الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Pneumothorax is an unusual accumulation of air inside the pleural cavity. It is mostly linked to emphysema, asthma, and tuberculosis. It could be spontaneous, traumatic, or iatrogenic.
PSP affects young, otherwise, healthy adults with no clinical evidence of pulmonary disease; while SSP is a complication of an underlying lung pathology, usually chronic obstructive pulmonary disease (COPD).
With the advent of high-resolution computed tomography (HRCT), PSP is now more comprehensible and can be treated more effectively. Its underlying could be diagnosed in most cases. PSP is predominantly caused by rupture of a small subpleural emphysematous vesicle (bleb) or of a subpleural paraseptal emphysematous lesion (bulla).
Generally, SP is managed surgically in the second attack or in selected patients with the first attack. Surgical intervention is the most effective management to reduce the risk of recurrence. Studies have shown that minimally invasive procedures are considered to be better than conventional thoracotomy since they reduce postoperative pain and linked to more rapid recovery and returning to daily activity.
VATS offers better outcomes regarding postoperative pain and postoperative respiratory function in comparison to conventional thoracotomy.
VATS is a minimally invasive procedure that does not use a conventional thoracotomy incision. It provides detailed visualization, allowing the procedure to be done in patients who are debilitated or have reduced lung function. Its main benefits are less time consuming, decreased postoperative morbidity, and faster return to daily activities.
U-VATS was introduced as a less invasive approach in comparison to the traditional multiports VATS. U-VATS has shown to be a safe and effective surgical technique for a variety of lung procedures, including pulmonary resections, biopsies, and lobectomy. In SP, the bullectomy/blebectomy and pleural abrasion/ pleurectomy are done through the single incision through which the ICD is then inserted.
The aim of this study was to compare between U-VATS and multiports VATS in the management of SP regarding the easiness, feasibility, intraoperative complications, post-operative pain, and patient satisfaction.
This was a prospective randomized clinical study that included 40 patients who were suffering from spontaneous pneumothorax and presented at Cardio-Thoracic Surgery Department at Alexandria Main University Hospitals.
Patients were divided into two groups; group A included 20 patients who were managed via uniportal VATS. group B included 20 patients who were managed via multi-ports VATS.
No female patient was included in this study. The mean age in group A was 26.50 ± 8.25 years, while it was 31.90 ± 6.36 years in group B.
History taking revealed that 17 out of 20 patients in group A were smokers (85%), while 18 out of 20 patients in group B were smokers (90 %); no significant statistical difference was found between both groups.
Patients in group A; were mostly presented by pain (n=19; 95%); followed by dyspnea (n=16; 80%); and the least presenting symptom was hemothorax (n=2; 10%). Similarly, the patients included in group B; almost have the same symptoms with slight variation in incidence as following: Pain (n=19; 95%), dyspnea (n=18; 90%), and hemothorax (n=1; 5%). Interestingly, patients were not presented with the single symptom