Tubeless uniportal thoracoscopic wedge resection with modified air leak test and chest tube drainage
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RESEARCH ARTICLE
Open Access
Tubeless uniportal thoracoscopic wedge resection with modified air leak test and chest tube drainage Zhengcheng Liu1,2, Rusong Yang1,2* and Yang Sun3
Abstract Background: To investigate whether tubeless uniportal thoracoscopic wedge resection with modified air leak test and chest tube drainage has better short-term outcomes than non-intubated approach with chest tube drainage. Methods: Data were collected retrospectively from January 2017 and December 2019. Tubeless group included 55 patients with pulmonary nodules underwent tubeless uniportal thoracoscopic wedge resection, 211 patients underwent non-intubated uniportal thoracoscopic wedge resection with chest tube drainage were included in drainage group. Peri-operative outcomes between two groups were compared. Results: After 1:1 matching, 110 patients remained for analysis, baseline demographic and clinical variables were comparable between the two groups. Mean incision size was 3 cm in both group. Mean operative time was 59.3 min in tubeless group and 52.8 min in drainage group. The detectable mean lowest S pO2 and mean peak E tCO2 during operation was acceptable in both groups. Conversion to intubated ventilation or thoracotomy was not required. No patient failed the air leak test and did not undergo a tubeless procedure. Mean postoperative hospital stay was 1.5 days in tubeless group and 2.5 days in drainage group. Residual pneumothorax or subcutaneous emphysema was not frequent and mild in tubeless group. Side effects were rare and mild, including cough and hemoptysis. No reintervention or readmission occurred. The postoperative VAS score was significantly lower in tubeless group. Conclusions: Tubeless uniportal thoracoscopic wedge resection with modified air leak test and chest tube drainage is feasible and safe for selected patients with peripheral pulmonary nodules, it might reduce post-operation pain and lead to faster recovery. Keywords: Tubeless, Uniportal, Thoracoscopic, Non-intubated Background Thoracoscopic surgery is an option for diagnosis and treatment of peripheral pulmonary nodules (PPN). Nonintubated anaesthesia might prevent the adverse events caused by intubation, ventilation and extubation procedure [1]. Tubeless approach could further relieve wound *Correspondence: [email protected] 1 Department of Thoracic Surgery, Nanjing Chest Hospital, Treatment and Research Center for Pulmonary Nodule in Nanjing Medical University, Nanjing 210029, Jiangsu, China Full list of author information is available at the end of the article
pain associated with chest tube placement [2]. However, full expansion of lung sometimes could not be achieved after operation and presented as pneumothorax [3]. We describe a modified air leak test and chest tube drainage method in tubeless uniportal thoracoscopic wedge resection. The objective is to investigate whether tubeless uniportal thoracoscopic wedge resection with modified air leak test and chest tube drainage has better short-term outcomes than non-intubated approach with ch
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