Application of Single-port Thoracoscopy Combined With Small Incision Surgical Stabilization of Rib Fractures in the Treatment of Multiple Rib Fractures
10.3969/j.issn.1009-6604.2025.08.004
- VernacularTitle:单孔胸腔镜联合小切口肋骨骨折复位内固定术在治疗多发性肋骨骨折中的应用
- Author:
Zongrong LI
1
;
Jiacheng SUN
1
;
Hui WANG
1
Author Information
1. 平湖市第一人民医院胸外科,平湖 314200
- Publication Type:Journal Article
- Keywords:
Single-port thoracoscopy;
Rib fracture;
Surgical stabilization of rib fractures
- From:
Chinese Journal of Minimally Invasive Surgery
2025;25(8):469-475
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate clinical efficacy of single-port thoracoscopy combined with small incision surgical stabilization of rib fractures(SSRF)in the treatment of multiple rib fractures.Methods A retrospective comparison was carried out on clinical data of 73 patients who underwent multiple rib fractures surgery in our hospital from August 2023 to November 2024.Among them,31 patients underwent single-port thoracoscopy combined with small incision SSRF(thoracoscopic group),while 42 patients underwent traditional open SSRF by using small incision muscle-preserving technique(open group).The two groups were compared in terms of intraoperative blood loss,operation time,total chest tube drainage volume,pain relief time,postoperative hospital stay,postoperative complications,incision healing grade,and stability of internal fixation.Results Both groups successfully completed the surgery and were discharged.Compared to the open group,the thoracoscopic group had less intraoperative blood loss[(67.9±26.7)ml vs.(96.1±38.3)ml,t=-3.508,P=0.001],shorter pain relief time[(59.5±12.7)h vs.(67.9±13.9)h,t=-2.647,P=0.010],shorter postoperative hospital stay[(9.0±2.2)d vs.(10.3±2.5)d,t=-2.332,P=0.023],and better incision healing grade(Z=-2.867,P=0.004).The open group was superior to the thoracoscopic group in terms of operation time[(82.7±20.4)min vs.(116.6±30.6)min,t=5.350,P=0.000],total drainage volume of the chest tube[(417.5±116.5)ml vs.(575.2±191.4)ml,t=4.064,P=0.000],and incidence of encapsulated pleural effusion(2.4%vs.22.6%,χ2=5.532,P=0.019).There was no significant difference in the incidence of atelectasis and pulmonary infection between the two groups(P>0.05).All the patients were followed up for3-12 months after surgery,with an average of 6 months.They all recovered their ability to work within 3 months after surgery,with no obvious symptoms such as chest pain or tightness,no chest collapse or deformity,and no displacement or detachment of internal fixation devices.Conclusion Single-port thoracoscopy combined with small incision SSRF is safe and feasible,and is especially suitable for posterior rib fractures that are difficult to expose and covered by the scapula or deep paraspinal rib fractures of the erector spinae muscle.
