Single-incision thoracoscopic surgery for primary spontaneous pneumothorax using the SILS port compared with conventional three-port surgery
Background Single-incision thoracoscopic surgery (SITS) is postulated to cause less incisional pain, less paresthesia, and less wound scarring than the conventional three-port approach. The difficulties performing the technique have prevented it from being widely accepted. This study shows how the a...
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| Veröffentlicht in: | Surgical endoscopy 2013, Vol.27 (1), p.139-145 |
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| description | Background
Single-incision thoracoscopic surgery (SITS) is postulated to cause less incisional pain, less paresthesia, and less wound scarring than the conventional three-port approach. The difficulties performing the technique have prevented it from being widely accepted. This study shows how the authors overcame the difficulties by using the SILS port and proved it to be a safe and useful procedure for the treatment of primary spontaneous pneumothorax (PSP).
Methods
The same surgeon operated on all the patients using the three-port technique (
n
= 13) and SITS (
n
= 27) under the same procedural and management policy. The two groups were retrospectively compared in terms of operation time, postoperative complications, hospital stay, pain score, residual paresthesia, satisfaction regarding the wound scar, and surgical material cost.
Results
The mean age, sex ratio, and previous pneumothorax episodes were similar between the two groups. The uniport and three-port groups did not differ statistically in terms of mean operation time (74.6 ± 22.8 vs 72.4 ± 20.2 min;
p
= 0.77), hospital stay (2.3 ± 0.7 vs 2.5 ± 0.8 days;
p
= 0.72), visual analog pain scale (on the day of surgery: 4.1 ± 1.7 vs 4.8 ± 2.2,
p
= 0.26; on day 1: 3.2 ± 1.4 vs 2.8 ± 1.4,
p
= 0.33; on day 2: 2.7 ± 1.0 vs 2.6 ± 1.1,
p
= 0.61), or total surgical material cost (US$1,810 ± $320 vs $1,741 ± $329;
p
= 0.58). However, the uniport group had a lower incidence of paresthesia than the three-port group (33.3 vs 76.9 %;
p
= 0.01) and showed a higher satisfaction rate regarding wound scarring (70.4 vs 30.7 %;
p
= 0.03).
Conclusions
Compared with the three-port approach, SITS using the SILS port in PSP patients proved to be a safe and feasible procedure that can be clinically implemented without additional economic burden or operation time. Additionally, SITS showed better cosmesis with minimized neurologic sequelae, which contributed to higher satisfaction among patients. Progress in uniport instruments and surgical experience will lead to wider applications of SITS. |
| doi_str_mv | 10.1007/s00464-012-2381-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1273742022</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1273742022</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-cb543b970014711775d47b3cca3b0c12236044e3ddda2910d46923162c8046d73</originalsourceid><addsrcrecordid>eNp1kc1O6zAQhS0EglJ4ADZXltiwMYx_GjdLhPiTKrEorK3EcSEosXPt5ALvwEMzNAWhK7GyR_7OGc8cQo44nHIAfZYAVKYYcMGEnHOWbZEJVxIrwefbZAK5BCZ0rvbIfkrPgHjOZ7tkT4gsFyidkPdl7R8bx2pv61QHT_unEAsbkg1dbWka4qOLb3QVIu1i3RZ4T13wfeFdGBLtvBvasNa80iGhFxo4urxdLGkXYk9taLsiuoq-1P0TVv6f8z32KRoEo3NsTW3aHJCdVdEkd7g5p-Th6vL-4oYt7q5vL84XzEotembLmZJlrgG40pxrPauULqW1hSzBciFkBko5WVVVIXIOlcJpJc-EneO-Ki2n5GT07WL4O7jUm7ZO1jXNOJXhQkutBKDTlBz_hz6HIeL31xRImc1nEik-UjaGlKJbmc2yDAfzGZUZozIYlfmMymSo-bNxHsrWVd-Kr2wQECOQ8Mnjfn60_tX1A4BQoIQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1270336853</pqid></control><display><type>article</type><title>Single-incision thoracoscopic surgery for primary spontaneous pneumothorax using the SILS port compared with conventional three-port surgery</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Yang, Hee Chul ; Cho, Sukki ; Jheon, Sanghoon</creator><creatorcontrib>Yang, Hee Chul ; Cho, Sukki ; Jheon, Sanghoon</creatorcontrib><description>Background
Single-incision thoracoscopic surgery (SITS) is postulated to cause less incisional pain, less paresthesia, and less wound scarring than the conventional three-port approach. The difficulties performing the technique have prevented it from being widely accepted. This study shows how the authors overcame the difficulties by using the SILS port and proved it to be a safe and useful procedure for the treatment of primary spontaneous pneumothorax (PSP).
Methods
The same surgeon operated on all the patients using the three-port technique (
n
= 13) and SITS (
n
= 27) under the same procedural and management policy. The two groups were retrospectively compared in terms of operation time, postoperative complications, hospital stay, pain score, residual paresthesia, satisfaction regarding the wound scar, and surgical material cost.
Results
The mean age, sex ratio, and previous pneumothorax episodes were similar between the two groups. The uniport and three-port groups did not differ statistically in terms of mean operation time (74.6 ± 22.8 vs 72.4 ± 20.2 min;
p
= 0.77), hospital stay (2.3 ± 0.7 vs 2.5 ± 0.8 days;
p
= 0.72), visual analog pain scale (on the day of surgery: 4.1 ± 1.7 vs 4.8 ± 2.2,
p
= 0.26; on day 1: 3.2 ± 1.4 vs 2.8 ± 1.4,
p
= 0.33; on day 2: 2.7 ± 1.0 vs 2.6 ± 1.1,
p
= 0.61), or total surgical material cost (US$1,810 ± $320 vs $1,741 ± $329;
p
= 0.58). However, the uniport group had a lower incidence of paresthesia than the three-port group (33.3 vs 76.9 %;
p
= 0.01) and showed a higher satisfaction rate regarding wound scarring (70.4 vs 30.7 %;
p
= 0.03).
Conclusions
Compared with the three-port approach, SITS using the SILS port in PSP patients proved to be a safe and feasible procedure that can be clinically implemented without additional economic burden or operation time. Additionally, SITS showed better cosmesis with minimized neurologic sequelae, which contributed to higher satisfaction among patients. Progress in uniport instruments and surgical experience will lead to wider applications of SITS.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-012-2381-6</identifier><identifier>PMID: 22692464</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Abdominal Surgery ; Adult ; Chest tubes ; Cicatrix - psychology ; Feasibility Studies ; Female ; Gastroenterology ; Gynecology ; Hepatology ; Hospitals ; Humans ; Laparoscopy ; Length of Stay ; Male ; Medicine ; Medicine & Public Health ; Operative Time ; Pain ; Patient Satisfaction ; Patients ; Pneumothorax ; Pneumothorax - psychology ; Pneumothorax - surgery ; Postoperative Care - methods ; Postoperative Complications - etiology ; Proctology ; Retrospective Studies ; Surgeons ; Surgery ; Thoracic surgery ; Thoracic Surgery, Video-Assisted - methods ; Thoracic Surgery, Video-Assisted - psychology ; Young Adult</subject><ispartof>Surgical endoscopy, 2013, Vol.27 (1), p.139-145</ispartof><rights>Springer Science+Business Media, LLC 2012</rights><rights>Springer Science+Business Media New York 2013</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-cb543b970014711775d47b3cca3b0c12236044e3ddda2910d46923162c8046d73</citedby><cites>FETCH-LOGICAL-c372t-cb543b970014711775d47b3cca3b0c12236044e3ddda2910d46923162c8046d73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-012-2381-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-012-2381-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22692464$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yang, Hee Chul</creatorcontrib><creatorcontrib>Cho, Sukki</creatorcontrib><creatorcontrib>Jheon, Sanghoon</creatorcontrib><title>Single-incision thoracoscopic surgery for primary spontaneous pneumothorax using the SILS port compared with conventional three-port surgery</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Background
Single-incision thoracoscopic surgery (SITS) is postulated to cause less incisional pain, less paresthesia, and less wound scarring than the conventional three-port approach. The difficulties performing the technique have prevented it from being widely accepted. This study shows how the authors overcame the difficulties by using the SILS port and proved it to be a safe and useful procedure for the treatment of primary spontaneous pneumothorax (PSP).
Methods
The same surgeon operated on all the patients using the three-port technique (
n
= 13) and SITS (
n
= 27) under the same procedural and management policy. The two groups were retrospectively compared in terms of operation time, postoperative complications, hospital stay, pain score, residual paresthesia, satisfaction regarding the wound scar, and surgical material cost.
Results
The mean age, sex ratio, and previous pneumothorax episodes were similar between the two groups. The uniport and three-port groups did not differ statistically in terms of mean operation time (74.6 ± 22.8 vs 72.4 ± 20.2 min;
p
= 0.77), hospital stay (2.3 ± 0.7 vs 2.5 ± 0.8 days;
p
= 0.72), visual analog pain scale (on the day of surgery: 4.1 ± 1.7 vs 4.8 ± 2.2,
p
= 0.26; on day 1: 3.2 ± 1.4 vs 2.8 ± 1.4,
p
= 0.33; on day 2: 2.7 ± 1.0 vs 2.6 ± 1.1,
p
= 0.61), or total surgical material cost (US$1,810 ± $320 vs $1,741 ± $329;
p
= 0.58). However, the uniport group had a lower incidence of paresthesia than the three-port group (33.3 vs 76.9 %;
p
= 0.01) and showed a higher satisfaction rate regarding wound scarring (70.4 vs 30.7 %;
p
= 0.03).
Conclusions
Compared with the three-port approach, SITS using the SILS port in PSP patients proved to be a safe and feasible procedure that can be clinically implemented without additional economic burden or operation time. Additionally, SITS showed better cosmesis with minimized neurologic sequelae, which contributed to higher satisfaction among patients. Progress in uniport instruments and surgical experience will lead to wider applications of SITS.</description><subject>Abdominal Surgery</subject><subject>Adult</subject><subject>Chest tubes</subject><subject>Cicatrix - psychology</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Laparoscopy</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Operative Time</subject><subject>Pain</subject><subject>Patient Satisfaction</subject><subject>Patients</subject><subject>Pneumothorax</subject><subject>Pneumothorax - psychology</subject><subject>Pneumothorax - surgery</subject><subject>Postoperative Care - methods</subject><subject>Postoperative Complications - etiology</subject><subject>Proctology</subject><subject>Retrospective Studies</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Thoracic surgery</subject><subject>Thoracic Surgery, Video-Assisted - methods</subject><subject>Thoracic Surgery, Video-Assisted - psychology</subject><subject>Young Adult</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kc1O6zAQhS0EglJ4ADZXltiwMYx_GjdLhPiTKrEorK3EcSEosXPt5ALvwEMzNAWhK7GyR_7OGc8cQo44nHIAfZYAVKYYcMGEnHOWbZEJVxIrwefbZAK5BCZ0rvbIfkrPgHjOZ7tkT4gsFyidkPdl7R8bx2pv61QHT_unEAsbkg1dbWka4qOLb3QVIu1i3RZ4T13wfeFdGBLtvBvasNa80iGhFxo4urxdLGkXYk9taLsiuoq-1P0TVv6f8z32KRoEo3NsTW3aHJCdVdEkd7g5p-Th6vL-4oYt7q5vL84XzEotembLmZJlrgG40pxrPauULqW1hSzBciFkBko5WVVVIXIOlcJpJc-EneO-Ki2n5GT07WL4O7jUm7ZO1jXNOJXhQkutBKDTlBz_hz6HIeL31xRImc1nEik-UjaGlKJbmc2yDAfzGZUZozIYlfmMymSo-bNxHsrWVd-Kr2wQECOQ8Mnjfn60_tX1A4BQoIQ</recordid><startdate>2013</startdate><enddate>2013</enddate><creator>Yang, Hee Chul</creator><creator>Cho, Sukki</creator><creator>Jheon, Sanghoon</creator><general>Springer-Verlag</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>2013</creationdate><title>Single-incision thoracoscopic surgery for primary spontaneous pneumothorax using the SILS port compared with conventional three-port surgery</title><author>Yang, Hee Chul ; Cho, Sukki ; Jheon, Sanghoon</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-cb543b970014711775d47b3cca3b0c12236044e3ddda2910d46923162c8046d73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Abdominal Surgery</topic><topic>Adult</topic><topic>Chest tubes</topic><topic>Cicatrix - psychology</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Laparoscopy</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Operative Time</topic><topic>Pain</topic><topic>Patient Satisfaction</topic><topic>Patients</topic><topic>Pneumothorax</topic><topic>Pneumothorax - psychology</topic><topic>Pneumothorax - surgery</topic><topic>Postoperative Care - methods</topic><topic>Postoperative Complications - etiology</topic><topic>Proctology</topic><topic>Retrospective Studies</topic><topic>Surgeons</topic><topic>Surgery</topic><topic>Thoracic surgery</topic><topic>Thoracic Surgery, Video-Assisted - methods</topic><topic>Thoracic Surgery, Video-Assisted - psychology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yang, Hee Chul</creatorcontrib><creatorcontrib>Cho, Sukki</creatorcontrib><creatorcontrib>Jheon, Sanghoon</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yang, Hee Chul</au><au>Cho, Sukki</au><au>Jheon, Sanghoon</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Single-incision thoracoscopic surgery for primary spontaneous pneumothorax using the SILS port compared with conventional three-port surgery</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2013</date><risdate>2013</risdate><volume>27</volume><issue>1</issue><spage>139</spage><epage>145</epage><pages>139-145</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><abstract>Background
Single-incision thoracoscopic surgery (SITS) is postulated to cause less incisional pain, less paresthesia, and less wound scarring than the conventional three-port approach. The difficulties performing the technique have prevented it from being widely accepted. This study shows how the authors overcame the difficulties by using the SILS port and proved it to be a safe and useful procedure for the treatment of primary spontaneous pneumothorax (PSP).
Methods
The same surgeon operated on all the patients using the three-port technique (
n
= 13) and SITS (
n
= 27) under the same procedural and management policy. The two groups were retrospectively compared in terms of operation time, postoperative complications, hospital stay, pain score, residual paresthesia, satisfaction regarding the wound scar, and surgical material cost.
Results
The mean age, sex ratio, and previous pneumothorax episodes were similar between the two groups. The uniport and three-port groups did not differ statistically in terms of mean operation time (74.6 ± 22.8 vs 72.4 ± 20.2 min;
p
= 0.77), hospital stay (2.3 ± 0.7 vs 2.5 ± 0.8 days;
p
= 0.72), visual analog pain scale (on the day of surgery: 4.1 ± 1.7 vs 4.8 ± 2.2,
p
= 0.26; on day 1: 3.2 ± 1.4 vs 2.8 ± 1.4,
p
= 0.33; on day 2: 2.7 ± 1.0 vs 2.6 ± 1.1,
p
= 0.61), or total surgical material cost (US$1,810 ± $320 vs $1,741 ± $329;
p
= 0.58). However, the uniport group had a lower incidence of paresthesia than the three-port group (33.3 vs 76.9 %;
p
= 0.01) and showed a higher satisfaction rate regarding wound scarring (70.4 vs 30.7 %;
p
= 0.03).
Conclusions
Compared with the three-port approach, SITS using the SILS port in PSP patients proved to be a safe and feasible procedure that can be clinically implemented without additional economic burden or operation time. Additionally, SITS showed better cosmesis with minimized neurologic sequelae, which contributed to higher satisfaction among patients. Progress in uniport instruments and surgical experience will lead to wider applications of SITS.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>22692464</pmid><doi>10.1007/s00464-012-2381-6</doi><tpages>7</tpages></addata></record> |
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| ispartof | Surgical endoscopy, 2013, Vol.27 (1), p.139-145 |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Abdominal Surgery Adult Chest tubes Cicatrix - psychology Feasibility Studies Female Gastroenterology Gynecology Hepatology Hospitals Humans Laparoscopy Length of Stay Male Medicine Medicine & Public Health Operative Time Pain Patient Satisfaction Patients Pneumothorax Pneumothorax - psychology Pneumothorax - surgery Postoperative Care - methods Postoperative Complications - etiology Proctology Retrospective Studies Surgeons Surgery Thoracic surgery Thoracic Surgery, Video-Assisted - methods Thoracic Surgery, Video-Assisted - psychology Young Adult |
| title | Single-incision thoracoscopic surgery for primary spontaneous pneumothorax using the SILS port compared with conventional three-port surgery |
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