Abstract
BackgroundThe transthoracic thoracoscopic surgery is currently accepted as a favorable technique for bullectomy for primary spontaneous pneumothorax. Recently, uniportal subxiphoid thoracoscopic surgery has been proposed as an alternative to conventional transthoracic thoracoscopic surgery.MethodsFrom November 2014 and January 2016, 127 consecutive patients who met the inclusion criteria were enrolled in this study. Among these patients, 32 were treated using subxipoid approach, whereas 95 were treated using transthoracic approach. Propensity score case-matching was performed to adjust for patient backgrounds.ResultsThe two groups of 32 pairs were well matched for baseline and surgical characteristics. Patients who underwent subxipoid approach had a longer operation time than transthoracic approach (p = 0.004). The subgroup analysis showed that the operation time for bilateral bullectomy was similar between the groups (p = 0.986). There were no differences between the groups with respect to the hospital stay after surgery, chest drain duration, the number of the staples used for the operation, and postoperative recurrence. However, the provoked arrhythmias events during surgery were significantly higher in the subxiphoid approach group (p = 0.011).ConclusionsAlthough transthoracic thoracoscopic surgery for spontaneous pneumothorax is well established, uniportal subxiphoid thoracoscopic surgery may be a potentially alternative way to management of patients with spontaneous pneumothorax in selected cases, especially for bilateral surgery, but causions should be taked.
Highlights
The transthoracic thoracoscopic surgery is currently accepted as a favorable technique for bullectomy for primary spontaneous pneumothorax
Spontaneous pneumothorax is defined as the presence of gas in the pleural space which is between the chest wall and the lung [1]
Between November 2014 and January 2016, we retrospectively reviewed the surgical records of 127 consecutive patients with spontaneous pneumothorax who received thoracoscopic surgery at Nanjing chest hospital
Summary
Between November 2014 and January 2016, we retrospectively reviewed the surgical records of 127 consecutive patients with spontaneous pneumothorax who received thoracoscopic surgery at Nanjing chest hospital. The exclusion criteria for this study include a history of lung diseases, such as chronic obstructive pulmonary disease, pulmonary tuberculosis and a history of ipsilateral thoracic surgery. The difference of these two methods, such as incisions, surgical risks, and potential complications were fully introduced to each patient before operation. A 1–1 ratio was used for the present propensity score matching. Categorical variables of the two groups of propensity score-matched patients were compared by chi-square test or the Fisher’s exact test and continuous variables were compared by independent-samples t-test. A p < 0.05 with two-sided was considered statistically significant
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