ArticleJournal of thoracic disease2023
Chest tube-free video-assisted thoracoscopic surgery secured by quantitative air leak monitoring: a case series.
Article in Journal of thoracic disease, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 8 citations in OpenAlex.
- Multimodal digital assessment of early recovery after chest tube omission in early-stage lung cancer patients undergoing wedge resection: a post hoc analysis of a prospective cohort.Translational lung cancer research · 2026Article
- [Digital Drainage Systems in Postoperative Chest Tube Management after Pulmonary Resection: Current Status and Future Perspectives].Zhongguo fei ai za zhi = Chinese journal of lung cancer · 2026Review
- Surgical technique of uniportal VATS for pneumothorax: the lateral and subxiphoid approaches.Journal of visualized surgery · 2026Article
- Observational
- Is it safe to remove the chest tube in the operating room after robotic lobectomy, segmentectomy, and wedge resection with lymphadenectomy?Frontiers in surgery · 2025Article
- Preliminary outcomes of drainless videothoracoscopic pulmonary wedge resection procedure from Turkey.Kardiochirurgia i torakochirurgia polska = Polish journal of cardio-thoracic surgery · 2023Article
- Editorial: Early chest drain removal following lung resection.Frontiers in surgery · 2023Article
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Authors and funding
10 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Although chest tube-omitted video-assisted thoracoscopic surgery (VATS) has been proven to be safe and efficacious, its universal application is precluded by a varying morbidity rate due to a lack of standardization. Since digital chest drainage has already shown improved accuracy and consistency in the management of postoperative air leak, we incorporated it in the strategy of intraoperative chest tube withdrawal, aiming to achieve better results. Methods: We collected the clinical data of 114 consecutive patients who underwent elective uniportal VATS pulmonary wedge resection at the Shanghai Pulmonary Hospital from May 2021 to February 2022. Their chest tubes were withdrawn intraoperatively after an air-tightness test facilitated by digital drainage: the end flow rate had to be kept ≤30 mL/min for >15 s at the setting of -8 cmH Results: The mean age of the patients was 49.7±11.7 years. The mean size of the nodules was 1.0±0.2 cm. The location of the nodules encompassed all lobes, and 90 (78.9%) patients received preoperative localization. The postoperative morbidity and mortality rates were 7.0% and 0%, respectively. Six patients had clinically overt pneumothorax and two patients had postoperative bleeding that required intervention. All of the patients recovered on conservative treatment except for one case of pneumothorax that required additional tube thoracostomy. The median length of postoperative stay was 2 days; and the median time of suctioning, peak flow rate, and end flow rate were 126 s, 210 mL/min, and 0 mL/min, respectively. The median numeric rating scale for pain was 1 on postoperative day (POD) 1 and 0 on the day of discharge. Conclusions: Chest tube-free VATS assisted by digital drainage is feasible with minimal morbidity. Its strength of quantitative air leak monitoring produces important measurements for the prediction of postoperative pneumothorax and future standardization of the procedure.
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