The short-term outcomes for the early removal of pigtail catheter drainage within 24 hours of uniportal video-assisted anatomic surgery in patients with lung cancer

Shuo Zheng; Qinlang Shi; Qinya Ma; Qiang Fu; Kun Qiao

doi:10.21037/tcr-22-1910

The short-term outcomes for the early removal of pigtail catheter drainage within 24 hours of uniportal video-assisted anatomic surgery in patients with lung cancer

Transl Cancer Res. 2022 Sep;11(9):3260-3266. doi: 10.21037/tcr-22-1910.

Authors

Shuo Zheng^#^{1

2}, Qinlang Shi^#^{1

2}, Qinya Ma^{1

2}, Qiang Fu^{1

2}, Kun Qiao^{1

2}

Affiliations

¹ The Second Affiliated Hospital, Southern University of Science and Technology, Shenzhen, China.
² Department of Thoracic Surgery, The Third People's Hospital of Shenzhen, Shenzhen, China.

^# Contributed equally.

Abstract

Background: Early removal of the chest tube has advantages of reducing postoperative pain and speed recovery. This study aimed to confirm its safety and feasibility of early removal of a pigtail catheter used as a chest drain in patients undergoing anatomical surgery.

Methods: This retrospective cohort study included 126 patients who removed pigtail catheter ≤24 h after surgery, and 56 patients >24 h who underwent uniportal video-assisted thoracic surgery (u-VATS) between January 2020 and April 2022. All patients had stage I lung cancer and underwent anatomical surgery (lobectomy or segmentectomy). The clinical characteristics, perioperative data, and postoperative complications of both groups were analyzed and compared.

Results: The >24 h group had more patients with a higher body mass index (BMI) (P<0.001), a lower forced expiratory volume in the first second (FEV1) (P<0.001), Chronic obstructive pulmonary disease (COPD) (P<0.001), and current smokers (P=0.006) than the ≤24 h group. There were no significant differences in terms of age, sex, type of resection, operation time, and bleeding loss between the two groups (P>0.05). The pain of patients in the ≤24 h group was significantly less than that in the >24 h group only on the third postoperative day (P=0.035). There were no significant differences in the postoperative visual analogue scale (VAS) at postoperative day 0, day 1, day 7, and 1 month between the two groups (P>0.05). With the exception of a higher occurrence of subcutaneous emphysema in the >24 h group (71.7% vs. 100%, P=0.001), there were no statistically significant differences in the postoperative complications (e.g., pneumonia, atrial fibrillation, atelectasis, pleural effusion, and wound infection) between the 2 groups (P>0.05). During the 30-day follow-up period, none of the patients required tube reinsertion for pneumothorax. A total of 8 patients in the ≤24 h group and 4 in the >24 h group required tube reinsertion (6.7% vs. 7.1%, P>0.99) due to pleural effusion.

Conclusions: In stage I lung cancer patients who underwent u-VATS anatomic surgery, the pigtail catheter used as a thoracic drainage tube removed with 24 h after was safe and feasible.

Keywords: Lung cancer; drainage; enhanced recovery after surgery (ERAS); surgery.