Is it safe and feasible to use multi-lateral-pores drainage strategy after video-assisted thoracoscopic surgery?

Objectives: Evidence-based studies optimizing chest tube management have been conducted to accelerate the recovery process for lung cancer patients after video-assisted thoracoscopic surgery (VATS). This study is to evaluate whether using the multi-lateral pores chest tube can achieve better drainage performance than conventional-lateral-pore drainage.

Methods: Data from patients undergoing VATS were consecutively collected from September 2023 to June 2024. The groups were randomized into two subgroups, which were multi-lateral-pores drainage group (MDG) and conventional-lateral-pore drainage group (CDG). The primary outcomes included chest drainage performance, and the secondary outcomes included postoperative complications (PPCs).

Results: After screening, 228 patients were randomized into two groups, in which 116 patients in MDG and 112 patients in CDG. The daily drainage volume [199.70 (95%CI: 165.19~234.99) mL/d vs 149.43 (95%CI: 120.70~179.21) mL/d, P<0.01] and total drainage volume [342.79 (95%CI: 291.91~392.63) mL vs 272.68 (95%CI: 225.87~322.11) mL, P = 0.04] in the MDG was significantly higher that that in the CDG. The drainage duration in the MDG was also less than that in the CDG [36.41 (95%CI: 32.23~40.72) h vs 51.02 (95%CI: 46.03~56.38) h, P < 0.01]. The incidence of pleural effusion was lower in the MDG when compared with that in CDG (1.7% vs 9.0%, P = 0.04). No differences were found in the other incidences of chest tube-related PPCs, including pneumothorax (12.0% vs 15.2%, P = 0.15) and subcutaneous emphysema (17.2% vs 17.9%, P = 0.35), however.

Conclusions: Based on this single-center analysis, multi-lateral pores chest tube provided better drainage performance after VATS.