Postoperative drainage with double 8F ultrafine chest tubes improves pain control and reduces specific complications in uniportal thoracoscopic lung tumor resection: a retrospective multicenter cohort study.
单孔胸腔镜手术（U-VATS）是治疗肺部肿瘤的成熟微创术式，但关于术后胸腔引流管最佳尺寸和数量的共识仍缺乏。与传统引流方式相比，超细猪尾胸腔引流管可能减少组织损伤并促进伤口愈合，但支持其在U-VATS患者中安全性和可行性的证据尚不充分。本回顾性多中心队列研究纳入了三家中国医院接受U-VATS的1，076例肺部肿瘤患者。患者被分为三组：双8F超细胸腔引流管组（n=427）、22F+8F胸腔引流管组（n=452）和单根24F胸腔引流管组（n=197）。采用1：1：1倾向性评分匹配（PSM）和线性回归模型分析围手术期结局，以校正混杂因素。多因素分析确定引流管特征、胸膜粘连、术后感染、漏气、胸腔内出血和引流量是与引流持续时间相关的独立因素。PSM后（每组93例），与22F+8F组相比，双8F组疼痛数字评分法（NRS）评分显著降低[术后第1-3天（POD）]，早期引流量减少（POD1和POD3），肺不张和胸腔内出血发生率降低（均P<0.05）。其住院时间和总引流量与另外两组相当。单根24F组引流持续时间最短（P<0.001），在感染、漏气、再插管或乳糜胸方面无组间差异。双8F超细胸腔引流管虽不缩短引流持续时间，但能有效减轻术后疼痛（尤其是POD1），减少术后早期引流量，并降低特定并发症的发生。其符合加速康复外科（ERAS）理念，是肺部肿瘤患者U-VATS术后一种有前景的引流策略。
Uniportal video-assisted thoracoscopic surgery (U-VATS) is a well-established minimally invasive approach for lung tumors, but consensus on the optimal size and number of postoperative chest tubes remains lacking. Ultrafine pigtail chest tubes may reduce tissue injury and improve wound healing compared with traditional drainage methods, yet evidence supporting their safety and feasibility in U-VATS patients is insufficient. This retrospective multicenter cohort study enrolled 1,076 lung tumor patients who underwent U-VATS across three Chinese hospitals. Patients were assigned to three groups: double 8F ultrafine chest tube ( = 427), 22F + 8F chest tube ( = 452), and single 24F chest tube ( = 197). Perioperative outcomes were analyzed using 1:1:1 propensity score matching (PSM) and linear regression models to adjust for confounders. Multivariate analysis identified chest tube characteristics, pleural adhesions, postoperative infection, air leakage, intrathoracic hemorrhage, drainage volume as independent factors associated with drainage duration. After PSM (93 cases/group), the double 8F group had significantly lower NRS pain scores [postoperative days (POD) 1-3], reduced early drainage volume (POD1 and POD3), and lower incidences of atelectasis and intrathoracic hemorrhage (all < 0.05) compared with the 22F + 8F group. It showed comparable hospital stay and total drainage volume to the other two groups. The single 24F group had the shortest drainage duration ( < 0.001), with no intergroup differences in infection, air leakage, reintubation, or chylothorax. Double 8F ultrafine chest tubes do not shorten drainage duration but effectively alleviate postoperative pain (especially on POD1), reduce early postoperative drainage volume, and lower specific complications. Aligning with enhanced recovery after surgery (ERAS) principles, they represent a promising drainage strategy for lung tumor patients after U-VATS.
Hongde Jiang, Di Wu, Zhengwei Huang, Donghui Chu, Jun Wang, Zufang Liao, et al. Postoperative drainage with double 8F ultrafine chest tubes improves pain control and reduces specific complications in uniportal thoracoscopic lung tumor resection: a retrospective multicenter cohort study.. Frontiers in medicine. 2026; doi:10.3389/fmed.2026.1806379.
Hongde Jiang, Di Wu, Zhengwei Huang, Donghui Chu, Jun Wang, Zufang Liao, et al (2026). Postoperative drainage with double 8F ultrafine chest tubes improves pain control and reduces specific complications in uniportal thoracoscopic lung tumor resection: a retrospective multicenter cohort study.. Frontiers in medicine. https://doi.org/10.3389/fmed.2026.1806379
Hongde Jiang, Di Wu, Zhengwei Huang, Donghui Chu, Jun Wang, Zufang Liao, et al. Postoperative drainage with double 8F ultrafine chest tubes improves pain control and reduces specific complications in uniportal thoracoscopic lung tumor resection: a retrospective multicenter cohort study.[J]. Frontiers in medicine, 2026 doi:10.3389/fmed.2026.1806379.
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