Clinical Effect Analysis of the Timing of Chest Drainage Tube Removal After Video-Assisted Thoracoscopic Surgery for Lung Cancer

doi:10.3969/j.issn.1674-3245.2025.06.037

Abstract：Objective To observe the timing of chest drainage tube removal in patients with non-small cell lung cancer (NSCLC) who underwent video-assisted thoracoscopic lobectomy or segmentectomy. Methods A total of 144 NSCLC patients who underwent radical resection at the Second Affiliated Hospital of Air Force Medical University from June 2022 to October 2024 were prospectively selected and randomly divided into three groups based on postoperative drainage volume of 200, 300, and 450 mL/day, with 48 patients in each group. The total drainage volume, postoperative drainage duration, length of hospital stay, pain scores, number of additional analgesia cases, incidence of complications, rate of thoracentesis, and reinsertion rate were compared among the three groups. Results There were statistically significant differences in total drainage volume, postoperative drainage duration, and length of hospital stay among the three groups (t=4.957, 6.204, 5.936, P<0.05). The total drainage volume, postoperative drainage duration, and length of hospital stay in the 300 mL and 450 mL groups were lower than those in the 200 mL group, and the total drainage volume and drainage duration in the 450 mL group were lower than those in the 300 mL group (t=2.382, 5.099, P<0.05). There was no statistically significant difference in the length of hospital stay between the 450 mL and 300 mL groups (P>0.05). The number of additional analgesia cases in the 300 mL and 450 mL groups was lower than that in the 200 mL group, with statistically significant differences among the three groups (t=18.061, P<0.05). There were no statistically significant differences in the overall complication rate, thoracentesis rate, and reinsertion rate among the three groups (P>0.05). Conclusion Compared with the standard of 200 mL/day, using <300 mL/day and 450 mL/day as the criteria for removing the chest drainage tube after video-assisted thoracoscopic lobectomy or segmentectomy can reduce pain, shorten the drainage time and postoperative hospital stay. However, it is not advisable to blindly increase the threshold for drainage volume. It is important to refine surgical techniques and combine them with comprehensive perioperative training.