Evaluation of different minimally invasive approaches in thoracoscopic management of spontaneous pneumothorax

Abstract

Background: Pneumothorax is one of the most prevalent diseases facing thoracic surgeons. Spontaneous pneumothorax could be primary, if not associated with underlying lung disease, or secondary spontaneous pneumothorax when there is underlying pulmonary pathology. Surgical excision of bullae and diseased lungs is usually indicated in recurrent pneumothorax, bilateral disease, occupation at risk like pilots, even after the first attack, and a patient with persistent air leak after chest tube insertion for more than 7days.Aim of the study: The aim of our study was to evaluate the advantage of performing single-port thoracoscopy versus multiple-port VATS in the treatment of spontaneous pneumothorax regarding operative parameters, postoperative course, and pain score. Results: Regarding the epidemiological data, there were no statistically significant difference between both group as the mean age in group A was 26.50 ± 8.25 years; while it was 31.90 ± 6.36 years in Group B. Regarding the intraoperative parameters and findings in group A, apical blebs were found in 13 patients (65%), 20% of the patients had no clear pathology, two patients revealed apical bullae, and only one patient (5%) had segmental atelectasis. Conclusion: Thoracoscopic bullectomy, either by single port or multiple ports, for the treatment of spontaneous pneumothorax is a safe and feasible approach. Our study declared that there was no clear advantage of either approach over the other, except for a minor, non-significant advantage in the VAS score in the single port VATS versus the multiport one.