Materials and Methods: A comparative study was conducted on spontaneous pneumothorax patients (primary or secondary) undergoing VATS in Assiut University Heart Hospital from January 2017 till April 2019. Patients included in our study were prominent bullous forms in PSP pneumothorax lines, recurrent pneumothorax, bilateral pneumothorax, previous history of contralateral pneumothorax, and spontaneous hemothorax, air leakage more than five days with drainage catheter for first-episode patients. Patients were divided into two groups as group A patients who underwent uniport VATS procedure, and group B patients who underwent biport VATS procedure.

Results: The study included 32 patients, 22 were primary spontaneous pneumothorax (PSP), while 10 were secondary spontaneous pneumothorax (SSP). The male to female ratio (MF ratio) was 3.2:1. The mean ± SD for age was 30.04 ± 10.245 in PSP and was 50.43 ± 9.071 in SSP. Eighteen patients underwent uniport VATS, and 14 underwent biport VATS. The mean time for operation was 81.5 ± 33.74 in uniport VATS versus 109.79 ± 25.37 in biport VATS (p = 0.014). No significant statistical difference was found between uniport and biport VATS regarding pain, air leak, complications, hospital stay, recurrence, and mortality. Despite no statistical difference regarding mortality (p = 0.492), there were two mortalities in the uniport VATS group known as interstitial pulmonary fibrosis.

Conclusions: We concluded that there are no differences between both techniques except for operative time. Keywords : pneumothorax, video- assisted thoracic surgery, uniport, multiport