Minimally invasive approach to pneumothorax: Single port or two ports?

Abstract

ÖZAmaç: Bu çalışmada pnömotoraks olan hastalarda tek port ve iki port video yardımlı torakoskopik cerrahinin etkinliği karşılaştırıldı. Ça lış ma pla nı:Haziran 2016 -Aralık 2018 tarihleri arasında, spontan pnömotoraks nedeni ile hastanemizde video yardımlı torakoskopik cerrahi uygulanan toplam 44 hasta (39 erkek, 5 kadın; ort. yaş 27.0±9.5 yıl; dağılım, 15-60 yıl) retrospektif olarak değerlendirildi. Çalışma grubu operasyon sırasında uygulanan port giriş sayısına göre tek port (n=29) ve iki port (n=15) işlem olarak iki gruba ayrıldı. İki hasta grubu yaş, cinsiyet, drenaj gün sayısı, hastanede yatış süresi, hava kaçağı gün sayısı, ameliyat endikasyonu, pnömotoraks tarafı, pnömotoraks tipi, ameliyat süresi ve komplikasyonlar açısından karşılaştırıldı. Bul gu lar:Yirmi iki hasta (%50) sağ taraftan, 22 hasta (%50) sol taraftan ameliyat edildi. Ameliyat süresi ortalama 81.1±19.2 dk. olup, gruplar arasında anlamlı bir fark gözlenmedi (p= 0.053). İki grup arasında drenaj gün sayısı, hastanede yatış süresi ve hava kaçağı gün sayısı açısından anlamlı bir fark saptanmadı. Tek port grubunda sekiz hastada (%27.6) ve iki port grubunda beş hastada (%33.3) komplikasyon gelişti; gruplar arasında anlamlı bir fark bulunmadı (p= 0.475). So nuç:Çalışma sonuçlarımız video yardımlı torakoskopik cerrahinin tek port yaklaşımı ile pnömotoraks tedavisinde başarılı bir şekilde yapılabileceğini göstermektedir.Anah tarsöz cük ler: Pnömotoraks, tek port, video yardımlı torakoskopik cerrahi. ABSTRACTBackground: This study aims to compare the effectiveness of single-port and two-port video-assisted thoracoscopic surgery in patients with pneumothorax. Methods:Between June 2016 and December 2018, a total of 44 patients (39 males, 5 females; mean age 27.0±9.5 years; range, 15 to 60 years) who underwent video-assisted thoracoscopic surgery due to the spontaneous pneumothorax in our center were retrospectively evaluated. The study population was divided into two groups as the single-port (n=29) and two-port (n=15) procedure according to the number of port entries applied during the operation. Age, gender, number of days of drainage, length of hospitalization, number of days of air leak, the indication of operation, pneumothorax side, type of pneumothorax, duration of operation, and complications were compared between the groups.Results: Twenty-two patients (50%) were operated on the right side and 22 patients (50%) on the left side. The mean operation time was 81.1±19.2 min, indicating no significant difference between the groups (p= 0.053). No significant difference was observed in the number of days of drainage, the length of hospitalization, and number of days of air leak between the two groups. Complications developed in eight patients (27.6%) in the single-port group and five patients (33.3%) in the two-port group, indicating no significant difference between the groups (p= 0.475). Conclusion:Our study results show that video-assisted thoracoscopic surgery for the treatment of pneumothorax can be successfully performed via a single-port approa...

Uniportal versus multiportal video-assisted thoracoscopic surgery for spontaneous pneumothorax

“…Standardized mean difference in length of hospital stay was − 0.39 days and − 0.68 days in chest drainage duration. Studies conducted after this meta-analysis, including a propensity matched study of prospectively collected data by Nachira et al (2018), confirm these results [16,[22][23][24][25][26][27]. This is also in line with the metaanalysis by Abouarab et al (2018), evaluating the effect of uVATS on perioperative outcomes in the broad field of thoracic surgery [28].…”

Minimally invasive approach to pleural empyema: uniportal or biportal?

“…Early surgical intervention was also shown to significantly reduce the length of hospital stay, costs, and mortality and morbidity rates, especially in patients with stage 2 and stage 3 empyema [12]. A few studies in the literature compare the effectiveness and outcomes of U-VATS and B-VATS in pneumothorax patients [13][14][15]. There are also reports in the literature of the results and features of lung resection performed with U-VATS [16,17].…”