title: Does 11.5 mm guided single port surgery has clinical advantage than multi-port thoracoscopic surgery in spontaneous pneumothorax?
abstract: BACKGROUND
  Video-assisted thoracoscopic surgery (VATS) has been widely used for spontaneous pneumothorax (SP). In recent years, thoracic surgeons have attempted single incision or single port surgery with the development of surgical technology and skills. Theoretically, single port surgery is expected to provide benefits such as less pain and early recovery. The purpose of this study was to determine the benefits of single port surgery in SP.
  
  
  METHODS
  The 107 patients with SP who underwent surgery, between July 2013 and May 2015, were reviewed retrospectively. The patients with secondary pneumothorax, who underwent open procedures and lacking of medical records were excluded. Visual analog scale (VAS), paresthesia and clinical outcomes were reviewed in 86 patients (46 patients: three-port, 40 patients: 11.5 mm guided single-port).
  
  
  RESULTS
  The mean age was 23.4 years in three-port and 22.4 in single-port (P=0.247). The height and body weight were not significantly difference between two groups. The mean operation time was 39 minutes (mins) in the three-port and 37.3 mins in the single port without statistical difference (P=0.204). The pain score in the single port surgery was significantly lower after postoperative day (POD) 1 (P=0.028). However chest tube duration time was significantly shorter in the single port group (P<0.001). After exclusion of the patients with chest tube removal within postoperative 1 day, the pain score was not significantly different at the POD 1 between two groups (P=0.176). The pain score between two groups were not different at 1 week after discharge.
  
  
  CONCLUSIONS
  The pain score reduction was found 1 day after operation in the single port group. However, the chest tube duration time was significantly shorter in the single port group and the pain score was not different at 1 week after discharge. Considering young age in primary SP, the benefit of single port surgery in SP was minimal.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Republic of Korea.
authors.forename: Hyun Woo
authors.initials: HW
authors.lastname: Jeon
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Republic of Korea.
authors.forename: Young-Du
authors.initials: YD
authors.lastname: Kim
keywords: Pneumothorax; bullae; emphysema; outcomes; thoracoscopy; video-assisted thoracoscopic surgery (VATS); wedge resection