A Novel Same Day Discharge Program After Pulmonary Wedge Resection: A Prospective Clinical Trial

Area of Science:

• Thoracic Surgery
• Minimally Invasive Procedures
• Patient Outcomes

Background:

• Current practice for minimally invasive pulmonary wedge resection (MIS-PWR) involves chest tube (CT) retention for at least 24 hours post-surgery.
• Emerging evidence suggests minimal complications during this period, but prospective data is lacking.

Purpose of the Study:

• To assess the feasibility and safety of early CT removal and same-day discharge (SDD) after elective MIS-PWR.
• To evaluate the primary outcomes of successful early CT removal and successful SDD.

Main Methods:

• A two-phase, nonrandomized prospective clinical trial was conducted.
• Phase 1: Assessed safety of early CT removal at 4 hours postoperatively.
• Phase 2: Evaluated both early CT removal and SDD, comparing outcomes to a control group.

Main Results:

• Phase 1: 71% of patients had early CT removal, with a significantly shorter hospital stay (1.0 vs 2.0 days) and no increase in complications.
• Phase 2: 74% underwent early CT removal, and 61% achieved SDD, with no significant differences in complications or hospital readmissions.
• No patients required pleural reintervention after early CT removal.

Conclusions:

• Early CT removal is feasible and safe for select patients undergoing MIS-PWR.
• Same-day discharge is a safe option for patients after MIS-PWR with early CT removal.
• These findings support a potential shift in postoperative care protocols for MIS-PWR.