Chest tube-free video-assisted thoracoscopic surgery secured by quantitative air leak monitoring: a case series

Preliminary outcomes of drainless videothoracoscopic pulmonary wedge resection procedure from Turkey

Introduction

A chest tube inserted through the intercostal space for air and blood evacuation after thoracic surgery is a serious cause of postoperative pain and prolongs the length of stay. Drainless video-assisted thoracoscopic thoracic surgical procedures, which were previously performed in mediastinal surgical procedures, have also been applied for lung resections in recent years.

Aim

To investigate the superiority of drainless videothoracoscopic pulmonary wedge resection over those with a drain in terms of postoperative pain and length of stay.

Material and methods

Data of patients who underwent video-assisted thoracoscopic (VATS) pulmonary wedge resection between December 2022 and May 2023 in our department were retrospectively reviewed. Age, gender, operation indication, postoperative complication, number of wedge resections, visual pain score, and length of hospital stay data were collected. Patients were divided into two groups: drainless and with-drain. The existence of differences or correlations between groups was investigated by the Pearson χ2, student' t-test, or Mann-Whitney-U test according to type or distribution of data.

Results

A total of 35 patients were included in the study. There were 14 patients in the drainless group and 21 in the with-drain group. Postoperative pain score and length of stay were significantly lower in the drainless group (p < 0.001). There was no significant difference between the groups in terms of age, gender, presence of complications, or number of wedge resections (p > 0.5).

Conclusions

Drainless VATS pulmonary wedge resections are safe methods that offer less postoperative pain and shorter hospital stays compared to with-drain methods.