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首页> 外文期刊>Surgical Endoscopy >Uniportal video-assisted thoracic surgery for primary spontaneous pneumothorax using a single-incision laparoscopic surgery port: a feasible and safe procedure.
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Uniportal video-assisted thoracic surgery for primary spontaneous pneumothorax using a single-incision laparoscopic surgery port: a feasible and safe procedure.

机译：使用单切口腹腔镜手术端口进行的单门电视辅助胸腔镜手术治疗原发性自发性气胸：一种可行且安全的程序。

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BACKGROUND: Recent authors have pioneered the use of single-incision laparoscopic surgery (SILS) for umbilical cholecystectomy. The SILS approach has the potential of reducing the trauma of the surgical access and postoperative pain. Video-assisted thoracic surgery (VATS) greatly reduces patient postoperative pain compared with traditional thoracotomy incisions. The current trend is to use fewer working ports to reduce even more postoperative pain, chest wall paresthesia, and hospital stay. No reports have described using a SILS port in VATS. METHODS: From September 2009 to March 2010, 13 patients had surgery for primary spontaneous pneumothorax. The patients underwent single-lung ventilation. A 2.5-cm-long incision was made at the sixth intercostal space in the median axillary line. The pleural space was entered by blunt dissection for placement of a single flexible port. A 5-mm 0 degrees videothoracoscope, a roticulating grasper, and an endoGIA stapler were introduced through port channels. Apical lung blebs were stapled, and pleurodesis by pleural abrasion with Marlex mesh was performed. RESULTS: The study enrolled nine men (69.2%) and four women with a median age of 26.3 years. No complications were recorded. The postoperative pain was mild for 10 patients (76.9%) and moderate for 3 patients. Mild chest wall paresthesia (numbness) was observed in three patients (23.07%). The postoperative hospital stay was 2.15 days. CONCLUSIONS: Although the SILS port is for laparoscopic use, it allowed an adequate lineup of the instruments along the intercostal space and adequate instrument maneuverability for stapling and resecting of apical lung bullae or blebs. The procedure was accomplished successfully for 92.3% of the patients. This is the first report on the use of a SILS port in VATS. Further work and development of a proper thoracic single port are needed to define the uses and advantages of this uniportal technique.
机译：背景：最近的作者开创了单切口腹腔镜手术（SILS）用于脐胆囊切除术的应用。 SILS方法具有减少手术通道创伤和术后疼痛的潜力。与传统的开胸切口相比，视频胸腔镜手术（VATS）大大减轻了患者的术后痛苦。当前的趋势是使用更少的工作端口以减轻甚至更大的术后疼痛，胸壁感觉异常和住院时间。 VATS中没有使用SILS端口描述任何报告。方法：2009年9月至2010年3月，有13例因原发性自发性气胸手术。患者接受单肺通气。在腋中线的第六肋间隙切开一个2.5厘米长的切口。通过钝性解剖进入胸膜空间以放置单个柔性端口。通过端口通道引入了5毫米0度视频胸腔镜，旋转抓紧器和endoGIA订书机。钉住顶端的肺泡，并用Marlex网格通过胸膜擦伤进行胸膜固定术。结果：该研究招募了9名男性（69.2％）和4名女性，中位年龄为26.3岁。没有并发症的记录。术后疼痛轻度为10例（76.9％），中度为3例。三例患者（23.07％）出现轻度胸壁感觉异常（麻木）。术后住院时间为2.15天。结论：尽管SILS口用于腹腔镜检查，但沿肋间空间有足够的器械排列，并且有足够的器械可操作性可用于钉扎和切除顶端肺大疱或小泡。该程序成功完成了92.3％的患者。这是有关在VATS中使用SILS端口的第一份报告。需要进一步的工作和开发合适的胸腔单孔来定义这种单孔技术的用途和优点。

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