ObjectiveTo investigate the effects of closed thoracic drainage with single tube or double tubes after video-assisted thoracoscopic lung volume reduction surgery.MethodsRetrospective analysis was performed on 50 patients (39 males, 11 females) who underwent three-port thoracoscopic lung volume reduction surgery in our hospital from January 2013 to March 2019. Twenty-five patients with single indwelling tube after surgery were divided into the observation group and 25 patients with double indwelling tubes were divided into the control group.ResultsThere was no significant difference in pulmonary retension on day 3 after surgery, postoperative complications, the patency rate of drainage tube before extubation, retention time or postoperative hospital stay (P>0.05). Postoperative pain and total amount of nonsteroidal analgesics use in the observation group was less than those in the control group (P<0.05). ConclusionIt is safe and effective to perform closed thoracic drainage with single indwelling tube after video-assisted thoracoscopic lung volume reduction surgery, which can significantly reduce the incidence of related adverse drug reactions and facilitate rapid postoperative rehabilitation with a reduction of postoperative pain and the use of analgesic drugs.
Objective To compare the efficacy of the single tube (ST) and double tube (DT) for closed thoracic drainage after lobectomy. Methods The PubMed, Medline, EMbase, Web of Science, CNKI, Wanfang Database, VIP database and CBMdisc from inception to March 30, 2018 were searched by computer to identify randomized controlled trial (RCT) about ST and DT drainage after lobectomy. Based on inclusion and exclusion criteria the literature was screened. Meta-analysis was performed using RevMan 5.3 software. Results Twelve RCTs were enrolled in this meta-analysis, including 1 442 patients. Compared with the patients using DT after lobectomy, the patients using ST had significantly less postoperative pain (MD=–0.64, 95%CI –0.71 to –0.56, P<0.000 01) and shorter duration of drainage (MD=–0.62, 95%CI –0.78 to –0.46, P<0.000 01) and hospital stay (MD=–0.55, 95%CI –0.80 to –0.29, P<0.000 1). Besides, there was no significant difference in postoperative complications (RR=1.11, 95%CI 0.83 to 1.49, P=0.49), air leaks (RD=0.03, 95%CI –0.02 to 0.08, P=0.19) and the redrainage rate (RR=0.89, 95%CI 0.51 to 1.54, P=0.67). ConclusionST drainage after lobectomy is effective, which reduces postoperative pain and duration of hospital stay and drainage, and moreover, does not increase the postoperative complications and redrainage rate.
ObjectiveTo investigate the application effect of digital chest drainage system in patients with air leak after lung resection and evaluate its efficacy and safety. MethodsClinical data of patients who underwent lung resection and received closed thoracic drainage postoperatively in the Department of Thoracic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University from January 2024 to November 2025 were collected. Patients with air leak graded Ⅰ to Ⅲ were divided into an experimental group (digital chest drainage system) and a control group (traditional closed thoracic drainage) according to different drainage devices used. Baseline characteristics and perioperative data were retrospectively analyzed and compared between the two groups. ResultsA total of 170 patients were included, with 81 in the experimental group (59 males, 22 females; median age 68 years) and 89 in the control group (60 males, 29 females; median age 68 years). There were no statistically significant differences between the two groups in terms of age, gender, body mass index, surgical type, pleural adhesions, surgical site, lesion nature, comorbidities, smoking index, or air leak grade (P>0.05). The experimental group had significantly less median total drainage volume [490 (883) mL vs. 740 (958) mL, P=0.023], shorter air leak duration [5 (2) d vs. 5 (4) d, P=0.005] and postoperative hospital stay [5 (1) d vs. 6 (4) d, P=0.029]. However, there were no statistically significant differences in hospitalization costs or drainage volume within the first 7 postoperative days between the two groups (P>0.05). The incidence of subcutaneous emphysema was significantly lower in the experimental group (27.16% vs. 41.57%, P=0.049). No significant differences were found between the groups in the incidence of pulmonary infection, atelectasis, pleural effusion, skin incision issues, secondary tube placement, or pain scores (P>0.05). Subgroup analysis revealed that for patients with grade Ⅰ air leak, the experimental group showed shorter air leak duration [5 (2) d vs. 5 (5) d, P=0.006] and postoperative hospital stay [5 (2) d vs. 6 (4) d, P=0.010] compared to the control group, with no significant difference in total drainage volume (P=0.055). For patients with grade Ⅱ air leak, there were no significant differences in total drainage volume, air leak duration, or postoperative hospital stay between the two groups (P>0.05). For patients undergoing wedge resection, the experimental group had less total drainage volume [289 (707) mL vs. 880 (1074) mL, P=0.035] compared to the control group, while no significant differences were found in air leak duration or postoperative hospital stay (P>0.05). For patients undergoing segmentectomy, there were no significant differences in total drainage volume, air leak duration, or postoperative hospital stay between the two groups (P>0.05). For patients undergoing lobectomy, the experimental group had shorter air leak duration [5 (2) d vs. 6 (4) d, P=0.029] compared to the control group, while no significant differences were found in total drainage volume or postoperative hospital stay (P>0.05). ConclusionCompared with traditional closed thoracic drainage, the digital chest drainage system effectively shortens the duration of postoperative air leak and hospital stay, reduces total drainage volume, and lowers the incidence of subcutaneous emphysema without increasing total hospitalization costs. It is a safe and effective drainage method for pulmonary resection patients, particularly those with grade Ⅰ air leak following lobectomy.
