Modified surgical incision suturing technique in uniportal video-assisted thoracoscopic pulmonary resection

Liuying Pan; Tengfei Chen; Zhipan Liang; Piergiorgio Solli; Benedetta Bedetti; Kyung Soo Kim; Xiaowei She

doi:10.21037/jtd-23-1968

Modified surgical incision suturing technique in uniportal video-assisted thoracoscopic pulmonary resection

J Thorac Dis. 2024 Feb 29;16(2):1388-1396. doi: 10.21037/jtd-23-1968. Epub 2024 Feb 26.

Authors

Liuying Pan^#¹, Tengfei Chen^#¹, Zhipan Liang¹, Piergiorgio Solli², Benedetta Bedetti³, Kyung Soo Kim⁴, Xiaowei She¹

Affiliations

¹ Department of Thoracic Surgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China.
² Department of Cardio-Thoracic Surgery and Hearth & Lung Transplantation, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
³ Department of Thoracic Surgery, University College of London Hospitals, London, UK.
⁴ Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

^# Contributed equally.

Abstract

Background: In recent years, single-hole thoracoscopic surgery technology is widely used in major medical centers and chest-specialized hospitals for the treatment of lung diseases. However, the single-hole minimally invasive surgery method focuses on one incision, and all surgical instruments need to pass through the same hole, resulting in repeated extrusion and tissue damage of the surgical incision. Therefore, we have improved the suture method of conventional surgical incision in order to reduce the probability of wound infection and dehiscence, promote early healing, and reduce the severity of postoperative wound scar, thereby enhancing the postoperative rapid recovery of patients. The purpose of this study is to explore the clinical efficacy of a modified surgical incision suture technique applied to uniportal thoracoscopic pulmonary resection.

Methods: This study retrospectively analyzed 151 patients who were admitted to the Department of Thoracic Surgery and underwent pulmonary resection from January 2019 to October 2021 in the North District of Suzhou Municipal Hospital. The patients were divided into two groups according to the different surgical incision suture methods: a modified group and a conventional group. The postoperative general clinical indexes, incision infection rate, secondary suture rate, postoperative incision pain score, and the severity of postoperative incision scar were compared and analyzed between the two groups.

Results: There were no statistically significant differences between the two groups in terms of chest tube duration or postoperative drainage and postoperative incision pain scores; the incision infection rate (1.3% vs. 6.7%, P<0.05), secondary suture rate (2.6% vs. 9.4%, P<0.05), and postoperative scar score (4.853 vs. 5.543, P=0.03) were better in the modified group than in the conventional group, and the differences between the two groups were statistically significant.

Conclusions: Our modified suture method reduces the chance of infection and splitting and the severity of postoperative incision scar formation, promoting early healing. It can be safely and effectively applied to the incision suture of uniportal thoracoscopic pulmonary resection, enhancing the rapid postoperative recovery of patients.

Keywords: Modified surgical incision suturing technique; rapid recovery; uniportal thoracoscopy.