Application Of Non Thoracic Catheter In Single Hole Thoracoscopic Surgery In Accelerated Rehabilitation Surgery

Object: To compare and analyze the efficacy of tubeless and traditional indwelling thoracic drainage tube after single hole thoracoscopy,so as to provide reference basis for the clinical application of tubeless after single hole thoracoscopy.Methods: From January 2021 to February 2022,75 patients who underwent single hole thoracoscopic surgery(pulmonary wedge resection and pulmonary segmental resection)in our hospital were selected.Whether to retain thoracic drainage tube was divided into two groups.One group was the tubeless group after single hole thoracoscopic surgery(25 cases).Among the50 patients in the tubeless group,21 patients underwent wedge resection for one lobe,accounting for 84% of the total,and 2 patients underwent wedge resection for two lobes,accounting for 8%of the total Two patients underwent segmental resection,accounting for 8% of the total number,and the other group was the single hole thoracoscopic postoperative tube retention group(50cases).Among the 50 patients in the retention group,41 patients underwent wedge resection for one lobe,accounting for 82%,3 patients underwent wedge resection for two lobes,accounting for 6%,and 6 patients underwent segmental resection,accounting for 12%.Endotracheal intubation was performed in the two groups under general anesthesia.The postoperative complications(postoperative pneumothorax,progressive hemorrhage in the thorax,pulmonary tissue insufficiency,pulmonary inflammation,pneumothorax),postoperative pain score,postoperative hospital stay,total hospital cost,postoperative hospital cost,incision size,operation time,intraoperative bleeding volume,etc.were compared and analyzed.Results: The operation of the two groups proceeded smoothly,and no patient died during the perioperative period.There were 24 male patients and 26 female patients in the retention group,accounting for 48.0% and 52.0% of the total number of patients.There were 10 male patients and 15 female patients in the non tube group,accounting for 40.0% and 60.0% of the total number of non tube patients,respectively.The average age of the tube retention group was54.8 ± 12.1 years;The mean age of tubeless group was 50.2 ± 14.3 years.There was no significant difference in the distribution of gender and age between the two groups.The P values were 0.512 and 0.148 respectively,which were greater than 0.05,indicating that the general data of the two groups were balanced and comparable.There was no significant difference in intraoperative bleeding,incision length and operation time between the tube retention group and the tube free group(P =0.619,P =0.429,P =0.485).There was no significant difference in postoperative complications between the two groups(P = 0.333).The postoperative pain score,postoperative hospitalization days,postoperative hospitalization expenses and total hospitalization expenses in the tube group were significantly higher than those in the non tube group(P values were P < 0.001,P =0.002,P < 0.001 and P < 0.001,respectively).(P values were 0.001 and 0.032,respectively).Conclusion: 1.No tube after single hole thoracoscopic surgery has the advantages of less postoperative pain,short hospital stay,less postoperative hospitalization expenses and less total hospitalization expenses.2.Early postoperative functional exercise and recovery,no drainage tube after operation,no drainage tube during operation,less postoperative complications,beautiful incision,rapid recovery and early discharge are in line with the concept of rapid rehabilitation surgery.