The use of single incision thoracoscopic surgery in diagnostic and therapeutic thoracic surgical procedures

Acta Chir Belg. Jan-Feb 2013;113(1):25-9. doi: 10.1080/00015458.2013.11680880.

Abstract

Background: As a minimal invasive procedure, a standard threeportal videothoracoscopy may have complications such as chronic and residual pain. However, a single incision thoracoscopic surgery is a less invasive procedure with minimal complications. We present our series of patients who had single incision thoracoscopic surgical procedures.

Patients and methods: A total of 49 patients, 29 (59.2%) male and 20 (40.8%) female with a mean age of 45.7 +/- 17.6 years (range, 16 to 86 years) underwent a total of 59 single incision thoracoscopic surgical procedures. We most often made a 2-2.5 cm single incision on the seventh or eighth intercostal space at the midaxillary line. VAS (Visual analogue scale) scores for pain at postoperative day 1 and the mean of chest tube removal times were recorded for each procedure. The patients were discharged following chest tube removal.

Results: We performed an overall of 59 procedures including 8 (13.7%) wedge resections for either histologic diagnosis or spontaneous pneumothorax, 4 (6.8%) pleural biopsies, 23 (38.9%) pleurectomies, 9 (15.2%) deloculation and decortications, 5 (8.6%) traumas in and 10 (17.5%) sympathectomies. No patient required an additional thoracoscopic port or conversion to thoracotomy. The overall mean of postoperative VAS scores for all procedures at postoperative day 1 and day 30 were 3.2 +/- 0.9 and 1.4 +/- 0.5, respectively (p <0.0001). The overall mean of chest tube removal time was 2.3 +/- 0.8 days (median; 2). We observed neither morbidity nor mortality.

Conclusions: In selected patients, single incision thoracoscopic surgery is an effective and a safe procedure with lower levels of pain and shorter hospital stay. A wide spectrum of thoracic surgical procedures can be performed with the use of single incision thoracoscopic surgery.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Lung Diseases / diagnosis
  • Lung Diseases / surgery
  • Male
  • Middle Aged
  • Pain Measurement
  • Pneumothorax / surgery
  • Thoracic Surgery, Video-Assisted / methods
  • Thoracic Surgical Procedures / methods*
  • Thoracoscopy / methods*
  • Young Adult