Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Apr 30;21(1):223.
doi: 10.1186/s12893-021-01220-4.

Modified technique of closing the port site after multiport thoracoscopic surgery using the shingled suture technique: a single centre experience

Haitao Xu  1 , Shuai Ren  1 , Tianyu She  1 , Jingyu Zhang  1 , Lianguo Zhang  1 , Teng Jia  1 , Qingguang Zhang  2
Affiliations

Modified technique of closing the port site after multiport thoracoscopic surgery using the shingled suture technique: a single centre experience

Haitao Xu et al. BMC Surg. .

Abstract

Background: Due to improvements in operative techniques and medical equipment, video-assisted thoracoscopic surgery has become a mainstay of thoracic surgery. Nevertheless, in multiport thoracoscopic surgery, there have been no substantial advances related to the improvement of the esthetics of the site of the chest tube kept for postoperative drainage of intrathoracic fluid and decompression of air leak after thoracoscopic surgery. Leakage of fluid and air around the site of the chest tube can be extremely bothersome to patients.

Methods: From March 2019 to April 2020, we used a modified technique of closing the port site in 67 patients and the traditional method in 51 patients undergoing multiport thoracoscopic surgery due to lung disease or mediastinal disease. We recorded patients' age, gender, body mass index, surgical method, postoperative drainage time, and postoperative complications.The NRS pain scale was used to score the pain in each patient on the day of extubation.The PSAS and the OSAS were used for the assessment of scars one month after surgery.

Results: In the modified technique group, only one patient (1.49%) had pleural effusion leakage, compared with five patients (9.80%) in the traditional method group (P < 0.05). There were no significant differences in the pain of extubating and wound dehiscence between the two groups. However,the incidence rates of wound dehiscence in the modified technique group were lower than in the traditional method group. There were no post-removal pneumothorax and wound infection in either of the groups. Significant differences in the PSAS and OSAS were observed between the groups,where the modified technique group was superior to the traditional method group.

Conclusions: The modified technique of port site closure is a leak-proof method of fixation of the chest tube after multiport thoracoscopic surgery. Moreover, it is effective and preserves the esthetic appearance of the skin.

Keywords: Chest tube; Multiport; Suture; Video‐assisted thoracoscopic surgery.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
a Intermittent suture of the deep muscles of the port site. b Intermittent suture of the subcutaneous adipose tissue of the port site. c Removal-free, absorbable, continuous intradermal suture of the skin
Fig. 2
Fig. 2
a Fixation of the chest tube and skin closure. b Removal of the chest tube. c Shingled suture technique
Fig. 3
Fig. 3
Closing the port site after operation using the shingled suture technique. a Day of operation. b 3 days after the operation. c 12 days after the operation
Fig. 4
Fig. 4
Traditional method, post-removal chest tube
See this image and copyright information in PMC

References

    1. Gonzalez D, Paradela M, Garcia J, Dela Torre M. Single-port video-assisted thoracoscopic lobectomy. Interact Cardiovasc Thorac Surg. 2011;12(3):514–5. doi: 10.1510/icvts.2010.256222. - DOI - PubMed
    1. Sihoe ADL. Uniportal lung cancer surgery: state of the evidence. Ann Thorac Surg. 2019;107(3):962–72. doi: 10.1016/j.athoracsur.2018.08.023. - DOI - PubMed
    1. Chung JH, Choi YS, Cho JH, Kim HK, Kim J, Zo JI, Shim YM. Uniportal video-assisted thoracoscopic lobectomy: an alternative to conventional thoracoscopic lobectomy in lung cancer surgery? Interact Cardiovasc Thorac Surg. 2015;20(6):813–9. doi: 10.1093/icvts/ivv034. - DOI - PubMed
    1. Son BS, Park JM, Seok JP, Kim DH. Modified incision and closure techniques for single-incision thoracoscopic lobectomy. Ann Thorac Surg. 2015;99(1):349–51. doi: 10.1016/j.athoracsur.2014.07.062. - DOI - PubMed
    1. Xu Y, Guo Z, Huang J, Liu R, Ning J, Feng L, Tan Q. Simple continuous suture to strengthen the closure of intra-muscle used in the removal of uni-portal video-assisted thoracoscopic surgery thoracic drainage tube. Ann Transl Med. 2019;7(23):764. doi: 10.21037/atm.2019.11.62. - DOI - PMC - PubMed