Uniportal versus three-port video-assisted thoracoscopic surgery for spontaneous pneumothorax: a meta-analysis

Pneumothorax has been described as a situation in which air is inserted into the pleural space. Open thoracotomy and video-assisted thoracoscopic surgery (VATS) are the main surgical treatments for pneumothorax. Open thoracotomy with pleurectomy was once used as the gold standard technique as recent as 2003 (1). The treatment of spontaneous pneumothorax has been developed from open thoracotomy to VATS over recent decades. Because of the lesser invasion, compared with open thoracotomy, conventional VATS has been clearly shown to offer greater advantages in regard to postoperative stay, operative time, length of postoperative drainage and postoperative pain (2-4). However the recurrence and residual neurological symptoms (including paresthesia, postoperative pain) still frequently occurred in this minimally invasive surgery (5-8). The main reason for postoperative pain may be injury to the intercostal nerves, as open thoracotomy usually requires one large incision or costal resection, and conventional VATS usually requires one small incision for the scope and multiple small incisions, to complete the procedure of dissection, resection, and grasping