Comparison of single-port vs. two-port VATS technique for primary spontaneous pneumothorax

Video-assisted thoracoscopic surgery (VATS) has been used for thoracic surgery for about two decades. As the trend in VATS is to use fewer ports to decrease postoperative complications, we compared the results of our experience with single-port and two-port VATS for primary spontaneous pneumothorax (PSP).

This is a non-randomized retrospective study. From January 2017 to December 2018, 104 patients with PSP underwent VATS. Fifty-six patients received single-port VATS and 48 patients received two-port VATS. Operation time, blood loss, number of staplers used, drainage time, postoperative hospital stay, complications, chest wall paresthesia, visual analog scale (VAS) pain scores, and patient satisfaction scale scores were compared between the two groups.

There was no difference in age, gender, body mass index (BMI), smoking status, surgical indication, and involved side between the two groups. The procedures performed in the single-port group were similar to those performed in the two-port group. No significant difference was found in operation time, blood loss, number of staplers used, drainage time, and recurrence rate. The rate of chest wall paresthesia was lower in the single-port group than in the two-port group (28.6 vs. 52.1%, p = .014). The VAS scores in the single-port group were lower than those in the two-port group at 24 and 48 h (p = .032 and p = .004).

Compared with two-port VATS, single-port VATS for PSP showed more favorable results in terms of postoperative paresthesia and pain. The single-port procedure may be considered a good alternative to the standard thoracoscopic treatment of PSP. Abbreviations: VATS: Video-assisted thoracic surgery; PSP: primary spontaneous pneumothorax.