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. 2025 Apr 10;87(6):3215-3220.
doi: 10.1097/MS9.0000000000003233. eCollection 2025 Jun.

Chest drain through utility vs separate incision in single-port video-assisted thoracoscopic lobectomy: a randomized controlled trial

Fahmi H Kakamad  1   2   3 , Bnar J Hama Amin  2 , Abdulwahid M Salih  2 , Shvan H Mohammed  2 , Hiwa O Baba  3 , Gasha S Ahmed  4 , Soran H Tahir  1   3 , Rawezh Q Salih  2   3 , Berun A Abdalla  2   3 , Dahat H Hussein  2   3 , Suhaib H Kakamad  2 , Hussein M Hamasalih  3 , Mohammed Subhan Mohammed  5
Affiliations

Chest drain through utility vs separate incision in single-port video-assisted thoracoscopic lobectomy: a randomized controlled trial

Fahmi H Kakamad et al. Ann Med Surg (Lond). .

Abstract

Background: This study explores whether using a separate incision for pleural drainage will yield superior results compared to inserting a chest drain through the utility incision in patients with operable lung cancer undergoing single utility port video-assisted thoracoscopic lobectomy.

Research question: Which one is the best?! Inserting the drain through the utility incision or separate incision in a single utility port video-assisted thoracoscopic lobectomy for lung cancer.

Materials and methods: This was a randomized, open-label, superiority trial including patients with bronchogenic carcinoma who underwent a single utility port video-assisted thoracoscopic lobectomy over a 32-month period. The primary outcome was wound infections and postoperative pain, while the secondary outcomes were the duration of hospitalization and return to work.

Results: The study included 89 patients, and 80 patients completed the trial. The mean age was 65.35 ± 9.47 years, 64 (80%) patients were male, and 69 (86.25%) patients had a 0 ECOG score. Eleven patients (13.75%) had a score of 1. The majority of the patients (35%) were in stage IIIA. There was a small but statistically significant difference in return to work when comparing group A with group B (34 ± 6 vs 31 ± 4 days, P = 0.038). More important were the differences in patients with wound discharge (29 vs 4; P < 0.001) and especially the need for intravenous antibiotic treatment (12 vs 1; P < 0.002). There was only a minimal trend for a decrease in the duration of hospitalization. There was no significant difference in postoperative pain scores.

Conclusions: Inserting the chest drain through a separate incision has superior results compared to inserting it through the utility incision in patients with operable lung cancer undergoing single-port video-assisted thoracoscopic lobectomy. However, more studies with a larger sample size are necessary to confirm these results.

Clinical trial registration: The research was registered in the Research Registry. The registration number is researchregistry8426. The link is https://www.researchregistry.com/register-now#home/?view_2_search=researchregistry8426&view_2_page=1.

Keywords: chest tube; lobectomy; single utility port; uniport; video-assisted thoracoscopic surgery.

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Conflict of interest statement

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. None to be declared.

Figures

Figure 1.
Figure 1.
Flowchart of patient enrollment and inclusion.
See this image and copyright information in PMC

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