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Background: There are no standard guidelines regarding the number and size of chest tubes that should be selected after thoracic surgery. This study aimed to evaluate the effects of adopting a drainage strategy with bi-pigtail catheters (BPCs) on patients undergoing lobectomy by uniportal video-assisted thoracic surgery (VATS)., Methods: A retrospective study was performed of patients undergoing uniportal lobectomy at the Department of Thoracic Surgery of the Cancer Hospital of Dalian University of Technology between August 2021 and August 2022. The patients were divided into the following two groups according to the drainage strategy adopted: (I) a traditional chest tube (TCT) group; and (II) a BPC group. The outcomes measured included postoperative complications, as measured by the Clavien-Dindo method, and the visual analogue scale (VAS) pain scores of the patients after surgery., Results: In total, 868 patients underwent lung resection during the study period, after exclusion, the data of 470 patients who underwent uniport lobectomy were reviewed (235 in the TCT group, and 235 in the BPC group). There were no statistically significant differences between the two groups in terms of baseline data (P>0.05). The incidence of postoperative complications (7.7% vs . 19.1%) and postoperative VAS pain scores at 7-24 hours (3.3±1.0 vs . 3.7±1.5) and 25-48 hours (3.1±0.8 vs . 3.6±1.5) were significantly lower in the BPC group than the TCT group (all P<0.001). Additionally, the postoperative length of stay (4.6±1.5 vs . 5.4±4.5 days) and the collapse rate of the residual lung (19.2%±9.1% vs . 20.9%±9.6%) of the BPC group were better than those of the TCT group (P<0.05). The results of univariable and multivariable analyses showed that a drainage strategy with a TCT was an independent risk factor for decreased postoperative complications, and reduced moderate or severe pain scores at 7-24 and 25-48 hours after surgery., Conclusions: Our drainage strategy with BPCs decreased the incidence of postoperative complications and alleviated the postoperative pain of patients undergoing lobectomy by uniportal VATS and is safe and feasible., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-24-925/coif). H.C.F. serves as an unpaid editorial board member of Journal of Thoracic Disease from April 2024 to June 2026. The other authors have no conflicts of interest to declare., (2024 Journal of Thoracic Disease. All rights reserved.)

Background: This study aims to present our experience with endobronchial coils in patients who underwent endobronchial lung volume reduction due to advanced emphysema., Methods: The study included 46 patients (45 males, 1 female; mean age 61.7±8 years; range, 43 to 80 years) who underwent endobronchial lung volume reduction with endobronchial coils for advanced emphysema. Patients" age, gender, pulmonary function tests, post-treatment morbidity, mortality, pre- and post-treatment (6 months) six-minute walking distance, modified Medical Research Council dyspnea scores, chronic obstructive pulmonary disease assessment test and Hospital Anxiety and Depression Scale scores were recorded., Results: Patients had an average of 65 pack/year smoking history. An average of 11 (range, 9-15) coils were placed per lobe (right upper lobe=35, left upper lobe=19, right lower lobe=2, left lower lobe=4). Mean follow-up duration was 12.6 months (±5.6 months). Post-treatment forced expiratory volume in one second, residual volume and six-minute walking distance values were improved with statistical significance. Also, significant improvement was seen in quality of life, quantified by modified Medical Research Council, chronic obstructive pulmonary disease assessment test and Hospital Anxiety and Depression Scale scores. While no immediate major postoperative complications occurred, three patients developed chronic obstructive pulmonary disease exacerbation, two developed pneumonia, and one developed recurrence of previous neurologic disorder within 30 days., Conclusion: Endobronchial coil administration provides lower morbidity and mortality compared to lung volume reduction surgery as well as significant improvement in pulmonary functions and quality of life in selected patients with advanced emphysema., Competing Interests: Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article., (Copyright © 2019, Turkish League Against Rheumatism.)