Can single-incision thoracoscopic surgery using a wound protector be used as a first-line approach for the surgical treatment of primary spontaneous pneumothorax? A comparison with three-port video-assisted thoracoscopic surgery.

Abstract

In this study, we compared single-incision thoracoscopic surgery (SITS) using a wound protector, with three-port video-assisted thoracoscopic surgery (VATS) to investigate whether it can be used as a first-line approach for primary spontaneous pneumothorax (PSP). We retrospectively reviewed and analyzed the medical records of patients who were diagnosed with PSP in our hospital between March 2013 and January 2014 who underwent SITS (n = 37) or three-port VATS (n = 23). There was no significant difference between the patients who underwent SITS and those who underwent three-port VATS in terms of their age, gender, number of episodes, pneumothorax laterality, operation time, number of wedge resection, duration of post-operative hospital stay and post-operative drainage, and complications. The post-operative pain score was significantly lower in the SITS group compared to the three-port group at both 24 and 72 h (3.9 ± 1.2 vs. 5.2 ± 1.3, p = 0.022, 2.5 ± 1.5 vs. 3.9 ± 1.8, p = 0.03). There was no statistically significant difference in the use of additional intramuscular analgesia between the two groups, but it was lower in the SITS group. We consider that SITS using a wound protector is an appropriate first-line surgical approach for PSP.