Objective To investigate the effect of combining the placement of a low-position pigtail catheter under direct intraoperative vision with a single-incision drainage tube in improving pleural effusion drainage.

Methods A total of 136 lung cancer patients who underwent single-port video-assisted thoracoscopic left or right lower lobectomy combined with systematic lymph node dissection were included in this study. The patients were divided into experimental group and control group based on the method of postoperative thoracic drainage tube placement. In the control group, a conventional thoracic drainage tube was placed through the single incision. In the experimental group, in addition to placing a thoracic drainage tube through the incision, a fine-bore pigtail catheter was placed at the lowest position in the thoracic cavity under direct intraoperative vision for combined drainage, without any puncture-related bleeding or secondary injuries. The postoperative pleural fluid drainage effect, pain scores Visual Analogue Scale (VAS), and other clinical prognostic indicators were compared between the two groups.

Results The experimental group included 72 patients, while the control group included 64 patients. The total pleural fluid drainage volume on the first postoperative day in the experimental group was (225.64±43.32) mL, which was significantly higher than (172.28±37.81) mL in the control group (P < 0.001). The proportion of patients with postoperative pleural effusion in the experimental group was significantly lower than that in the control group, and the postoperative thoracic drainage tube indwelling time and postoperative hospital stay were significantly shorter in theexperimental group than that in the control group (P= 0.016 or P < 0.001). The VAS score for activity status on the third postoperative day was lower in the experimental group than that in the control group, with a statistically significant difference (P=0.032). There was no statistically significant difference in the incidence of postoperative chylothorax, recurrent laryngeal nerve injury, arrhythmia, poor incision healing and fever between the two groups (P>0.05).

Conclusion The combined use of a low-position fine-bore pigtail catheter in single-port video-assisted thoracoscopic radical resectionof lower lobe lung cancer can improve postoperative drainage efficiency and shorten hospital stay without increasing pain or trauma.