Small-bore vs. large-bore chest tubes for pneumothorax: a retrospective study

OBJECTIVE: To compare the clinical efficacy and safety of small-bore (≤ 14 Fr) versus large-bore (> 14 Fr) chest tubes in the treatment of pneumothorax. METHODS: A retrospective analysis was conducted. Patients were categorized into small-bore and large-bore groups based on the initial drainage tube size. Outcomes, including treatment efficacy, drainage duration, lung re-expansion time, hospital stay, complication rates, and analgesic use, were compared between groups. Subgroup analyses were performed based on pneumothorax type as primary and secondary spontaneous pneumothorax. RESULTS: In the overall population of 95 patients (55 large-bore, 40 small-bore), no statistically significant differences were found between the two groups regarding treatment efficacy (90.9% vs. 80.0%, P = 0.063), drainage time, lung re-expansion time, or hospital stay. The large-bore group required a significantly higher equivalent dose of analgesics (P = 0.049). Complication rates were similar between groups. In patients with secondary spontaneous pneumothorax (SSP), the small-bore tube group demonstrated significantly shorter drainage duration and lung re-expansion time compared to the large-bore group (both P = 0.007). CONCLUSION: In this retrospective analysis, small-bore and large-bore chest tubes demonstrated comparable treatment efficacy for pneumothorax management, with no statistically significant difference observed between groups. The large-bore group required a higher equivalent analgesic dosage, although this finding is exploratory given the borderline statistical significance and absence of validated pain assessment instruments. In the SSP subgroup, small-bore tubes were associated with significantly shorter drainage duration and lung re-expansion time, though these findings warrant further prospective validation.