Outcomes of Video-Assisted Thoracoscopic Wedge Resection Using a Non-Crushing Clamp and Continuous Sutures Plus Hemovac Drains Versus Staplers Plus Conventional Chest Tube: A Comparative Study

Abstract

Abstract OBJECTIVES. In thoracoscopic surgery, we described wedge resection of the parenchyma with clamps and subsequent use of hemovac drains and compared it with the standard technique of using staplers and conventional chest tubes. METHODS. Fifty-nine patients who underwent thoracoscopic wedge resection between 2018 and 2024 were retrospectively analyzed. Patients were divided into two groups according to the surgical and drain types: stapler plus chest tube (S-ct, n = 27) and clamp plus hemovac drain (C-hd, n = 32). Air leak duration, postoperative drainage time, hospital stay duration, and total medical costs were also investigated. RESULTS. There were no significant differences in patient characteristics between both groups. The operation time was longer in Group C-hd (median 70 min versus median 60 min, p = 0.115). Prolonged air leak rates were similar between the two groups (11.1% and 12.5% in Groups S-ct and C-hd, respectively). The air leak duration and postoperative drainage time were not statistically significantly different between both groups (p = 0.872 and p = 0.176, respectively). The VAS scores on the first postoperative and day were significantly lower in Group C-hd (p = 0.02, and p = 0.02, respectively). Pain requiring additional treatment was significantly higher in Group S-ct (33.3% vs. 9.4%, p = 0.04). Total medical cost was statistically significantly higher in Group S-ct (median 371.7 vs. 191.6 dollars, p < 0.001). CONCLUSION. In thoracoscopic surgery, wedge resection of the parenchyma with clamping and subsequent use of a hemovac drain are comparable to the standard technique of using staplers and conventional chest tubes regarding short-term results and better economic results. Hemovac drainage can reduce postoperative pain.