| Objective:Lung cancer is the leading cause of cancer death in the world,of which the main type is non-small cell carcinoma（NSCLC）.Adenocarcinoma is the most common type of NSCLC,accounting for about 40%of lung cancers.Surgical resection remains an important and effective means of curing lung cancer patients.Video-assisted thoracoscopic surgery（VATS）has been widely used in thoracic surgery.In recent years,with the promotion and application of the concept of enhanced recovery after surgery（ERAS）,how to effectively improve the postoperative drainage volume of patients,shorten the drainage time,and make patients recover quickly has become the primary issue.Therefore,the reasonable selection of drainage tubes after VATS is of great significance for the postoperative recovery of clinical patients.In this study,by comparing the differences in the corresponding indicators between drainage tubes of different diameters,to further evaluated the correlation between pulmonary function-related indicators and drainage volume,and objectively evaluated the effect of different drainage tubes on postoperative recovery of patients.Methods:A total of 146 lung cancer patients who underwent thoracoscopic radical resection of lung cancer from July 2020 to July 2021 in the Thoracic Department of the First Hospital of Jilin University were selected as the research subjects.The patients were divided into three groups according to the choice of postoperative drainage tube:single 28F drainage tube（group I）,single 16F and single 28F drainage tube（group II）and single 16F drainage tube（group III）（1F≈0.33mm）.Incision length,operation time,intraoperative blood loss,number of lymph node dissection groups,catheterization time,drainage volume,early postoperative pain level（NRS score）,the number of analgesics,the number of secondary catheterization,hospitalization time and post-complications（including pulmonary leak,bleeding,pneumonia,etc.）were recorded.All data processing and drawing analysis were performed by SPSS 26.0 and Graphpad Prism 8.0 software,respectively.The measurement data between groups was compared using non-parametric independent sample test,and the enumeration data was tested byχ~2.P<0.05 was considered statistically significant.Results:GroupⅠ:There were 20 males and 28 females,with an average age of 52.00-64.75 years.Right lobectomy was performed in 32 cases and left lobectomy in 16 cases.The pathological stages were stageⅠA1（7cases）,stageⅠA2（19 cases）,stageⅠA3（8 cases）,stageⅠB（5 cases）,stageⅡB（5 cases）and stageⅢA（1 case）.There were 43 cases of adenocarcinoma,4 cases of squamous cell carcinoma and 1 case of small cell carcinoma.The first second forced expiratory volume（FEV1）was2.03-3.13 m L,the percentage of the first second forced expiratory volume in the predicted value（FEV1%）was 88.25-106.48,and the forced vital capacity（FVC）was 92.85-112.38 m L.There were 2 cases of coronary heart disease,7 cases of diabetes,15 cases of hypertension,19 cases of smokers,48 cases of incision length greater than 3cm,catheter time3.00-5.75d,drainage volume 465.00-872.50ml,times of pain-relieving agent 1.25-2.75,1 case of secondary catheter,number of lymph node dissection group 2.00-4.00,The operative time was 123.25-173.75min,the intraoperative blood loss was 50.00-137.50ml,and postoperative complications were 6 cases.Group II:There were 24 males and 23females,with an average age of 52.00-66.00 years.Right lobectomy in 32cases and left lobectomy in 15 cases;There were 15 cases of stageⅠA1,12 cases of stageⅠA2,10 cases of stageⅠA3,9 cases of stageⅠB,0 cases of stageⅡB and 1 case of stageⅢA.Adenocarcinoma 45cases,squamous cell carcinoma 2 cases,small cell carcinoma 0 cases;FEV1 was 2.25-3.02 m L,FEV1%was 86.90-109.70 ml,AND FVC was92.70-114.50 m L.There were 5 cases of coronary heart disease,9 cases of diabetes,10 cases of hypertension and 15 cases of smokers.The incision length was greater than 3cm in 37 cases and less than or equal to3cm in 10 cases.The catheter time was 3.00-4.00d,the drainage volume was 464.00-980.00ml,the number of pain-relieving agent was 1.00-2.00times,the number of lymph node dissection group was 2.00-5.00,the operation time was 128.00-176.00 min,the intraoperative blood loss was50.00-100.00 ml,and 4 cases of postoperative complications.Group III:There were 21 males and 30 females,with an average age of 51.00-66.00years.Right lobectomy in 35 cases and left lobectomy in 16 cases;The pathological stages wereⅠA1 stage（n=13）,ⅠA2 stage（n=16）,ⅠA3 stage（n=5）,ⅠB stage（n=6）,ⅡB stage（n=4）andⅢA stage（n=7）.Adenocarcinoma in 48 cases,squamous carcinoma in 3 cases,small cell carcinoma in 0 cases;FEV1 was 2.03-2.82 m L,FEV1%was92.00-106.00 ml,and FVC was 94.00-109.10 m L.Coronary heart disease in 1 case,diabetes in 1 case,hypertension in 5 cases,smokers in 6 cases;The incision length was greater than 3cm in 5 cases and less than or equal to 3cm in 46 cases.Tube time 3.00-5.00d,drainage flow 350.00-730.00ml,times of pain relief 1.00-1.80 times;The number of lymph node dissection groups was 4.00-5.00,operation time was 121.00-164.00 min,intraoperative blood loss was 50.00-80.00 m L,and postoperative complications were 15 cases.There was no significant difference in age,sex ratio,surgical site,lobectomy location,pulmonary function test,pathological stage,cancer type and the prevalence of other diseases among the three groups of lung cancer patients（P>0.05）.There were significant differences in the length of incision between groups I,II,and III（P<0.05）.The patients in group I had a longer catheterization time than those in groups II and III（P<0.05）.The drainage volume of patients in groups I and II It was significantly higher than that in group III（P<0.05）.The frequency of using analgesics in group I was higher than that in group II and group III（P<0.05）.The number of lymph node dissection groups in group III was significantly different from that in group I and group II.The pain score in groupⅠwas significantly higher than that in groupⅢ（P<0.05）.There were significant differences in the operative time among the three groupsⅠ,ⅡandⅢ（P<0.05）,and the operative time of theⅡgroup was the longest.There were significant differences in intraoperative blood loss among groupsⅠ,ⅡandⅢ（P<0.05）,and groupⅠhad the most bleeding.The postoperative complications in groupⅠandⅡwere significantly different from groupⅢ（P<0.05）.The pulmonary function FEV1%of group I was significantly negatively correlated with the corresponding drainage volume,the correlation coefficient R=-0.98（P<0.05）;the pulmonary function FEV1%of group II was significantly negatively correlated with the corresponding drainage volume,the correlation coefficient R=-0.98（P<0.05）;The pulmonary function FEV1%of group III was significantly negatively correlated with the corresponding drainage volume,the correlation coefficient was R=-0.95（P<0.05）.Conclusion:The application of 16F drainage tube after thoracoscopic radical resection of lung cancer can reduce postoperative pain,shorten the tube-carrying time,reduce the number of applications of analgesics,accelerate postoperative recovery,forming an effective,safe and reliable drainage method.It is helpful for the postoperative recovery of lung cancer patients. |
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