Chest drainage is routinely used after pulmonary lobectomy to evacuate air and fluid from the pleural cavity and promote lung re-expansion. However, the optimal chest drain size after minimally invasive lung surgery remains uncertain. Smaller chest drains may improve patient comfort and reduce postoperative pain, but their ability to provide adequate pleural drainage compared with larger drains requires evaluation.
This single-center, prospective, randomized interventional study compared 20-Fr and 24-Fr chest drains in patients undergoing uniportal video-assisted thoracoscopic (uVATS) lung lobectomy with systematic mediastinal lymphadenectomy for non-small cell lung cancer (NSCLC). Eligible patients were randomly assigned in a 1:1 ratio to receive either a 20-Fr or a 24-Fr thoracic drain at the end of surgery.
Postoperative assessment included radiographic evaluation for pneumothorax and residual pleural effusion, as well as evaluation of subcutaneous emphysema, prolonged air leak, analgesic use, postoperative pain using the Numerical Rating Scale, chest drain duration, and length of hospital stay. The study was designed to evaluate whether chest drain size influences postoperative clinical outcomes and patient comfort following minimally invasive pulmonary lobectomy.
