: lateral decubitus
•Incision: fifth intercostal space in mid-axillaryline, 2.5cm
•Instrument:Alexis Wound Protector/Retractor, 5-mm, 30-degree oblique endoscope, Articulating dissector (SILS clinch, Covidien)

Result
•The mean follow-up duration in the SITS group and the conventional VATS group were 14.0±4.2months and 22.9±7.4months.
•There was 1 case with recurrence in the SITS group and 3 cases in the conventional group during follow-up.

Conclusion
This study suggests that SITS could be an effective and safe as the first-line approach for PSP by showing less postoperative pain, shorter hospital stay and shorter duration of chest tube placement than conventional VATS.
However,a prospective, randomized study is needed to confirm these findings.

 

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