A Retrospective Comparative Study on the Omission Versus Placement of Chest Drain Following Thoracoscopic Sublobar Resection.

[PURPOSE] This study aims to investigate the clinical applicability of omitting chest drainage tube following thoracoscopic sublobar resection.

[METHODS] We gathered data from 1,054 patients who met the inclusion criteria and underwent thoracoscopic sublobar resection at the Thoracic Surgery Department of Huzhou Central Hospital between January 2023 and December 2024. Using propensity score matching, a total of 488 patients were ultimately chosen as the study participants. Key outcome measures included postoperative analgesic consumption, incidence of pneumothorax, pleural effusion, inflammatory markers, re-drainage rate, pneumothorax following tube removal, average hospitalization costs, and average length of hospital stay.

[RESULTS] The no-drain cohort exhibited notable benefits: the mean duration of hospitalization was reduced by 1.02 days (2.48 ± 0.93 vs. 3.50 ± 1.46,  < 0.001), and healthcare expenditures decreased by 9.4% (23284.80 ± 3556 vs. 25706.39 ± 4443,  < 0.001). A significant difference was observed in the utilization of pain pumps (8.2% vs. 87.7%,  < 0.001). Additionally, 28 cases (11.47%) in the no-tube group experienced lung compression between 20% and 40%, compared to 9 cases (3.68%) in the tube group. Furthermore, 11 cases (4.91%) in the no-tube group had lung compression greater than 40%, whereas the tube group had only 3 cases (1.22%). The incidence of severe complications in both groups remained below 1.5%.

[CONCLUSION] The implementation of a no-drain approach following thoracoscopic sublobar resection effectively reduces hospital stay, duration and medical costs without exacerbating inflammatory responses.