ArticleFrontiers in surgery2026
Complete Tubeless video-assisted thoracoscopic surgery for pulmonary nodules: association with faster recovery, less pain, and shorter hospital stay.
Article in Frontiers in surgery, 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: Conventional video-assisted thoracoscopic surgery (VATS) with intubation and chest drainage is associated with increased postoperative pain and delayed recovery. This retrospective, non-randomized comparative cohort study evaluated the safety and feasibility of a complete Tubeless VATS approach (spontaneous breathing with laryngeal mask anesthesia, without urinary catheter or chest tube) for peripheral pulmonary nodules in young and middle-aged patients. Methods: Between September 2022 and December 2023, 50 patients undergoing wedge or segmental resection for pulmonary nodules (≤3 cm) were enrolled. Twenty-five received Tubeless VATS (experimental group) and 25 received conventional VATS (control group). Perioperative outcomes included operative time, blood loss, time to first oral intake, hospital stay, anesthesia recovery time, visual analog scale (VAS) pain scores, PetCO Results: All 50 surgeries were successful without conversion to open surgery or endotracheal intubation. Compared with conventional VATS, Tubeless VATS was associated with significantly shorter time to first oral intake (5.12 ± 0.83 vs. 7.68 ± 1.11 h), shorter hospital stay (3.00 ± 1.04 vs. 4.84 ± 0.89 days), faster anesthesia recovery (11.12 ± 5.74 vs. 23.80 ± 5.82 min), lower VAS pain scores at all postoperative time points ( Conclusion: In selected young and middle-aged patients with peripheral pulmonary nodules ≤3 cm undergoing wedge or segmental resection, complete Tubeless VATS appears safe and feasible. It was associated with reduced postoperative pain, shorter hospital stay, lower inflammatory response, fewer complications, and improved early patient-reported outcomes, consistent with enhanced recovery after surgery principles. This Tubeless technique may represent a surgical innovation worthy of further evaluation in clinical practice.
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