Abstract: Objective：To compare the clinical effect and safety of subxiphoid singlepore videoassisted thoracoscopy and intercostal singlepore videoassisted thoracoscopy in the treatment of bilateral bullae.Methods：320 patients with bilateral pulmonary bulbar admitted to the department of thoracic and cardiac surgery of the air force hospital of the western theater command from September 2014 to September 2019 were selected.All cases were divided into subxiphoid group and intercostal group according to the random number table,160 cases each.In the subxiphoid group,videoassisted thoracoscopy was performed with single hole of subxiphoid.The intercostal group was treated with videoassisted thoracoscopic surgery with single intercostal foramina,followed up for 3 months,and the operation,hospitalization and complications of the patients in the two groups were observed.Results：There was significant difference in the intraoperative blood loss,total blood loss,operation time,drainage tube retention time and hospitalization time of the patients between the subxiphid process group and the intercostal group(P<0.05).The VAS score and comfort score of patients in the subxiphoid group were significantly better than those in the intercostal group,and the difference was statistically significant(P<0.05).There were no death complications caused by thoracoscopic surgery in the two groups,and the incidence of complications in the subxiphoid group was significantly lower than that in the intercostal group,with a statistically significant difference(P<0.05).Conclusion：Compared with traditional intercostal singlehole videoassisted thoracoscopy,single hole videoassisted thoracoscopy under xiphoid has the advantages of less bleeding,less pain,more comfort and less complication rate,which is safe and reliable and worthy of clinical promotion and application.

Key words: pulmonary bullae, on both sides, thoracoscope, visual analogue score for pain