Jung Hanna, Oh Tak Hyuk, Cho Joon Yong, Lee Deok Heon
Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital, Kyungpook National University School of Medicine.
Korean J Thorac Cardiovasc Surg. 2017 Jun;50(3):184-189. doi: 10.5090/kjtcs.2017.50.3.184. Epub 2017 Jun 5.
The benefits of video-assisted thoracoscopic surgery (VATS) have been demonstrated over the past decades; as a result, VATS has become the gold-standard treatment for primary spontaneous pneumothorax (PSP). Due to improvements in surgical technique and equipment, single-port VATS (s-VATS) is emerging as an alternative approach to conventional three-port VATS (t-VATS). The aim of this study was to evaluate s-VATS as a treatment for PSP by comparing operative outcomes and recurrence rates for s-VATS versus t-VATS.
Between March 2013 and December 2015, VATS for PSP was performed in 146 patients in Kyungpook National University Hospital. We retrospectively reviewed the medical records of these patients.
The mean follow-up duration was 13.4±6.5 months in the s-VATS group and 28.7±3.9 months in the t-VATS group. Operative time (p<0.001), the number of staples used for the operation (p=0.001), duration of drainage (p=0.001), and duration of the postoperative stay (p<0.001) were significantly lower in the s-VATS group than in the t-VATS group. There was no difference in the overall recurrence-free survival rate between the s-VATS and t-VATS groups.
No significant differences in operative outcomes and recurrence rates were found between s-VATS and t-VATS for PSP. Therefore, we cautiously suggest that s-VATS may be an appropriate alternative to t-VATS in the treatment of PSP.
在过去几十年中,电视辅助胸腔镜手术(VATS)的优势已得到证实;因此,VATS已成为原发性自发性气胸(PSP)的金标准治疗方法。由于手术技术和设备的改进,单孔VATS(s-VATS)正在成为传统三孔VATS(t-VATS)的替代方法。本研究的目的是通过比较s-VATS与t-VATS的手术结果和复发率,评估s-VATS作为PSP的治疗方法。
2013年3月至2015年12月期间,庆北国立大学医院对146例PSP患者进行了VATS手术。我们回顾性分析了这些患者的病历。
s-VATS组的平均随访时间为13.4±6.5个月,t-VATS组为28.7±3.9个月。s-VATS组的手术时间(p<0.001)、手术用吻合钉数量(p=0.001)、引流时间(p=0.001)和术后住院时间(p<0.001)均显著低于t-VATS组。s-VATS组和t-VATS组的总体无复发生存率无差异。
s-VATS和t-VATS治疗PSP的手术结果和复发率无显著差异。因此,我们谨慎地建议,在PSP治疗中,s-VATS可能是t-VATS的合适替代方法。