单孔胸腔镜下壁层胸膜剥脱联合肺大疱结扎术治疗继发性自发性气胸的效果OA

Objective To compare the clinical efficacy and cost-effectiveness of single port thoracoscopic parietal pleurectomy combined with bullae ligation versus single port thoracoscopic stapler resection combined with biological mesh for the treatment of secondary spontaneous pneumothorax(SSP).Methods A retrospective analysis was conducted on 122 consecutive patients with SSP who underwent surgical intervention between January 2021 and December 2024.Based on the surgical procedure,patients were allocated to group A(single port thoracoscopic parietal pleurectomy with bullae ligation,n=65)or group B(single port thoracoscopic stapler resection with biological mesh reinforcement,n=57).The perioperative related indicators,cost-effectiveness and prognosis of the two groups were compared.Results All procedures were successfully completed via single port thoracoscopy.The operation time of group A was significantly longer than that of group B,the intraoperative blood loss was significantly more than that of group B,the postoperative extubation time and postoperative hospital stay were significantly shorter than those of group B,postoperative drainage volume and the hospitalization cost were significantly lower than those of group B,and the incidence of pulmonary prolonged air leakage(PAL)after surgery was significantly lower than that of group B.The differences were all statistically significant(P<0.05).There were no significant differences in the improvement rate of pulmonary function and postoperative mortality rate between the two groups(P>0.05).Conclusion Single port thoracoscopic parietal pleurectomy combined with ligation of pulmonary bullae for the treatment of SSP can effectively reduce postoperative PAL,shorten extubation time and postoperative hospital stay,and reduce treatment costs compared with single port thoracoscopic stapler resection combined with biological mesh.It is worthy of clinical promotion and application.