Abstract: Objective To investigate and compare the clinical effects of two different thoracoscopic surgery under DRGs in patients with spontaneous pneumothorax. Methods From April 1,2014 to May 30,2020,120 patients with primary pneumothorax who underwent thoracoscopic surgery in the Department of thoracic surgery,Hong Kong University-Shenzhen Hospital.All patients underwent thoracoscopic surgery.They were divided into low-cost group and conventional group according to whether low-cost thoracoscopic surgery was used or not during the operation.The time required for surgery,postoperative thoracic drainage tube indwelling time,postoperative hospitalization days,total cost of surgery and related consumables,total hospitalization costs,postoperative complications and recurrence rate of pneumothorax were calculated respectively. Results All patients successfully completed the operation without death or serious complications.The comparison of total hospitalization cost between experimental group and control group showed significant difference（P<0.05）,The average and IQR values were 12 998 yuan(10 645,14 427 yuan) versus 32 121 yuan(25 383,33 152 yuan).There were significant differences in the cost of operation and related consumables(P<0.05).The average and IQR value was 8 104 yuan(6 430,7 247 yuan) to 26 158 yuan(20 492,27 256 yuan).There was no significant difference in the number of postoperative complications and pneumothorax recurrence between the two groups（P＞0.05）. 〗Conclusion The clinical application of low-cost VATS in the treatment of spontaneous pneumothorax is safe and feasible.Compared with the conventional VATS group,it can significantly reduce the cost of patients.

Key words: low-cost VATS, twining high-tension knot, ligation, pneumothorax, pulmonary bullae