Comparison of clinical outcomes between non-drainage and conventional drainage after uniportal video-assisted thoracoscopic lobectomy: A retrospective study

With the advancement of minimally invasive techniques, uniportal video-assisted thoracoscopic surgery (VATS) for lobectomy has been increasingly adopted due to minimal trauma and faster recovery. Conventionally, chest drains are routinely placed to evacuate air/fluid and monitor complications, but they cause pain, restrict mobility, and prolong hospitalization. Recently, the safety of omitting drains has drawn attention. This retrospective study analyzed 200 patients undergoing uniportal VATS lobectomy, divided into a no-drain group (n = 100) and a drain group (n = 100). Intraoperative parameters, recovery, complications, imaging, pain scores, and satisfaction were compared. Baseline characteristics were comparable (P > .05). Intraoperative blood loss showed no difference (15.2 ± 4.2 mL vs 20.4 ± 5.1 mL, P = .103). The no-drain group achieved earlier ambulation (1.2 ± 0.6 vs 2.3 ± 0.9 days, P < .001) and shorter hospital stay (3.6 ± 1.2 vs 5.2 ± 1.4 days, P < .001). Visual analog scale pain scores were significantly lower at all time points, persisting to day 30 (P < .001). Complication (8% vs 15%, P = .048) and fever rates (12% vs 20%, P = .048) were reduced. Computed tomography on day 3 showed smaller pneumothorax and pleural effusion volumes (P < .001). Suture removal occurred earlier (12.6 ± 2.2 vs 15.0 ± 2.4 days, P < .001). Satisfaction on day 7 was higher in the no-drain group (9.1 ± 0.7 vs 8.3 ± 0.9, P < .001). Omitting chest tubes after uniportal VATS lobectomy is safe and feasible with proper selection. It reduces pain, accelerates recovery, lowers complication rates, and improves satisfaction, supporting wider clinical use.