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首页> 外文期刊>Surgical Endoscopy >A prospective study comparing three-port video-assisted thoracoscopy with the single-incision laparoscopic surgery (SILS) port and instruments for the video thoracoscopic approach: a pilot study.
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A prospective study comparing three-port video-assisted thoracoscopy with the single-incision laparoscopic surgery (SILS) port and instruments for the video thoracoscopic approach: a pilot study.

机译：一项前瞻性研究将三端口电视胸腔镜与单切口腹腔镜手术（SILS）端口和视频胸腔镜方法的仪器进行了比较：一项试点研究。

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Single-incision laparoscopic surgery (SILS) has proved its advantages in several procedures, mainly a shorter hospital stay, improved aesthetic results, and less postoperative pain. The authors have used this approach for several thoracic surgical procedures.This prospective study compared 20 cases between standard three-port video-assisted thoracic surgery (VATS) and the single-incision approach using a standard abdominal SILS system. In both groups, postsurgical analgesia was provided with 15 ml of bupivacaine 0.5% at 3 h intervals via a paravertebral catheter. The hospital length of stay and chest drain duration (in hours) were recorded as well as postoperative pain using an analogic visual pain scale (AVPS). A telephone survey was conducted for all the outpatients. The Mann-Whitney U test was used for statistical analysis.This study of 20 procedures included 11 lung biopsies, 6 pneumothorax procedures, 2 mediastinic cystectomies, and 1 catamenial pneumothorax procedure. No statistically significant difference was reported in hospital length of stay or chest drain duration between the two groups. However, postoperative pain at 24 h was significantly less in the SILS group (AVPS, 4.40) than in the VATS group (AVPS, 6.20) (p = 0.035). The SILS group reported two minor surgical wound complications and one catamenial pneumothorax recurrence that did not require drainage. The VATS group reported one case of skin rash with no identifiable cause.The use of the SILS port in thoracic surgery results in less postoperative pain. This is related to the port's protective effect over the periostium and the intercostal nerve, relieving them of direct contact with surgical instruments. However, the findings showed a higher incidence of surgical wound complications with the SILS port, which can be attributed to increased pressure on the skin and soft tissues surrounding the port and to the fact that this same incision was used for chest drain placement, thus increasing the risk for complications.
机译：单切口腹腔镜手术（SILS）已在多种手术中证明了其优势，主要是缩短了住院时间，改善了美容效果并减轻了术后疼痛。作者将这种方法用于多种胸外科手术。这项前瞻性研究比较了标准三孔电视胸腔镜手术（VATS）与采用标准腹部SILS系统的单切口方法之间的20例病例。在两组中，均通过椎旁导管在术后3h间隔内给予15 ml 0.5％布比卡因镇痛。使用类比视觉疼痛量表（AVPS）记录医院的住院时间和胸水持续时间（小时），以及术后疼痛。对所有门诊病人进行了电话调查。采用Mann-Whitney U检验进行统计分析。该研究共20项研究，包括11例肺活检，6例气胸手术，2例纵隔膀胱切除术和1例月经气胸手术。两组之间的住院时间或胸腔引流持续时间均无统计学差异。但是，SILS组（AVPS，4.40）在24小时时的术后疼痛明显低于VATS组（AVPS，6.20）（p = 0.035）。 SILS组报告了2例较小的手术伤口并发症和1例无需引流的月经期气胸复发。 VATS组报告了1例皮疹，无可查明原因。在胸外科中使用SILS端口可减少术后疼痛。这与端口对骨膜和肋间神经的保护作用有关，从而减轻了它们与手术器械的直接接触。但是，研究结果表明，SILS口的手术伤口并发症发生率较高，这可能是由于该口周围的皮肤和软组织上的压力增加以及该切口用于放置胸腔引流的事实，从而增加了发生并发症的风险。

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