Abstract
This study compares the clinical efficacy of total thoracoscopic surgery (TTS) and thoracoscopy-assisted small-incision surgery (TASIS) in treating multiple rib fractures. A total of 95 patients were included, and propensity score matching (1:1) yielded 70 matched patients (35 per group) for primary comparison. Key perioperative parameters, including operation time, intraoperative blood loss, incision length, chest tube drainage volume, chest tube duration, hospital stay, and postoperative complications, were analyzed. Postoperative pain was assessed using the Visual Analogue Scale (VAS) on days 3 and 7, and clinical efficacy was evaluated at 3 months. No significant differences were observed in chest tube drainage volume, removal time, hospital stay, or complication rates (p > 0.05). However, TTS resulted in significantly shorter incisions but longer operation times (p < 0.05). VAS scores on postoperative days 3 and 7 were lower in the TTS group (p < 0.05), and clinical outcomes at 3 months were superior (p < 0.05). Both TTS and TASIS are effective for multiple rib fractures, but TTS offers less trauma, reduced postoperative pain, and better mid-term clinical outcomes, supporting its use as a minimally invasive approach.
Data availability
The datasets generated and/or analyzed during the current study are not publicly available due to privacy and confidentiality agreements with the participants but are available from the corresponding author on reasonable request.
Abbreviations
- ANOVA:
-
Analysis of variance
- ARF:
-
Acute respiratory failure
- CT:
-
Computed tomography
- EIT:
-
Electrical impedance tomography
- GEE:
-
Generalized estimation equation
- ICU:
-
Intensive care unit
- PSM:
-
Propensity score matching
- TASIS:
-
Thoracoscopy-assisted small-incision surgery
- TTS:
-
Total thoracoscopic surgery
- VAS:
-
Visual analogue scale
- VATS:
-
Video-assisted thoracoscopic surgery
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Funding
This study was supported by Scientific Research Project of Jiangyin Municipal Health Commission (M202316).
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Xiaofeng Huang and Dengshu Wang contributed equally to the conception and design of the study, data collection, and manuscript drafting. Xuewei Jiang, Song Wu, and Guiping Yu participated in patient enrollment, perioperative management, and data acquisition. Yunqiang Zhang and Ning Sheng provided technical guidance and assisted in surgical procedures. Fei Shen and Yedong Mi supervised the project, contributed to study design, data interpretation, and critical revision of the manuscript. All authors reviewed and approved the final version of the manuscript.
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This study was conducted in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The research protocol was reviewed and approved by the Clinical Ethics Committee of Jiangyin People’s Hospital (Approval number: 2024ER(057)). This statement ensures compliance with ethical standards and confirms that informed consent was obtained from all participants or their legal guardians.
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Huang, X., Wang, D., Jiang, X. et al. Comparative clinical study of total thoracoscopic surgery and thoracoscopy-assisted small-incision surgery for multiple rib fractures. Sci Rep (2026). https://doi.org/10.1038/s41598-026-37976-z
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DOI: https://doi.org/10.1038/s41598-026-37976-z
