Abstract
BackgroundDue to improvements in operative techniques and medical equipment, video-assisted thoracoscopic surgery has become a mainstay of thoracic surgery. Nevertheless, in multiport thoracoscopic surgery, there have been no substantial advances related to the improvement of the esthetics of the site of the chest tube kept for postoperative drainage of intrathoracic fluid and decompression of air leak after thoracoscopic surgery. Leakage of fluid and air around the site of the chest tube can be extremely bothersome to patients.Methods From March 2019 to April 2020, we used a modified technique of closing the port site in 67 patients and the traditional method in 51 patients undergoing multiport thoracoscopic surgery due to lung disease or mediastinal disease. We recorded patients’ age, gender, body mass index, surgical method, postoperative drainage time, and postoperative complications.The NRS pain scale was used to score the pain in each patient on the day of extubation.The PSAS and the OSAS were used for the assessment of scars one month after surgery.ResultsIn the modified technique group, only one patient (1.49%) had pleural effusion leakage, compared with five patients (9.80%) in the traditional method group (P < 0.05). There were no significant differences in the pain of extubating and wound dehiscence between the two groups. However,the incidence rates of wound dehiscence in the modified technique group were lower than in the traditional method group. There were no post-removal pneumothorax and wound infection in either of the groups. Significant differences in the PSAS and OSAS were observed between the groups,where the modified technique group was superior to the traditional method group.ConclusionsThe modified technique of port site closure is a leak-proof method of fixation of the chest tube after multiport thoracoscopic surgery. Moreover, it is effective and preserves the esthetic appearance of the skin.
Highlights
Due to improvements in operative techniques and medical equipment, video-assisted thoracoscopic surgery has become a mainstay of thoracic surgery
A total of 51 patients received the traditional method of fixation of the chest tube using two nonabsorbable sutures to close the skin on each side of the drainage tube by another team
The modified technique group was superior to the traditional method group(1.49 % vs. 9.80 %)
Summary
Due to improvements in operative techniques and medical equipment, video-assisted thoracoscopic surgery has become a mainstay of thoracic surgery. In multiport thoracoscopic surgery, there have been no substantial advances related to the improvement of the esthetics of the site of the chest tube kept for postoperative drainage of intrathoracic fluid and decompression of air leak after thoracoscopic surgery. There are different approaches to video-assisted thoracoscopic surgery, such as multiport and uniport approaches. Since Gonzales first reported uniport thoracoscopy for a lobectomy in 2011 [1], different operative procedures [2, 3] and techniques for fixation of postoperative drainage tubes [4, 5] have attracted attention. Xu et al BMC Surg (2021) 21:223 have been no substantial improvements in the esthetic management of the port site or in the optimal means of assuring an adequate watertight fixation of the chest tube to prevent leakage of fluid or air around the postoperative drainage tube. We shared our experience using a new method of thoracoscopy port site closure that improves both the esthetic appearance of thoracoscopy port site and the fixation and function of the postoperative chest tube
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