Video-assisted thoracic wedge resection without drainage tube placement

Chest tubes have been routinely placed in patients undergoing lung resection; however, it may increase pain and cost. Postoperative air leakage is not common in minimally invasive surgery such as video-assisted thoracic wedge resection, leading to the view that it may be possible to omit the chest tubes in some patients. The aim of this study was to evaluate the safety and effectiveness of omitting chest tubes after video-assisted thoracic wedge resection. A retrospective review of medical records was performed involving patients undergoing video-assisted thoracic wedge resection. In the 56 patients showing no air leakage before closing the incision, we omitted chest tubes in 43 patients (drainage-free group) and placed them in 13 patients (drainage group). The patients in the drainage group showed significantly poorer FEV1/FVC. Chest radiograph after surgery showed more subcutaneous emphysemas in the drainage-free group; however, all of them were mild and the patients were cured without any treatment such as aspiration or placement of a chest tube in both groups. The median length of hospital stay was shorter in the drainage-free group, although there were no significant differences. Omitting chest tubes may be feasible in some patients undergoing video-assisted thoracic wedge resection.