Department of Cardiothoracic Surgery, Jingling Hospital, Jingling School of Clinical Medicine, Nanjing Medical University, Nanjing, China.
Department of Cardiothoracic Surgery, Jingling Hospital, Medical School of Nanjing University, Nanjing, China.
Thorac Cancer. 2023 Sep;14(26):2648-2656. doi: 10.1111/1759-7714.15049. Epub 2023 Jul 25.
The type and placement of chest tube for patients undergoing uniportal video-assisted thoracoscopic lobectomy remains controversial. The aim of this study was to assess the efficacy and safety of a novel technique in which a pigtail catheter was used alone as the chest tube and placed near the incision for chest drainage after uniportal video-assisted thoracoscopic lobectomy and extended lymphadenectomy.
A total of 217 patients undergoing uniportal video-assisted thoracoscopic lobectomy were retrospectively reviewed and divided into two groups. In group A, a 12-Fr pigtail catheter with several side ports was placed next to the uniportal wound. In group B, a conventional 20-Fr chest tube was placed through the uniportal wound itself. Postoperative complications related to chest tube placement and patients' subjective satisfaction were compared between the two groups. Postoperative pain management effect and other clinical outcomes such as duration of chest drainage and postoperative stay were also compared.
There were 112 patients in group A and 105 patients in group B. A significantly lower incidence of wound complications was found in group A postoperatively (p = 0.034). The pain score on coughing in group A was significantly lower than that in group B on postoperative day two (POD2) (p = 0.021). There was no significant difference of other clinical outcomes such as duration of chest drainage and postoperative stay as well as major complications between the two groups.
Placing a 12-Fr pigtail catheter alone next to the uniportal wound for chest drainage might be effective and safe after uniportal video-assisted thoracoscopic lobectomy and extended lymphadenectomy.
单孔电视辅助胸腔镜肺叶切除术后的胸腔引流管类型和位置仍存在争议。本研究旨在评估一种新的技术，即使用单独的猪尾导管作为引流管，并将其放置在单孔电视辅助胸腔镜肺叶切除和扩大淋巴结清扫术后切口附近，用于胸部引流的有效性和安全性。
回顾性分析 217 例接受单孔电视辅助胸腔镜肺叶切除术的患者，并将其分为两组。在 A 组中，将 12Fr 猪尾导管带有几个侧孔放置在单孔切口旁边。在 B 组中，通过单孔切口本身放置传统的 20Fr 胸腔引流管。比较两组患者术后与胸腔引流管放置相关的并发症以及患者的主观满意度。比较两组术后疼痛管理效果以及其他临床结果，如胸腔引流时间和术后住院时间。
A 组 112 例，B 组 105 例。A 组术后切口并发症发生率明显较低（p=0.034）。A 组术后第 2 天（POD2）咳嗽时疼痛评分明显低于 B 组（p=0.021）。两组胸腔引流时间和术后住院时间以及主要并发症等其他临床结果无明显差异。
单孔电视辅助胸腔镜肺叶切除和扩大淋巴结清扫术后，在单孔切口旁单独放置 12Fr 猪尾导管进行引流可能是有效且安全的。
