ABSTRACT
Objective To compare the clinical efficacy between single span video-assisted thoracoscope (VATS) surgery and traditional VATS surgery for spontaneous pneumothorax in elderly patients.Methods A total of 88 elderly patients diagnosed as spontaneous pneumothorax by chest X-ray and CT were selected and randomly divided into single span VATS group and traditional VATS group (n=44,each).The bleeding volume,duration of operation,hospitalization time,time of postoperative analgesic use,chest tube indwelling time,postoperative complications and adverse reactions were observed.All patients were follow-up for 1-2 years to record the recurrence rate and death rate.Results All patients were received VATS surgery successfully.Their clinical symptoms disappeared and X-ray showed that pneumothorax disappeared.There were significant differences in bleeding volume,time of postoperative analgesic use,hospitalization time between single span VATS group and traditional VATS group [(46.7±18.8)ml vs.(46.7±18.8)ml,(1.7±0.9)d vs.(2.4± 1.7)d,(6.3±1.7)d vs.(9.1±2.1)d,t=3.04,2.18,5.59,respectively,all P＜0.05].The duration of operation and chest tube indwelling were shorter in single span VATS group than in traditional VATS group (both P＜0.05).Patients with chest pain and incision numb after operation were less in single span VATS group than in traditional VATS group (11 cases vs.26 cases,7 cases vs.21 cases,t=10.50,10.26,both P＜0.05).There were no significant differences in recurrence rate and death rate between the two groups.Conclusions Single span VATS surgery is an safe and effective treatment for spontaneous pneumothorax in elderly patients,which has a better postoperative recovery and fewer adverse reactions.