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. 2020 Nov 30;20(1):301.
doi: 10.1186/s12893-020-00910-9.

Tubeless uniportal thoracoscopic wedge resection with modified air leak test and chest tube drainage

Zhengcheng Liu  1   2 , Rusong Yang  3   4 , Yang Sun  5
Affiliations

Tubeless uniportal thoracoscopic wedge resection with modified air leak test and chest tube drainage

Zhengcheng Liu et al. BMC Surg. .

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 SpO2 and mean peak EtCO2 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 re-intervention 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: Non-intubated; Thoracoscopic; Tubeless; Uniportal.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
The flowchart of the study
Fig. 2
Fig. 2
Air leak test and chest tube drainage. a Lung was immersed in saline and expanded for air leak test. b A chest tube was inserted to top of thoracic cavity. c Chest tube was connected to a water-sealed bottle. d Incision was closed with continuous sutures
Fig. 3
Fig. 3
Patients was changed to reverse trendelenburg position with 30° before modified air leak test and chest tube drainage in tubeless group
Fig. 4
Fig. 4
Chest radiography was performed post-operatively
See this image and copyright information in PMC

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