Application of uniportal video-assisted thoracoscopic surgery without chest tube in enhanced recovery after thoracic surgery
- VernacularTitle:单孔胸腔镜手术后不留置胸腔引流管在胸部加速康复外科中的应用
- Author:
ZHANG Man
1
;
GUO Zhanlin
1
;
LIANG Junguo
1
;
JIN Zhiyong
1
;
KANG Shirong
1
Author Information
1. Department of Thoracic Surgery, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010050, P.R.China
- Publication Type:Journal Article
- Keywords:
Uniportal;
video-assisted thoracoscopic surgery;
chest drainage
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2019;26(12):1219-1222
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical feasibility and safety of uniportal video-assisted thoracoscopic surgery (VATS) without chest tube in enhanced recovery thoracic surgery. Method The clinical data of patients with pulmonary bulla, pulmonary nodules and mediastinal tumors who underwent uniportal VATS in Department of Thoracic Surgery in the Affiliated Hospital of Inner Mongolia Medical University between January 2015 to May 2018 were retrospectively analyzed. A total of 78 patients did not receive closed thoracic drainage tube (a tube-free group), including 30 males and 48 females aged 32.5±8.3 years, 92 patients closed thoracic drainage tube after operation (a control group), including 38 males and 54 females aged 31.4±13.6 years. The surgery-related indicators, postoperative complications and visual analogue score (VAS) were compared between the two groups. Results The time of early ambulation and hospital stay after operation in the tube-free group (1.0±0.3 d, 3.3±0.7 d) were significantly shorter than those in the control group (1.8±0.6 d, 5.2±0.8 d) (P=0.000, P=0.000). The VAS pain scores on the first, second and third day after operation in the tube-free group (4.5±1.8, 3.6±2.4, 2.5±1.4) were also significantly lower than those in the control group (6.8±2.2, 5.7±2.9, 3.9±1.2) (P=0.000, P=0.000, P=0.000). Operation time and intraoperative blood loss in the tube-free group (55.3±12.2 min, 21.5±5.1 mL) and the control group (57.1±6.5 min, 22.2±3.5 mL) were not statistically different (P=0.220, P=0.146). There was no pulmonary infection in both groups, and the wound healing rate was 100.0%. There was no significant difference in pneumothorax, pleural effusion, arrhythmia and re-insertion of chest drain between the tube-free group (5 patients, 8 patients, 1 patient, 3 patients) and the control group (1 patient, 4 patients, 2 patients, 1 patient, P=0.145, P=0.134, P=0.885, P=0.499). Conclusion In strictly screened patients undergoing uniportal thoracoscopic surgery, no thoracic closed drainage tube can relieve postoperative pain, promote early ambulation activities and enhanced recovery of patients.
