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 standard practice for minimally invasive pulmonary wedge resection (MIS-PWR) involves a minimum 24-hour hospital stay with an indwelling chest tube (CT).
• Emerging evidence suggests minimal complications during this period, but prospective studies are lacking.
• The safety and feasibility of early CT removal and same-day discharge (SDD) after MIS-PWR require investigation.

Purpose of the Study:

• To assess the feasibility and safety of early chest tube removal following elective minimally invasive pulmonary wedge resection (MIS-PWR).
• To evaluate the safety and success rate of same-day discharge (SDD) after early chest tube removal in MIS-PWR patients.
• To determine if early CT removal and SDD impact postoperative complications or hospital readmission rates.

Main Methods:

• A two-phase, nonrandomized prospective clinical trial was conducted.
• Phase 1: Assessed the safety of early CT removal at 4 hours postoperatively.
• Phase 2: Evaluated both early CT removal and same-day discharge (SDD).

Main Results:

• In Phase 1, 71% of patients undergoing early CT removal experienced a significantly shorter hospital stay (1 day vs. 2 days) without increased complications.
• In Phase 2, 74% had early CT removal, and 61% successfully achieved SDD, with no significant increase in complications or readmissions.
• No patients required pleural reintervention after early CT removal in either phase.

Conclusions:

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