Resident physician training in bedside pleural procedures: A one-year experience at a teaching hospital.

BACKGROUND AND OBJECTIVE: This study aims to quantify bedside pleural procedures performed at a quaternary teaching hospital describing technical and epidemiological aspects. MATERIALS AND METHODS: The authors retrospectively reviewed consecutive patients who underwent invasive thoracic bedside procedures between March 2022 and February 2023. RESULTS: 463 chest tube insertions and 200 thoracenteses were performed during the study period. Most procedures were conducted by 1st-year Thoracic Surgery residents, with Ultrasound Guidance (USG). There was a notable preference for small-bore pigtail catheters, with a low rate of immediate complications. CONCLUSION: Bedside thoracic procedures are commonly performed in current medical practice and are significant in surgical resident training. The utilization of pigtail catheters and point-of-care ultrasonography by surgical residents in pleural procedures is increasingly prevalent and demonstrates high safety.

Advances in Minimally Invasive Procedures of the Thoracic Cavity.

Significant advances in veterinary minimally invasive surgeries and procedures have occurred in the past 10 years. These advances have been allowed due to continual research into optimizing working space through one-lung ventilation techniques and carbon dioxide insufflation. Additionally, minimally invasive surgery enthusiasts have joined forces with interventionalists and, in many cases, physicians to push the boundaries, minimize pain, suffering, and time away from owners with advances in a variety of procedures. Several larger multi-institutional retrospective studies on various disease processes allow veterinarians and owners to understand that minimally invasive approaches allow for outcomes comparable to traditional open surgery and, in some cases, may now be considered the standard of care in canine and feline patients.

How can I treat calcified chronic pleural empyema in African context: A case report.

INTRODUCTION AND IMPORTANCE: Despite the chance of a complete cure that surgery offers for patients seen early, the management of some complicated forms of chronic pyothorax with calcified pleural pockets of tuberculosis origin is risky, if not impossible. In these conditions, thoracomyoplasty with complete effacement of the pleural pocket is an effective alternative in the surgical management of these pockets. CASE PRESENTATION: We report the case of a 37-year-old male African Arab who was treated for a chronic, calcified pleural pocket of tuberculous origin and in whom low thoracomyoplasty was performed because of the impossibility of performing a left pleuropneumonectomy. The operating courses were uneventful with full pocket closures. REVIEW: 1 year later, the patient reported having resumed his active professional life. CLINICAL DISCUSSION: Pleural decortication associated or not with a pulmonary resection is the main surgical procedure used to manage chronic pyothorax. However, this procedure remains difficult with the risk of death, if not impossible, in cases of long-term chronicity with calcification of the pleural poche wall. In these cases, thoracomyoplasty constitutes a viable alternative in the surgical management of these pleural pockets. CONCLUSION: In the context of tuberculosis and chronic pleural empyema, thoracomyoplasty can be an alternative with satisfactory results when performed by an experienced team using this technique.

Percutaneous transthoracic catheter drainage prior to surgery in treating neonates with congenital macrocystic lung malformation presenting with respiratory distress.

Backgound: It is rarely seen that neonates with congenital macrocystic lung malformation (CMLM) presenting with respiratory distress require emergency intervention. No consensus has been achieved concerning the best policy facing such condition. This study aims to evaluate the efficacy and safety of our strategies in treating neonates with CMLM presenting with respiratory distress. Methods: We retrospectively reviewed the data of six neonates with CMLM presenting with respiratory distress from April 2020 to October 2022 for whom drainage-prior-to-surgery strategy were adopted and favorable outcomes were obtained. The relevant data was reviewed and analyzed. Results: All the patients were prenatally diagnosed with congenital lung malformation and postnatally as congenital macrocystic lung malformation via CT scan. Each neonate accepted percutaneous thoracic catheter drainage prior to surgery. The first and fifth neonates with macrocystic lung mass experienced prompt open lobectomy and delayed thoracoscopic surgery due to failure of air drainage, respectively. The other four patients obtained good drainage of the large air-filled cyst, thus gaining the opportunity for elective thoracoscopic surgery within median 45 days. Conclusions: For neonates with macrocystic lung malformation presenting with respiratory distress due to mediastinal compression, percutaneous thoracic catheter drainage is worth a shot for elective thoracoscopic surgery due to its feasibility and safety.

A randomized controlled trial: Comparison of 14 and 24 French thoracic drainage after minimally invasive lobectomy - MZ 14-24 study.

Background: The optimal placement of a chest drain after video-assisted minimally invasive lobectomy should facilitate the aspiration of air and drainage of fluid. Typically, a conventional 24Ch polyvinyl chloride chest drain is used for this purpose. However, there is currently no scientific literature available on the impact of drain diameter on postoperative outcomes following anatomical lung resection. Methods: This is a prospective, randomized, phase-1 trial that will include 40 patients, which will be randomly assigned into two groups. Group 1 will receive a 24 French chest drain according to current standards, while group 2 will receive a 14 French drain. Primary endpoint of the trial is the incidence of postoperative drainage-related complications, such as obstruction, dislocation, pleural effusion, and reintervention. Secondary endpoints are postoperative pain, chest drainage duration, incidence of complications, and hospital length of stay. The study aims to determine the number of subjects needed to achieve a sufficient test power of 0.8 for a non-inferiority study. Discussion: Thoracic surgery is becoming more and more minimally invasive. One of the remaining unresolved problems is postoperative pain, with the intercostal drain being one of the main contributing factors. Previous data from other studies suggest that the use of small-bore drains can reduce pain and speed up recovery without an increase in drain-related complications. However, no studies have been conducted on patients undergoing anatomic lung resections to date. The initial step in transitioning from larger to smaller drains is to establish the safety of this approach, which is the primary objective of this trial.Trial registration: The study has been registered in the German Clinical Trials Register.Registration number: DRKS00029982.URL: https://drks.de/search/de/trial/DRKS00029982.

Design and application of small-diameter closed thoracic drainage tube fixation following lung wedge resection: A randomised prospective study.

BACKGROUND: The use of indwelling closed thoracic drainage tubes in the wedge resection of the lungs is of great significance to postoperative recovery. However, there are potential risks. OBJECTIVE: To explore the design feasibility and application effect of triple-buffer-system-fixed small-diameter (18 F) thoracic closed drainage tubes following lung wedge resection. METHODS: A total of 136 patients with indwelling thoracic drainage tubes following pulmonary wedge resection were recruited, with 70 patients allocated to the control group and 66 to the experimental group. The drainage tube in the experimental group was fixed with the triple-buffer system, while that in the control group was fixed using the conventional lifting platform method. The incidence of unplanned extubation, the indwelling time of the drainage tube and the time and material costs, as well as information regarding any subcutaneous emphysema and skin tension blisters, were recorded following the operation. The pain and degree of comfort were assessed using a chi-square test and a rank sum t-test to compare the differences between the two groups. RESULTS: There were no statistically significant differences in terms of age, gender and sweating between the two groups. Compared with the control group, the unplanned extubation rate of the experimental group was lower (χ2= 8.513; P= 0.004), the indwelling time of the drainage tube was shorter (t= 2.108; P= 0.037), the cumulative material cost was lower (t= 3.778; P< 0.001), the time cost was also lower (Z= 2.717; P= 0.008), the degree of comfort was higher (Z= 2.752; P= 0.006), and the degree of pain was lower (Z= 4.019; P< 0.001). The incidence of subcutaneous emphysema was significantly lower in the experimental group than in the control group (χ2= 8.513; P= 0.004). CONCLUSION: The use of the triple-buffer system to fix small-diameter (18 F) thoracic closed drainage tubes can reduce the unplanned extubation rate, indwelling time of the drainage tube and the incidence of adverse reactions.

Pleural drainage vs video-assisted thoracoscopic debridement in children affected by pleural empyema.

BACKGROUND: Both thoracic drainage and video-assisted thoracic surgery (VATS) are available treatment for pleural empyema in pediatric patients. MATERIALS AND METHODS: This retrospective multicenter study includes pediatric patients affected by pleural empyema treated from 2004 to 2021 at two Italian centers. Patients were divided in G1 (traditional approach) and G2 (VATS). Demographic and recovery data, laboratory tests, imaging, surgical findings, post-operative management and follow-up were analyzed. RESULTS: 70 patients with a mean age of 4.8 years were included; 12 (17.1%) in G1 and 58 (82.9%) in G2. Median surgical time was 45 min in G1, 90 in G2 (p < 0.05). Mean duration of thoracic drainage was 7.3 days in G1, 6.2 in G2 (p > 0.05). Patients became afebrile after a mean of 6.4 days G1, 3.9 in G2 (p < 0.05). Mean duration of antibiotic therapy was 27.8 days in G1, 25 in G2 (p < 0.05). Mean duration of postoperative hospital stay was 16 days in G1, 12.1 in G2 (p < 0.05). There were 4 cases (33.3%) of postoperative complications in G1, 17 (29.3%) in G2 (p > 0.05). 2 (16.7%) patients of G1 needed a redosurgery with VATS, 1 (1.7%) in G2. CONCLUSIONS: VATS is an effective and safe procedure in treatment of Pleural Empyema in children: it is associated to reduction of chest tube drainage, duration of fever, hospital stay, time of antibiotic therapy and recurrence rate.

Benefits of using digital thoracic drainage systems for post-operative treatment in pediatric populations: personal experience and review of literature.

Introduction: The digital chest drainage monitoring system (Medela Thopaz+), unlike analogical systems, reliably regulates the pressure applied to the patient's chest and digitally and silently monitors critical therapeutic indicators (volume of fluid and/or drained air). Its use in adulthood has been widely described, but there is still little experience in the pediatric field. The aim of this study is to test this new device in the pediatric population. Materials and methods: We conducted a retrospective study of 160 patients undergoing chest surgery at our Hospital. These patients were divided into 82 treated with the Thopaz system in the period from January 2021 to April 2023 and 78 in whom Pleurevac, had been used in the time period from January 2020 to April 2023. Results: The average age of patients was 10.45 years (range: 3.1-17.2) for the Thopaz Group and 10.71 years for Pleurevac Group. The groups were homogeneus also by weight and type of intervention. The device was held in place for 10.64 days (mean) for Thopaz Group, compared to 16.87 days (mean) for Pleurevac Group (p < 0.05). The median number of postoperative x-rays before the closure of the chest tube was 4.29 in the digital drainage group compared to 8.41 in the traditional draining group (p < 0.05). Conclusions: The digital chest monitoring device provides objective measurement, allows for rapid patient mobilization (with good pain control and increased compliance). In addition, the use of Thopaz in the paediatric population seems to be safe (there is no statistically significant difference in terms of complications such as prolonged air leaks and pneumothorax after the chest tube closure) and potentially beneficial.

Comparison of central venous catheter thoracic drainage and traditional closed thoracic drainage following minimally invasive surgery for esophageal carcinoma: a retrospective analysis.

OBJECTIVE: To compare the effectiveness and safety of central venous catheter thoracic drainage (CVCTD) with traditional closed thoracic drainage (TCTD) after minimally invasive surgery for esophageal cancer. METHODS: We conducted a retrospective investigation of 103 patients who underwent minimally invasive esophageal cancer surgery at our institution between January 2017 and December 2019. Among them, 44 patients underwent CVCTD, while 59 received TCTD. We compared the following outcomes between the two cohorts: drainage volume, duration of drainage, postoperative complications (including pleural effusion, pulmonary infection, atelectasis, anastomotic leakage, etc.), length of hospital stay, and postoperative pain assessment. RESULTS: No significant differences were observed between the experimental and control groups regarding postoperative thoracic drainage, the timing of postoperative tube removal, or postoperative complications. However, significant disparities were noted in the duration of postoperative hospitalization, drainage tube healing time, and pain threshold among the esophageal cancer patients in both cohorts (p < 0.05). CONCLUSION: CVCTD is a secure and potent alternative to TCTD following minimally invasive surgery for esophageal carcinoma. It potentially contributes to reducing the incidence of postoperative complications while curtailing the duration of hospitalization. Additional research is warranted to substantiate these findings.

Delayed Tension Hemothorax With Nondisplaced Rib Fractures After Blunt Thoracic Trauma.

Blunt thoracic trauma often causes rib fractures, hemothorax, and pneumothorax. Although there is no established definition regarding the duration and management of delayed hemothorax, it commonly occurs in a few days and exhibits at least one displaced rib fracture. Moreover, delayed hemothorax rarely develops tension hemothorax. A 58-year-old male who had a motorcycle accident received conservative treatment from his orthopedic doctor. He felt a sudden severe chest pain 19 days after the accident. Contrast-enhanced computed tomography (CT) of the chest revealed multiple left-sided rib fractures without displacement, left pleural effusion, and extravasation near the intercostal space of the seventh rib fracture. After transfer to our hospital and a plain CT scan, which showed a more mediastinal shift toward the right, his condition deteriorated with cardiorespiratory embarrassment, such as restlessness, hypotension, and neck vein distention. We diagnosed him with obstructive shock due to tension hemothorax. Immediate chest drainage ameliorated restlessness and elevated blood pressure. Here, we report an extremely rare and atypical case of delayed tension hemothorax after blunt thoracic trauma without displaced rib fractures.

Misconnected chest tube: An extremely unusual fatal complication of secondary pneumothorax.

A rare and fatal complication of suction drainage of secondary spontaneous pneumothorax is reported. The patient, likely by a mistake, arbitrarily connected the oxygen supply tube to the thoracic drain. The sharp increase of intrapleural pressure combined with the atmospheric intraalveolar environment caused diffuse lung injury and cardiopulmonary collapse without a direct lung injury. The conflicting interests of patient autonomy and patient safety require further consideration.

A long-lasting Sphingomonas paucimobilis outbreak: A potential for pathogens to persist on environmental devices despite disinfection measures.

BACKGROUND: Sphingomonas paucimobilis, an aerobic, non-fermentative, Gram-negative opportunistic bacillus, can colonize everywhere in hospital settings where water is used. We reported a hospital S paucimobilis outbreak that persisted for nearly 2 years despite all necessary preventive measures. METHODS: Over a period from February 13, 2020 to December 3, 2021, 67 patients were identified to have S paucimobilis as documented by positive cultures from clinical samples, along with 19 positive environmental samples. RESULTS: Bacterial regrowth for molecular analysis could be obtained in 49 isolates (39 clinical, 4 extracorporeal membrane oxygenation (ECMO) water heater devices, 1 unused mouthwash solution, 5 water samples from thoracic drainage aspirators). Two distinct clonally indistinguishable genotypes were detected in AP-PCR and PFGE analyses, with 100% consistency. The main cluster was obtained consistently throughout the outbreak from 30 samples (61.2%: 24 clinical, 4 ECMO, 1 unused mouthwash solution, 1 water sample from the thoracic drainage aspirator). The other cluster involved 15 clinical samples and 4 water samples from the thoracic drainage aspirators. CONCLUSIONS: Given that waterborne pathogens can spread to a wide range of equipment used in healthcare environments, the pathogens can persist on the surfaces of environmental devices even after recommended disinfection measures have been applied. Therefore, individual tracking of all devices used in critical care settings, such as thoracic drainage aspirators and ECMO water heater devices, with records of pre- and post-disinfection procedures is of paramount importance for complete elimination of the source of infection.

Application of ultrafine thoracic drainage tube for postoperative lung tumors after pulmonary uniportal video-assisted thoracoscopic surgery / 中华胸心血管外科杂志

Objective:To investigate the clinical application of ultrafine thoracic drainage tube(Abel, 8FR, 20 cm) after pulmonary uniportal video-assisted thoracoscopic surgery lung tumors.Methods:A total of 2 031 patients who doing lung tumor surgery in the Department of Thoracic Surgery of the First Hospital of Lanzhou University from May 2015 to July 2020 were retrospectively enrolled. According to the types of thoracic drainage tubes, they were divided into the ultrafine drainage tube group(1 026 cases) and the conventional drainage tube group(1 005 cases). The groups were compared in terms of postoperative thoracic drainage at 24 h, 48 h and 72 h, postoperative hospital stay, drainage time, postoperative pain index at three days, postoperative analgesia times and postoperative complications.Results:There was no significant difference between two groups in terms of the postoperative thoracic drainage at 24h, 48h, 72h and drainage time( P>0.05). Notably, there were significant differences between two groups in terms of the postoperative hospital stay, postoperative pain index at three days, postoperative analgesia times and postoperative complications( P<0.05). Conclusion:The use of ultrafine thoracic drainage tube after lung tumor surgery is safe and reliable, can better postoperative drainage, achieve the purpose of relieving pain, speeding up postoperative rehabilitation, and convenient nursing, worthy of clinical promotion and application.

Application effects of thoracoscopic resection of a pulmonary bulla without tube thoracostomy / 中国基层医药

Objective:To investigate the application effects of thoracoscopic resection of a pulmonary bulla without tube thoracostomy.Methods:A total of 60 patients who underwent thoracoscopic resection of a pulmonary bulla from January 2019 to January 2021 in Urumqi Youai Hospital were included in this study. They were randomly divided into an observation group and a control group ( n = 30/group). Tube thoracostomy was performed in the control group but not in the observation group. Oxygenation index measured at 24 hours, pain score measured at 24, 48 and 72 hours after surgery, complications, hospital stay, and total hospitalization expense were compared between the two groups. Results:There was no significant significance in oxygenation index measured at 24 hours between the two groups ( P > 0.05). At 24, 48 and 72 hours after surgery, pain score in the observation group was (2.6 ± 1.2) points, (1.5 ± 0.8) points, and (0.9 ± 1.1) points, respectively, which were significantly lower than (4.5 ± 1.4) points, (3.8 ± 1.5) points, (2.8 ± 1.7) points in the control group ( t = 1.34, 1.13, 0.92, all P < 0.05). The total incidences of postoperative pleural effusion and complications in the observation group were 3.3% (1/30) and 20.0% (6/30), respectively, which were significantly lower than 26.7% (8/30) and 46.7% (14/30) in the control group ( χ2 = 6.40, 4.25, both P < 0.05). The postoperative hospitalization time and total hospitalization expense in the observation group were (3.4 ± 0.8) days and (1.1 ± 0.3) × 10 000 yuan, respectively, which were significantly shorter or less than (6.5 ± 1.4) days and (1.4 ± 0.5) × 10 000 yuan in the control group ( t = 10.22, -1.88, both P < 0.05). Conclusion:Thoracoscopic resection of a pulmonary bulla without tube thoracostomy is feasible and safe, which has a certain promotion value.

Aggressive approach for spontaneous pneumothorax treatment in children with Marfan syndrome?

Background and objectives: Marfan syndrome (MS) is a systemic disease of connective tissues consisting of a variable combination of anomalies. These patients have an increased risk of spontaneous pneumothorax (SP). However, there is a scarcity of pediatric literature on management, and no specific guidelines exist. Our aim was to analyze the management of spontaneous pneumothorax in children and adolescents with Marfan syndrome, comparing syndromic and non-syndromic patients. Methods: Retrospective analysis of pediatric patients (18 years) with SP diagnosed at our tertiary pediatric hospital (January 10-June 22), with special emphasis on diagnosis, treatment, and follow-up (FU). Results: Sixty-six patients with SP were identified, with nine (13%) having MS. In terms of baseline, there were no significant differences between the groups (age, sex, asthma, symptoms, and side, first-line treatment and hospitalization length). Overall, Marfan patients had significantly more first-line treatment failures requiring additional surgery, as well as more contralateral occurrences and the need for surgery/chest drain during the follow-up. Instead, conservative management resulted in significantly more ipsilateral recurrences and the need for surgery/chest drain in Marfan patients than controls during the follow-up. Conclusions: Treatment failure, contralateral occurrence, ipsilateral recurrence, and the need for surgery/chest drain during follow-up make management of patients with Marfan syndrome and spontaneous pneumothorax more difficult. In patients with a diagnosed MS a more aggressive first-line management should be considered, bearing in mind the higher risks of this population.

Boerhaave syndrome presenting black pleural effusion: A case report.

A 55-year-old man experienced nausea and vomiting after brushing his teeth. He experienced back pain after this episode and visited our emergency department. Chest computed tomography (CT) images revealed moderate pleural fluid accumulation and mild left pneumothorax. Thoracentesis showed black pleural effusion. Thoracic drainage included food debris with black pleural effusion, and gastroscopy revealed food debris and perforation of the lower esophagus. Esophageal perforation was surgically repaired using omental implantation and pleuroclysis. Given the high mortality rate associated with black pleural effusion, prompt diagnostic procedures and corresponding management are essential.

Open pneumothorax with extensive thoracic defects sustained in a fall: a case report.

BACKGROUND: Open pneumothorax with chest wall deficit is a rare chest trauma that is serious and can lead to severe respiratory failure; however, it is a potentially lifesaving injury if utilized appropriately. CASE PRESENTATION: Herein, we report a case of an open pneumothorax with extensive chest wall deficit due to falling from a height and highlight the importance of appropriate evaluation and intervention. The patient was a Japanese man in his 50 s who fell from the 6th floor to the 3rd floor while working at a height. The left chest wall was punctured due to injury, the thoracic cavity was open as if a left anterolateral thoracotomy had been performed, and the left lung had prolapsed from the thoracic cavity to the outside. In our emergency department, tracheal intubation with a double lumen tube for differential positive pressure ventilation and a right thoracic drain were inserted, and an emergency operation was started immediately. A pulmonary suture for lung injury and closure of the left thorax were performed during the surgery. The defect was closed with the remaining tissue, but the anterior thoracic skin with poor blood flow was necrotic, so debridement was undertaken. After his general condition was improved, pedicled latissimus dorsi myocutaneous flap was implanted. He was discharged home on the 63rd hospital day. CONCLUSIONS: Although open pneumothorax is rare and sometimes presents lurid findings, we highlighted that it is important to quickly assess the life-threatening organ injury, perform positive pressure ventilation by tracheal intubation, thoracic drainage, and wound closure simultaneously respond calmly as a team.

Boerhaave's Syndrome: A Case Report.

Boerhaave's syndrome is a rare spontaneous perforation of the esophagus with high mortality. The diagnosis is difficult because it has no specific symptom. It requires urgent intervention. We report the case of a 63-year-old male admitted to the emergency department with respiratory distress. Chest computed tomography (CT) revealed large, bilateral, and tension hydropneumothorax, stomach distention, and aerobilia. Thoracic drainage was performed immediately. Control CT revealed esophagus perforation in the middle third of the esophagus with extravasation of the contrast product from the esophagus to the pleura. Urgent surgery was performed, and the patient was admitted to the intensive care unit (ICU) with septic shock. Early diagnosis and management with a damage control approach including thoracic drainage and surgery are essential to improve prognosis and reduce mortality.

A propensity sore-matched study: Applying a modified chest tube drainage strategy in rapid rehabilitation following uni-portal thoracoscopic pulmonary wedge resection.

PURPOSE: This study aimed to compare the value of a modified chest tube drainage strategy to a traditional drainage strategy in single-port thoracoscopic pulmonary wedge resection. METHODS: From January 2019 to July 2021, we collected clinical data on 405 patients who underwent single-port thoracoscopic pulmonary wedge resection in the No.1 Department of Thoracic Surgery at Fujian Medical University Union Hospital, with 121 (29.9%) cases in the modified drainage strategy group and 284 (70.1%) cases in the traditional drainage strategy group. The propensity score matching method (Match Ratio = 1:1) was used to reduce differences in clinical characteristics between the two groups. RESULTS: Following 1:1 propensity score matching, 120 matched pairs (240 patients) were included in the study. There was no significant difference in general clinical characteristics between the two groups. There was no statistical difference in intraoperative factors except for operative times (71.42 ± 22.98 min vs. 86.80 ± 36.75 min, p < 0.001). In terms of postoperative factors, there were significant differences in postoperative chest tube duration (0.00 ± 0.00 h vs. 32.68 ± 18.51 h, p < 0.001), total drainage volume (143.03 ± 118.33 ml vs. 187.73 ± 140.82 ml, p = 0.008), postoperative hospital stay (2.61 ± 0.70 days vs. 3.27 ± 1.88 days, p < 0.001), number of additional pain relief (0.14 ± 0.40 vs. 0.42 ± 0.74, p < 0.001), facial pain score (2.7 ± 1.8 vs. 3.6 ± 2.7, p = 0.005) and adverse events (p = 0.046). Furthermore, there was a statistical difference between the two groups regarding CTCAE grade-1 complication, but no statistical difference in CTCAE grade-2 complication. CONCLUSIONS: A modified drainage strategy in single-port thoracoscopic pulmonary wedge resection is safe and feasible, allowing for less postoperative rehabilitation time, pain relief, reduced postoperative pleural effusion, and reduced clinical workload.

Analysis use different diameter thoracic drainage tube with negative pressure drainage ball on the chest drainage effect after biportal thoracoscopic radical resection for lung cancer / 中华胸心血管外科杂志

Objective:To explore the chest drainage effect of use different diameter thoracic drainage tube after biportal thoracoscopic radical resection for lung cancer.Methods:300 patients with lung cancer who received biportal thoracoscopic radical resection were divided into group A and group B from January 2018 to September 2020. Group A: 150 patients with single 28# thoracic drainage tube after surgery. Group B: 150 patients with single 20# thoracic drainage tube and a negative pressure drainage ball after surgery. The postoperative drainage volume, drainage time, postoperative pain, postoperative thoracic puncture, hospital stay and total hospital expenses were compared.Results:No significant difference between the two groups in terms of sex, age, postoperative pathological type and resection range. There no significant difference between the two groups in total drainage volume [(1 010.31±525.29)ml vs.(985.35±403.93)ml] and total drainage time [(5.69±2.55)days vs.(5.42±1.94)days]. The difference of different diameter thoracic drainage tube used [(5.69±2.55)days vs.(2.88±0.64)days] was statistically significant. There were significant differences between two groups in terms of hospital stay[(12.64±2.89)days vs.(11.25±1.62)days] and total hospital expenses[(62 899.00±1 588.82) yuan vs.(64 327.00±3 587.04)yuan]. No significant differences on the postoperative first day, second day and third day in VAS pain scores. However, on the postoperative fifth day, the difference was statistically significant. In addition, the rate of group A postoperative thoracic puncture was 10%, group B was 0, the comparison was statistically significant.Conclusion:Using a single thin thoracic drainage tube and plus a negative pressure drainage ball after biportal thoracoscopic radical resection for lung cancer will not cause pain increase, shorten hospital stay days, control the rate of postoperative thoracic puncture and then reduce patients total hospital expenses.