ArticleJournal of thoracic disease2026
Tubeless strategy following thoracoscopic pulmonary wedge resection: a safe and beneficial option in selected patients.
Article in Journal of thoracic disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Chest tube placement after pulmonary resection has been conventionally recommended, yet the associated patient discomfort can hinder postoperative recovery. In previous work, we demonstrated that catheter drainage is a safe alternative to conventional chest tube following wedge resection and provides superior pain relief. This study aims to evaluate whether a complete tubeless strategy offers further advantages compared to catheter drainage. Methods: We conducted a retrospective cohort study and enrolled patients who underwent video-assisted thoracoscopic surgery (VATS) pulmonary wedge resection at our institution between September 2020 and November 2024. Participants were categorized into a catheter drainage group or a tubeless group based on the absence of postoperative thoracic drainage. Propensity score matching (PSM) was applied in a 1:1 ratio to balance baseline characteristics. Univariate analysis was then used to compare operative outcomes and perioperative complications between the matched groups. Results: Of the 460 initially eligible patients, 133 matched pairs were generated after PSM. The tubeless group demonstrated a significantly shorter operative duration (57.00 Conclusions: Omitting thoracic drainage entirely is a feasible and advantageous approach for a highly selected subset of patients undergoing pulmonary wedge resection. In this selected cohort, the tubeless strategy is associated with diminished postoperative pain and enhanced patient satisfaction, without increasing perioperative risks. The observed reduction in operative time is likely confounded by patient selection factors and should not be interpreted as a direct benefit of the technique. These findings support its consideration in patients intraoperatively assessed as low-risk; however, the observed benefits should be interpreted in the context of the stringent selection criteria applied, which may limit generalizability.
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