Comparative clinical study of total thoracoscopic surgery and thoracoscopy-assisted small-incision surgery for multiple rib fractures

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.