Kara M, Alzafer S, Okur E, Halezeroğlu S
Department of General Thoracic Surgery, Acibadem University School of Medicine, Istanbul, Turkey.
Acta Chir Belg. 2013 Jan-Feb;113(1):25-9. doi: 10.1080/00015458.2013.11680880.
As a minimal invasive procedure, a standard threeportal videothoracoscopy may have complications such as chronic and residual pain. However, a single incision thoracoscopic surgery is a less invasive procedure with minimal complications. We present our series of patients who had single incision thoracoscopic surgical procedures.
A total of 49 patients, 29 (59.2%) male and 20 (40.8%) female with a mean age of 45.7 +/- 17.6 years (range, 16 to 86 years) underwent a total of 59 single incision thoracoscopic surgical procedures. We most often made a 2-2.5 cm single incision on the seventh or eighth intercostal space at the midaxillary line. VAS (Visual analogue scale) scores for pain at postoperative day 1 and the mean of chest tube removal times were recorded for each procedure. The patients were discharged following chest tube removal.
We performed an overall of 59 procedures including 8 (13.7%) wedge resections for either histologic diagnosis or spontaneous pneumothorax, 4 (6.8%) pleural biopsies, 23 (38.9%) pleurectomies, 9 (15.2%) deloculation and decortications, 5 (8.6%) traumas in and 10 (17.5%) sympathectomies. No patient required an additional thoracoscopic port or conversion to thoracotomy. The overall mean of postoperative VAS scores for all procedures at postoperative day 1 and day 30 were 3.2 +/- 0.9 and 1.4 +/- 0.5, respectively (p <0.0001). The overall mean of chest tube removal time was 2.3 +/- 0.8 days (median; 2). We observed neither morbidity nor mortality.
In selected patients, single incision thoracoscopic surgery is an effective and a safe procedure with lower levels of pain and shorter hospital stay. A wide spectrum of thoracic surgical procedures can be performed with the use of single incision thoracoscopic surgery.
作为一种微创手术，标准的三孔电视胸腔镜手术可能会出现慢性和残留疼痛等并发症。然而，单切口胸腔镜手术是一种侵入性较小的手术，并发症极少。我们展示了我们一系列接受单切口胸腔镜手术的患者。
共有49例患者，男性29例（59.2%），女性20例（40.8%），平均年龄45.7±17.6岁（范围16至86岁），共接受了59例单切口胸腔镜手术。我们最常在腋中线第七或第八肋间做一个2 - 2.5厘米的单切口。记录每个手术术后第1天的疼痛视觉模拟评分（VAS）以及胸管拔除时间的平均值。患者在胸管拔除后出院。
我们总共进行了59例手术，包括8例（13.7%）用于组织学诊断或自发性气胸的楔形切除术、4例（6.8%）胸膜活检、23例（38.9%）胸膜切除术、9例（15.2%）粘连松解和剥脱术、5例（8.6%）胸腔内创伤以及10例（17.5%）交感神经切除术。没有患者需要额外的胸腔镜端口或转为开胸手术。所有手术术后第1天和第30天的术后VAS评分总体平均值分别为3.2±0.9和1.4±0.5（p<0.0001）。胸管拔除时间的总体平均值为2.3±0.8天（中位数；2天）。我们未观察到任何发病率或死亡率。
对于选定的患者，单切口胸腔镜手术是一种有效且安全的手术，疼痛程度较低且住院时间较短。使用单切口胸腔镜手术可以进行广泛的胸外科手术。
