Do we need a small catheter drainage with chest tube after uniportal video-assisted thoracoscopic surgery for better drainage?

Abstract

Background: Some of the residual effusion cannot be drained by the chest tube due to the high port position of the uniportal video-assisted thoracoscopic surgery (VATS) which theoretically leads to prolonged hospital stay. Hypothesis that putting an additional small catheter drain at the most depended part of the hemi-thorax together with chest tube after uniportal VATS to evaluate value of small catheter drainage with chest tube after uniportal VATS in hospital stay, pain score and chest x-ray. Materials and Methods: It represents a pilot prospective study randomized trial from August 2019 to August 2020 who had undergone uniportal VATS procedures were divided into two groups as group A (chest tube with small catheter) and group B (chest tube only). Results: Fifty-three patients underwent uniportal VATS only 30 where eligible to the study divided into two equal groups (18 males, 12 females). The mean age of patients in the small catheter with chest tube was 42.07 ± 12.85 years, compared to 34.93 ± 10.73 years in the chest tube only. Six different types of operation was done. Postoperative pain and hospital stays was nearly equal in both groups (p > 0.05). Postoperative residual effusion in immediate chest x-ray in small catheter with chest tube was managed by aspiration from small catheter and show improvement in follow up chest x-ray next morning (p < 0.05) but in chest tube only was management conservatively didn’t show improvement in follow up chest x-ray next morning (p > 0.05). Conclusions: Small catheter with chest tube didn’t add more pain. Although more than half of the cases get aspiration from small catheter and show improvement in follow up chest x-ray next morning, this does not statically affect hospital stay.