No Drain After Thoracoscopic Major Lung Resection for Cancer Helps Preserve the Physical Function

Background. We previously proved that omitting chest tube drainage in select patients undergoing thoracoscopic major lung resection for cancer was safe. The aim of the present study was to clarify the impact of omitting postoperative chest tube drainage on preserving the early postoperative ventilatory capacity and exercise capacity. Methods. The subjects of this retrospective study were 116 patients undergoing either thoracoscopic radical segmentectomy (n = 18) or lobectomy (n = 98). Whether chest tube drainage was to be performed was determined from the predefined criteria. We routinely measured the vital capacity and 6-minute walking distance preoperatively, at postoperative day 1 and at postoperative day 7. Postoperative pain was assessed daily by the visual analogue scale, and the number of analgesic agents used until postoperative day 7 was recorded. Results. Postoperative chest tube drainage was omitted in 53 patents (46%). Omitting chest tube drainage was associated with a substantial reduction in both the postoperative pain and the number of analgesic agents used on postoperative day 0 and 1. In addition, omitting chest tube drainage was associated with a preservation of vital capacity and the 6-minute walking capacity on postoperative day 1. The vital capacity, the 6-minute walking distance, and the pain as measured on postoperative day 1 were substantially correlated with each other. Conclusions. Omitting chest tube drainage results in reducing the pain, preservation of the ventilatory capacity, and preservation of exercise capacity in the early postoperative period in patients undergoing thoracoscopic major lung resection for cancer. (C) 2019 by The Society of Thoracic Surgeons