两孔法与标准三孔法胸腔镜手术治疗原发性自发性气胸的比较

Comparison of Two-port and standard three-port video-assisted thoracoscopic surgery in treatment of primary spontaneous pneumothorax

目的探讨两孔法胸腔镜手术在治疗原发性自发性气胸中的价值。方法分析我院127例原发性自发性气胸患者,均经胸腔镜手术治疗,其中58例采用两孔法胸腔镜手术治疗(两孔法组),69例采用标准三孔法胸腔镜手术治疗(三孔法组)。比较两组的手术时间、手术出血量、伤口长度、术后胸腔闭式引流时间、术后VAS疼痛评分、术后住院时间。结果两组患者均成功经胸腔镜完成手术,两组之间的手术时间、手术出血量、术后胸腔闭式引流时间、术后住院时间无明显差别;两孔法组伤口长度较三孔法组短,两孔法组术后VAS疼痛评分较三孔法组低。结论两孔法胸腔镜行自发性气胸手术不增加手术操作难度,且能更有效减轻患者疼痛,减少手术创伤,增加患者满意度。

Objective To determine the role of two-port video-assisted thoracoscopic surgery in spontaneous pneumothorax （PSP）. Methods From September 2007 to March 2011, 127 patients with primary spontaneous pneumothorax were treated by VATS. 58 received two-port video-assisted thoracoscopic surgery （two-port group）, and the other 69 received standard three-port video-assisted thora- coscopic surgery （three-port group） . The operative time, blood loss, wound size, visual analog scale （VAS） pain score, postoperative drainage time, postoperative hospital stay between the two groups were compared. Results All 127 operations were performed successfully by VATS. There were no significant differences in operative time, blood loss, postoperative drainage time, and postoperative hospital stay between the two groups. The wound size of two-port group were shorter than that of three-port group. The VAS pain scores were significantly better in two-port group. Conclusion Two-port VATS and three-port VATS are equally effective for the treatment of PSP. Two-port VATS has fewer scars. It can decreased postoperative pain and offer the patient more satisfaction.