Application of single-port video-assisted thoracoscopic without chest tube in fast track thoracic surgery

Abstract

Objective To investigate the clinical feasibility and safety of single-port VATS without chest tube in fast track thoracic surgery. Methods The clinical data of patients with single-port VATS in thoracic surgery in Xiangya Hospital between January 2015 and May 2017 were retrospectively analyzed. Patients were divided into different groups according to chest tube placement and diseases respectively. The gender, age, postoperative complications, pain score and hospitalization time were statistically analyzed. Results A total of 59 patients were included in this research, including 44 patients with single-port VATS without chest tube and 15 patients with single-port VATS with chest tube. Compared to non hyperhidrosis patients with chest tube, there were significant differences in pain score [(3.6±0.79) scores vs (4.7±1.34) scores, P=0.021] in patients without chest tube, and no significant differences in hospitalization time and postoperative complications (P>0.05). In single-port VATS without chest tube group, compared to non palmar hyperhidrosis patients, there were significant differences in the hospitalization time [(1.7±0.9) d vs (3.9±1.1) d, P<0.001], pain score [(2.2±0.7) scores vs (3.6±0.8) scores, P<0.001] and complications (9.4% vs 58.3%, P=0.002) in palmar hyperhidrosis patients. Conclusions VATS in thoracic surgery without chest tube, if criterions for the surgery are strictly followed, is feasible and security in carefully selected patients. Key words: Video-assisted thoracoscopic surgery; Chest drainage; Fast track surgery