Abstract: Objective：To compare the results of the two different uniport locations between the 4th anterior axillary intercostal space and the 7th mid axillary intercostal space to develop a better surgical approach.Methods：Nintysix patients with unilateral primary spontaneous pneumothorax were treated with uniport VATS operation. They were divided into two groups, 37 cases of which took the anterior axillary line of the 4th intercostal space as the surgical incision, and 59 cases of them took the middle axillary line of the 7th intercostal as the surgical incision,the incision length was 2cm.The perioperative indicators differences were analyzed by statistical method.Results： None case with complications appeared from uniport to multiport, opening the chest, death, postoperative infection and chest infection. There were significant differences in the hospital stay, the amount of drainage, operation time, the time of chest drainage tube keeping, the time of pleural leakage, pain duration after operation, and hospitalization cost (P<0.05).The number of surgical stapler in the 4th intercostal group was less than the 7th intercostal group, the number of pulmonary bulla ligation in the 4th intercostal group was more than the 7th intercostal group(P<0.05).Conclusion：The study indicated that uniport VATS in the 4th anterior axillary intercostal space for the treatment of primary spontaneous pneumothorax is feasible and reliable, and can be used as a priority way.

Key words: videoassisted thoracoscopic surgery;pulmonary bullae;primary spontaneous pneumothorax, the 4th anterior axillary intercostal space, the 7th mid axillary intercostal space