Fung Stephen, Jaber Kefah, Kivilis Marius, Rehders Alexander, Schauer Anja, Dizdar Levent, Knoefel Wolfram-Trudo
Department of Surgery, University Hospital Duesseldorf and Heinrich-Heine-University Duesseldorf, 40225 Duesseldorf, Germany.
J Clin Med. 2022 Mar 4;11(5):1404. doi: 10.3390/jcm11051404.
Two-port (2P) and three-port (3P) video-assisted thoracoscopic surgery (VATS) are well-established surgical methods for the treatment of complicated spontaneous pneumothorax (SP). However, a comparison between both techniques, in terms of clinical outcomes in patients with secondary spontaneous pneumothorax (SSP), is unreported. The aim of this study was to evaluate and compare postoperative pain, as well as clinical outcome, following 2P and 3P VATS for SSP in our institution.
Between January 2008 and December 2020, we retrospectively analyzed the data of 115 SSP patients treated by VATS in our institution. Fifty-two patients underwent 2P-VATS, while 63 patients were treated by 3P-VATS. The total dose of analgesic use per stay (opioid and non-opioid), length of hospital stay (LOS), operation time, total area of pleurectomy, recurrence rates and postoperative complications were compared between both groups.
The 3P-VATS group had a significantly higher total dose of analgesic use compared with the 2P-VATS patients. The LOS and mean operation time were significantly shorter in the 2P-VATS group. A larger area of pleurectomy was resected using 3P-VATS compared to 2P-VATS. The postoperative complications and recurrence of SSP during a median follow-up period of 76.5 months were similar in both groups.
2P-VATS is a safe surgical technique. It is associated with a short LOS and less postoperative pain, and, thus, low analgesic use.
两孔（2P）和三孔（3P）电视辅助胸腔镜手术（VATS）是治疗复杂性自发性气胸（SP）的成熟手术方法。然而，关于这两种技术在继发性自发性气胸（SSP）患者临床结局方面的比较尚无报道。本研究的目的是评估和比较我院采用2P和3P VATS治疗SSP后的术后疼痛及临床结局。
回顾性分析2008年1月至2020年12月期间我院115例接受VATS治疗的SSP患者的数据。52例患者接受2P-VATS，63例患者接受3P-VATS。比较两组患者每次住院的镇痛药总用量（阿片类和非阿片类）、住院时间（LOS）、手术时间、胸膜切除术总面积、复发率和术后并发症。
与2P-VATS患者相比，3P-VATS组的镇痛药总用量显著更高。2P-VATS组的LOS和平均手术时间显著更短。与2P-VATS相比，3P-VATS切除的胸膜切除术面积更大。两组在中位随访期76.5个月期间的术后并发症和SSP复发情况相似。
2P-VATS是一种安全的手术技术。它与较短的LOS和较少的术后疼痛相关，因此镇痛药用量较低。
