Applied Research Of Single Ultra-Thin 12ga Pigtail Catheter Combined With Digital Drainage System After Thoracoscopic Anatomical Pulmonary Resection

Background:Enhanced recovery surgery refers to a clinical pathway method that reduces surgical stress and complications and promotes patient recovery through a combination of measures,which is widely developed in general surgery,orthopaedics and other fields.In recent years,the field of thoracic surgery has also paid more attention to the rapid recovery of patients.With the popularization of thin-slice CT,the detection rate of pulmonary nodules is increasing year by year.Anatomical lungs include lobectomy and segmentectomy for the treatment of lung cancer.Postoperative patients need routine indwelling chest tubes,while ordinary chest tubes are It will bring problems such as pain,inconvenience of movement,poor chest tube drainage,and insufficient training of lung function.This can lead to complications such as pulmonary infection.Objective:This study retrospectively analyzed the safety and feasibility of using a single ultra-thin 12 Ga pigtail catheter after anatomical pneumonectomy(lobectomy,segmentectomy)in the Thoracic Surgery Department of Shenzhen Third People’s Hospital.To analyze the factors influencing the application of a single ultra-thin pig tail catheter,and the intraoperative and postoperative treatment options.At the same time,the advantages and disadvantages of different thoracic drainage catheters were discussed and the experience was summarized,and the chest tube scheme for enhanced recovery surgery was formulated.Methods:In this study,174 patients with anatomical lung resection who underwent inpatient surgery in Shenzhen Third People’s Hospital from January 2020 to December 2021 were collected for retrospective analysis.Divided into the experimental group indwelling a single ultra-fine 12 Ga pig tail tube(91 cases),the control group indwelling a 28 Fr ordinary chest tube(83 cases),the postoperative hospital stay,pain score,chest tube indwelling time,chest tube indwelling time,and indwelling time were compared between the two groups.Whether there are differences in reintubation rate and other complications after extubation.Result:There were 91 cases in the experimental group.The postoperative hospital stay was4.82±2.02 days,the pain score was 1.58±0.49,the chest tube indwelling time was1.36±0.97 days,and the postoperative drainage was 117.71±150.45 ml.After extubation,4cases were re-intubated.There were 5 cases of infection,1 case of atelectasis,7 cases of pleural effusion,and 2 cases of wound infection.There were 83 cases in the control group.The postoperative hospital stay was6.61±4.78 days,the pain score was 1.94±0.59,the chest tube indwelling time was3.16±0.906 days,the postoperative drainage fluid was 261.71±218.88 ml,and the tube was placed again after extubation.2 cases,3 cases of pulmonary infection,1 case of atelectasis,5 cases of pleural effusion,and 2 cases of wound infection.There were no statistics on age,gender,type of resection(lobectomy or segmentectomy),operation time,intraoperative blood loss,VAS score on the first day after operation,postoperative complications,surgical resection method,and postoperative pathological type.Compared with the control group,the experimental group had a shorter postoperative hospital stay(4.82±2.02vs6.61±4.78,P=0.00),with a statistical difference.In terms of pain score,the pain score of the experimental group was lower on the 3rd day after operation(1.58±0.49 VS 1.94±0.592,P=0.00),the total postoperative pleural effusion drainage,and the experimental group had less pleural effusion drainage,which has statistical academic significance(P=0.00).ConclusionA single ultra-thin 12 Ga pig tail catheter can be safely used to drain pleural effusion and gas after anatomical pneumonectomy,reduce patient pain and shorten postoperative hospital stay.When combined with the digital drainage system,the need for low-level chest drainage can promote lung recruitment,achieve rapid extubation and rapid discharge.This approach is in line with the management concept of ERAS and deserves further exploration in prospective randomized controlled clinical trials.