Analysis of the effect of single-hole and three-hole thoracoscopic surgery for spontaneous pneumothorax with pulmonary bulla

doi:10.3877/cma.j.issn.2095-8773.2018.01.06

Abstract

Abstract:

Objective

To compare the single-hole and three hole video-assisted thoracoscopic surgery (VATS) clinical curative effect in youth spontaneous pneumothorax with pulmonary bullae.

Methods

Forty-one cases of young patients with spontaneous pneumothorax with pulmonary bullae from January 20 to February 2017 were retrospectively analyzed. They were divided into single-hole VATS group (n=22) and three-hole VATS group (n=19), and the operation index of the two groups with inflammatory index, postoperative visual analogue scale (VAS) and the incidence of complications were observed.

Results

There was no significant difference in intraoperative blood loss, operation time and postoperative thoracic drainage, intubation time and hospitalization time between the two groups (P> 0.05). But the incision length of the single-hole VATS group was significantly shorter than that of the three-hole VATS group [(3.9 + 0.6) cm vs (8.7 + 0.7) cm]. Incision satisfaction score was significantly higher than that of the three-hole VATS group [(4.8 + 1.1) % vs (2.6 + 1.8) %]. The incidence of postoperative complicated skin sensory abnormalities was significantly lower than that of the three-hole VATS groups (18.2% vs 47.4%), and the difference was statistically significant (P <0.01). On the first and third day after operation, the white blood cell count and CRP level in the single-hole VATS group were lower than those in the three-hole VATS group. The VAS pain score of the single-hole VATS group was significantly lower than that of the three-hole VATS group at the 3rd and 5th day after operation. The differences were statistically significant (P<0.01).

Conclusions

Compared to three-hole VATS surgery, one-hole VATS operation can reduce the patient’s postoperative pain, with a small incision, less trauma, quick recovery, and better postoperative satisfaction.

Key words: Spontaneous pneumothorax, Pulmonary bullae, Thoracoscopic surgery, Visual analogue scale

Zhanliang Ren, Yong Zhang, Xiaopeng Ren. Analysis of the effect of single-hole and three-hole thoracoscopic surgery for spontaneous pneumothorax with pulmonary bulla[J]. Chinese Journal of Thoracic Surgery(Electronic Edition), 2018, 05(01): 26-31.

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Figures/Tables 6

References 18

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组别	性别[n(%)]		平均年龄(岁，±s)	首次发病[n(%)]	手术部位[n(%)]
组别	男性	女性	平均年龄(岁，±s)	首次发病[n(%)]	左侧	右侧
单孔VATS组(n＝22)	14(63.6)	8(36.4)	25±7.3	18(81.8)	11(50.0)	11(50.0)
三孔VATS组(n＝19)	11(57.9)	8(42.1)	26±4.5	17(89.5)	9(47.4)	10(52.6)
检验值	χ²＝0.034	χ²＝0.062	t＝0.518	χ²＝0.038	χ²＝0.010	χ²＝0.010
P值	0.853	0.804	0.608	0.846	0.921	0.924

组别	性别[n(%)]		平均年龄(岁，±s)	首次发病[n(%)]	手术部位[n(%)]
组别	男性	女性	平均年龄(岁，±s)	首次发病[n(%)]	左侧	右侧
单孔VATS组(n＝22)	14(63.6)	8(36.4)	25±7.3	18(81.8)	11(50.0)	11(50.0)
三孔VATS组(n＝19)	11(57.9)	8(42.1)	26±4.5	17(89.5)	9(47.4)	10(52.6)
检验值	χ²＝0.034	χ²＝0.062	t＝0.518	χ²＝0.038	χ²＝0.010	χ²＝0.010
P值	0.853	0.804	0.608	0.846	0.921	0.924

组别	切口长度(cm)	术中出血量(ml)	手术时间(min)	胸腔引流量(ml)	插管时间(d)	住院时间(d)	切口满意度(分)
单孔VATS组(n＝22)	3.9±0.6	146.0±18.9	82.4±5.8	555.9±214.7	4.2±1.3	7.5±2.4	4.8±1.1
孔VATS组(n＝19)	8.7±0.7	150.3±15.8	81.2±4.2	615.2±208.6	4.6±1.0	8.7±1.9	2.6±1.8
t值	23.649	0.783	－0.748	0.894	1.091	1.755	－4.794
P值	<0.001	0.438	0.459	0.377	0.282	0.087	<0.001

组别	切口长度(cm)	术中出血量(ml)	手术时间(min)	胸腔引流量(ml)	插管时间(d)	住院时间(d)	切口满意度(分)
单孔VATS组(n＝22)	3.9±0.6	146.0±18.9	82.4±5.8	555.9±214.7	4.2±1.3	7.5±2.4	4.8±1.1
孔VATS组(n＝19)	8.7±0.7	150.3±15.8	81.2±4.2	615.2±208.6	4.6±1.0	8.7±1.9	2.6±1.8
t值	23.649	0.783	－0.748	0.894	1.091	1.755	－4.794
P值	<0.001	0.438	0.459	0.377	0.282	0.087	<0.001

组别	胸腔积液	肺不张	皮肤感觉异常
单孔VATS组(n＝22)	1(4.6)	1(4.6)	3(18.2)
三孔VATS组(n＝19)	5(26.3)	3(15.8)	9(47.4)
χ²值	2.866	1.198	7.213
P值	0.091	0.274	0.007

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