Abstract
We aimed to assess the perioperative outcomes of single-incision video-assisted thoracoscopic surgery (VATS) using pulley of chest wall for lung excision (PulLE) in patients with primary spontaneous pneumothorax (PSP) compared to conventional two- or three-port VATS in our hospital. Fifty-two patients (10 PulLE and forty-two conventional VATS) were enrolled in this study from 2009.
The PulLE procedure was performed as follows for straightforward cases: The patient was placed in a lateral position. A 17~25-mm single incision at the level of the 6th intercostal space (ICS) at the median axillary line was made and LAPPROTECTOR (HAKKO CO.) was placed for this procedure. The visceral pleura near the bulla was sutured for traction. The parietal pleura at the level of the 3 ICS at the anterior axillary line was sutured from the thoracic cavity as the pulley of the chest wall, and the traction thread was passed through the pulley. By manipulation of the traction thread, it was possible to move the lesion to an arbitrary place for excision by autosutures. The postoperative wound was almost invisible using this method.
Compared with conventional VATS, equivalent results were obtained with PulLE: operation time (76.1±25.0 vs. 67.0±22.7 min, NS), blood loss (2.8±1.9 vs. 5.4±4.2 ml, NS), duration of drainage after operation (1.0±0 vs.1.4±1.2 days, NS), postoperative hospital stay (3.8±2.5 vs. 3.9±2.0 days, NS), respectively.In conclusion, PulLE proved to be feasible as a surgical treatment for straightforward PSP.
