title: Tubeless Uniportal Thoracoscopic Wedge Resection for Peripheral Lung Nodules.
abstract: BACKGROUND
  Endotracheal intubation and chest tube drainage are considered mandatory for thoracoscopic pulmonary resection. The management of peripheral lung nodules by tubeless uniportal thoracoscopic surgical repair has not been reported previously.
  
  
  METHODS
  From October 2015 through January 2016, 30 consecutive patients with peripheral lung nodules underwent uniportal thoracoscopic wedge resection without endotracheal intubation and chest tube drainage (tubeless group). The clinical outcomes were compared with the outcomes in 30 consecutive patients with peripheral lung nodules who underwent uniportal thoracoscopic wedge resection with chest tube drainage from April through October 2015 (chest tube group).
  
  
  RESULTS
  The demographic, anesthetic, and operative characteristics of the patients were comparable in both groups. No major adverse events occurred after operation. A small residual pneumothorax was noted in 12 (40.0%) patients at 6 hours and day 1 and in 2 (6.6%) patients on day 14 in the tubeless group. No patient required reintervention or readmission to the hospital. Patients in the tubeless group had lower pain scale scores on postoperative day 1 (mean, 1.0 vs 1.5, p = 0.012) and shorter postoperative hospital stays (mean, 3.1 days vs 4.4 days, p = 0.011) than did those in the chest tube group.
  
  
  CONCLUSIONS
  Tubeless uniportal thoracoscopic wedge resection is feasible and safe and may be a less invasive alternative for treating selected patients with peripheral lung nodules.
authors.affiliation: Department of Surgery, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan; Division of Thoracic Surgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Shun-Mao
authors.initials: SM
authors.lastname: Yang
authors.affiliation: Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Man-Ling
authors.initials: ML
authors.lastname: Wang
authors.affiliation: Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Ming-Hui
authors.initials: MH
authors.lastname: Hung
authors.affiliation: Division of Thoracic Surgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: ntuhsu@gmail.com.
authors.forename: Hsao-Hsun
authors.initials: HH
authors.lastname: Hsu
authors.affiliation: Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Ya-Jung
authors.initials: YJ
authors.lastname: Cheng
authors.affiliation: Division of Thoracic Surgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan; Department of Traumatology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Jin-Shing
authors.initials: JS
authors.lastname: Chen
mesh_terms: D000368:Aged; D015505:Chest Tubes; D015331:Cohort Studies; D016208:Databases, Factual; D004322:Drainage / Q000639:trends*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007442:Intubation, Intratracheal; D007902:Length of Stay; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D056888:Patient Positioning; D061214:Patient Safety; D018579:Patient Selection; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D012189:Retrospective Studies; D003074:Solitary Pulmonary Nodule / Q000473:pathology / Q000601:surgery*; D013624:Taiwan; D062606:Tertiary Care Centers; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D020708:Thoracoscopes; D016896:Treatment Outcome