Less pain, faster recovery: evaluating 8Fr vs. 22Fr chest tubes in thoracoscopic lung cancer resection

PURPOSE: The objective of this study is to compare and analyze the clinical data differences between the use of a single ultra-fine 8Fr chest drainage tube and a single 22Fr conventional chest drainage tube, both commonly employed after single-port thoracoscopic lung cancer resection. This comparison aims to evaluate the overall postoperative effectiveness of each method. METHODS: We retrospectively analyzed 697 patients undergoing this procedure over two years. After exclusions, 665 patients were categorized: Group A (8Fr tube) and Group B (22Fr tube). Propensity score matching (PSM) was then applied to eliminate confounding factors between the two groups. After PSM, 202 pairs (404 patients) were included in both groups. Outcomes compared included postoperative hospital stay, total drainage volume, pain scores (days 1-3), inflammatory markers, complications, Chronic Postsurgical Pain (CPSP), and quality of life (QOL). RESULTS: Group A had significantly lower pain scores on postoperative days 1, 2, and 3 (all P < 0.001), shorter hospital stay (3 [3, 4] vs. 4 [3, 4] days, P = 0.032), and less total drainage volume (180 [130-236.25] ml vs. 255 [170-330] ml, P < 0.001) than Group B. Complication rates and inflammatory markers showed no significant differences (P > 0.05). At one month, Group A reported significantly lower worst/average pain scores (P < 0.001, P = 0.018) and better QOL in activities, mood, work, relationships, and enjoyment (all P < 0.05) compared to Group B. No significant differences existed in mildest pain or walking impact (P > 0.05) or in any pain/QOL measures at 3 months (P > 0.05). CONCLUSIONS: Compared to 22Fr tubes, using an 8Fr ultra-fine drain after thoracoscopic lung cancer resection significantly reduces postoperative pain, drainage duration, hospital stay, and total drainage volume. Patients discharged with the 8Fr tube experienced less severe pain and better short-term QOL without increased complications or inflammation. The 8Fr ultra-fine drain is an effective, safe, and clinically valuable alternative.