期刊论文详细信息
Journal of Cardiothoracic Surgery
Pain following thoracoscopic surgery: retrospective analysis between single-incision and three-port video-assisted thoracoscopic surgery
Yasuo Hashizume1  Yosuke Shimizu1  Masaya Tamura1 
[1] Department of Surgery, Fukui Prefectural Hospital, Yotsui 2-8-1, Fukui 910-8526, Japan
关键词: Minimally-invasive surgery;    Single incision;    Postoperative pain;    Video assisted thoracoscopic surgery;   
Others  :  824470
DOI  :  10.1186/1749-8090-8-153
 received in 2013-02-11, accepted in 2013-06-06,  发布年份 2013
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【 摘 要 】

Background

The current trend in thoracoscopic surgery is to use fewer ports to decrease postoperative pain, chest wall paresthesia, and duration of hospital stay. In this study we compared the results of our current experience with single-incision thoracoscopic surgery (SITS) and conventional three-port video-assisted thoracoscopic surgery (3P-VATS).

Methods

From October 2011 to August 2012, 37 consecutive patients underwent thoracoscopic surgery. This is a non-randomized retrospective study. Among these patients, 19 (SITS group) were treated using single port method (SITS), whereas 18 (3P-VATS group) were treated using the conventional three-port methods (3P-VATS). The surgical duration, number of resected lesions, duration of chest drainage, duration of hospital stay, inpatient pain scores, and patient satisfaction scores were compared between both groups.

Results

The mean age at surgery, indication, gender, body mass index, and the side involved were similar in both groups. The procedures performed in the SITS group were similar to those performed in the 3P-VATS group. The mean operative time was longer in the SITS group compared with the 3P-VATS group. Duration of postoperative drainage days and hospital stay was shorter in the SITS group compared with the 3P-VATS group, although these differences were not statistically significant. Pain scores on postoperative days 0,1, and 3 were significantly higher in patients who underwent 3P-VATS compared with those who underwent SITS (p = 0.012, 0.039, and 0.037, respectively). The SITS group reported higher patient satisfaction scores than the 3P-VATS group, patients in the 3P-VATS group tended to receive higher total doses of analgesics (NSAIDs) after surgery compared with those in the SITS group, although these differences were not statistically significant.

Conclusions

Our experience demonstrated that SITS decreased postoperative pain and resulted in higher patient satisfaction compared with the conventional three-port VATS. However, a prospective, randomized study is needed to confirm our preliminary findings. To overcome the technological limitations of SITS, the development of new instruments is needed.

【 授权许可】

   
2013 Tamura et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Hazelrigg SR, Magee MJ, Boley TM: Spontaneous pneumothorax. In Minimal access cardiothoracic surgery. Edited by Yim APC, Hazelrigg SR, Izzat MB, Landreneau RJ, Mack MJ, Naunheim KS. Philadelphia, PA: Saunders; 2000:73-79.
  • [2]Sihoe AD, Au SS, Cheung ML, Chow IK, Chu KM, Law CY, Wan M, Yim AP: Incidence of chest wall paraesthesia after video-assisted surgery surgery for primary spontaneous pneumothorax. Eur J CardiovascSurg 2004, 24:1054-1058.
  • [3]Lardionois D, Ris HB: Minimally invasive video-endoscopic sympathectomy by use of a transaxillary single port approach. Eur J CardiothoracSurg 2002, 21(1):67-70.
  • [4]Chen YB, Ye W, Yang WT, Shi L, Guo XF, Xu ZH, Qian YY: Uniportal versus biportal video-assisted thoracoscopicsympathectomy for palmar hyperhidrosis. Chin Med J 2009, 122(13):1525-1528.
  • [5]Murphy MO, Gohsh J, Khwaja N, Murray D, Halka AT, Carter A, Turner NJ, Walker MG: Upper dorsal endoscopic thoracic sympathectomy: a comparison of one-and two ablation techniques. Eur J CardiothoracSurg 2006, 30:223-227.
  • [6]Rocco G, Martin-Ucar A, Passera E: Uniportal VATS wedge pulmonary resections. Ann ThoracSurg 2004, 77:726-728.
  • [7]Salati M, Brunelli A, Xiume F, Refai M, Sciarra V, Soccetti A, Sabbatini A: Uniportal video-assisted thoracic surgery for spontaneous pneumothorax: clinical and economic analysis in comparison to the traditional approach. InteractCardiovascThoracSurg 2008, 7:63-66.
  • [8]Jutley RS, Khalil MW, Rocco G: Uniportalvs standard three-port VATS technique for spontaneous pneumothorax: comparison of post-operative pain and residual paraesthesia. Eur J CardiothoracSurg 2005, 28:43-46.
  • [9]Berlanga L, Gigirey O: Uniportal video-assisted thoracic surgery for primary spontaneous pneumothorax using a single-incision laparoscopic surgery port: a feasible and safe procedure. SurgEndosc 2011, 25:2044-2047.
  • [10]Chen PR, Chen CK, Lin YS, Huang HC, Tsai JS, Chen CY, Fang HY: Single-incision thoracoscopic surgery for primary spontaneous pneumothorax. J CardiothoracSurg 2011, 21(6):58.
  • [11]Yamamoto H, Okada M, Tanada M, Matsuoka H, Sakata K, Kawamura M: Video-assisted thoracic surgery through a single skin incision. Arch Surg 1998, 133:145-14.
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