Abstract
Objective
Although early removal of postoperative chest drains can facilitate recovery, it can be difficult to achieve in segmentectomy due to the management of air leakage in intersegmental planes. This study prospectively examined the feasibility of drain removal on the same day of uniportal thoracoscopic segmentectomy.
Methods
Twenty patients who underwent uniportal thoracoscopic segmentectomy between July 2021 and May 2022 were enrolled in this prospective study. The indications for drain removal on the day of surgery were absence of air leakage in an intraoperative sealing test, radiographic evidence of lung expansion, and continuous absence of air leakage via a drainage bottle for 4 h after the operation. The primary endpoint was rate of the patients who required re-drainage after the postoperative drainage tube was removed on the day of surgery. The secondary end points were postoperative pain evaluated using a numerical rating scale on postoperative days 1, 7, and 28; morbidity; and postoperative hospitalization period.
Results
Fifteen patients successfully underwent drain removal on the day of surgery. None required re-drainage. The mean postoperative hospitalization period was 2.3 ± 1.7 days. Overall, 12 of the 15 (80%) patients were discharged on postoperative day 1 or 2. The mean numerical rating scale scores were 1.2 ± 1.6, 0.4 ± 0.7, and 0.4 ± 1.5 on postoperative days 1, 7, and 28, respectively.
Conclusion
In uniportal thoracoscopic segmentectomy, drain removal on the day of surgery is feasible and may reduce pain on postoperative day 1.
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Data availability
The data related to this study are available from the corresponding author upon reasonable request.
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Acknowledgements
The authors are grateful to the surgeons and the teams who participated in the study, the editors, and the reviewers for their assistance with the manuscript.
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The study had no externally funding.
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HI: conceptualization; formal analysis; investigation; and writing of the original draft. MK: project administration. KN: writing, review, and editing. FO: writing, review, and editing. NM: writing, review, and editing.
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Igai, H., Matsuura, N., Numajiri, K. et al. Early chest drain removal on the day of uniportal thoracoscopic segmentectomy. Gen Thorac Cardiovasc Surg 71, 700–707 (2023). https://doi.org/10.1007/s11748-023-01951-6
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DOI: https://doi.org/10.1007/s11748-023-01951-6