Abstract
Purpose
The aim of the study was to evaluate the feasibility and compare the outcomes of single-incision thoracoscopic surgery using a chest wall pulley for lung excision (PulLE) vs. those of conventional video-assisted thoracic surgery (cVATS) in patients with primary spontaneous pneumothorax (PSP).
Methods
Sixty-nine patients who underwent PulLE (n = 34) or cVATS (n = 35) between January 2009 and December 2013 were enrolled in this study. PulLE was performed as follows. After making a 17- to 25-mm single incision in the 6th intercostal space (6ICS) at the median axillary line, the visceral pleura near the bulla was sutured for traction. The parietal pleura at 3ICS was then sutured from the thoracic cavity to serve as the chest wall pulley and a traction thread was passed through the pulley. By manipulating the traction thread, it was possible to move the lesion to an arbitrary site for excision. The postoperative scar was nearly invisible.
Results
The operative time, duration of postoperative drainage, and postoperative hospital stay were equivalent for PulLE vs. cVATS. There was no significant difference in postoperative recurrence rates.
Conclusions
PulLE has cosmetic benefits over cVATS and is easy to perform. We believe our novel procedure has the potential to become the standard operative treatment for PSP.
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References
Yamamoto H, Okada M, Takada M, Matsuoka H, Sakata K, Kawamura M. Video-Assisted Thoracic Surgery Through a Single Skin Incision. Arch Surg. 1998;133:145–7.
Rocco G, Martin-Ucar A, Passera E. Uniportal VATS wedge pulmonary resection. Ann Thorac Surg. 2008;77:726–8.
Salati M, Brunelli A, Xiume F, Refai M, Sciarra V, Soccetti A, Sabbatini A. Uniportal video-assisted thoracic surgery for spontaneous pneumothorax: clinical and economic analysis in comparison to the traditional approach. Interact Cardiovasc Thorac Surg. 2008;7:63–6.
Chen PR, Chen CK, Lin YS, Huang HC, Tsai JS, Chen CY, et al. Single-incision thoracoscopic surgery for primary spontaneous pneumothorax. J Cardiothorac Surg. 2011;6:58.
Berlanga LA, Gigirey O. Uniportal video-assisted thoracic surgery for primary spontaneous pneumothorax using a single-incision laparoscopic surgery port: a feasible and safe procedure. Surg Endosc. 2010;25:2044–7.
Tsuboshima K, Matoba Y, Sato M, Kobayashi I, Ohue H, Watanabe Y, Ohno T. Evaluation of 2 Ports Video-assisted Thoracoscopic Surgery (VATS) Using Endo-Close for Primary Spontaneous Pneumothorax. Kyobu Geka. 2013;66:210–3.
Ichinose J, Nakahara K, Kina S, Miyanaga S. One-port video-assisted thoracic surgery for pneumothorax using mini loop retractor. Kyobu Geka. 2010;63:371–4.
Conflict of interest
Kenji Tsuboshima, Teppei Wakahara, Yasumi Matoba, Harunori Miyauchi, Chikako Hayashi, Iwao Kobayashi, Hiroaki Ohue, Yoshihisa Watanabe, Toru Ono, and Yoshimasa Maniwa have no conflicts of interest or financial ties to disclosure.
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Tsuboshima, K., Wakahara, T., Matoba, Y. et al. Single-incision thoracoscopic surgery using a chest wall pulley for lung excision in patients with primary spontaneous pneumothorax. Surg Today 45, 595–599 (2015). https://doi.org/10.1007/s00595-014-0992-3
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DOI: https://doi.org/10.1007/s00595-014-0992-3