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

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 substantive improvements in how to improve the aesthetics of the site of the chest tube left for postoperative drainage of intrathoracic fluid and decompression of air leak after the thoracoscopic surgery. Leakage of fluid and air around the site of the chest tube can be extremely bothersome to the patient. Methods: From March 2019 to April 2020, we used modified technique of closing the port site in 67 patients and traditional method in 51 patients who underwent multiport thoracoscopic surgery due to lung disease or mediastinal disease. With our modified technique, the muscle and fat layers are sutured separately and a removal-free, absorbable, continuous intradermal suture is used for the skin closure to assure both a tight closure and a better aesthetic appearance. The traditional method of fixation of the chest tube use two sutures to close the skin on each side of the chest tube.Results: The chest tubes were removed 2–13 days after the thoracoscopic procedure. In the modified technique group,one patients (1.49%) had fluid extravasation, which was better than five patients (9.80%) in the traditional method group (P<0.05).There were no significant differences in subcutaneous emphysema and wound dehiscenc between the two groups.However,the incidence of subcutaneous emphysema and wound dehiscenc in the modified technique group were lower than in the traditional method group.There were no post-removal pneumothorax and wound infection in either groups.Conclusions: This modified technique of port site closure is a leak-proof method of fixation of the chest tube after multiport thoracoscopic surgery and effective with aesthetic appearance of the skin.