Comparison of perioperative hospital stay, postoperative chest tube retention, pain levels between uniportal and multiportal thoracoscopic lung cancer resection patients.

PURPOSE: To compare perioperative hospital stay, chest tube retention time, and postoperative pain intensity between uniportal video-assisted thoracoscopic surgery (UVATS) and multiportal VATS (MVATS) for anatomical lung resection in patients with non-small cell lung cancer (NSCLC). METHODS: This retrospective cohort study enrolled 201 patients (83 in the UVATS group and 118 in the MVATS group) who underwent pulmonary lobectomy or segmentectomy. Daily postoperative chest drainage volume was recorded within the first three postoperative days. Postoperative pain intensity was assessed via the Visual Analog Scale (VAS) at 24 hours, 48 hours and 7 days after surgery. Opioid consumption, converted to morphine milligram equivalents (MME), was documented within the initial 48 postoperative hours. Chest tube retention time, postoperative length of stay and surgical complications were compared between groups. RESULTS: The UVATS group yielded significantly lower daily drainage volumes on postoperative day (POD) 1 (284.56 vs. 338.92 mL, P = 0.007), POD 2 (197.34 vs. 236.48 mL, P = 0.009) and POD 3 (130.58 vs. 159.12 mL, P = 0.004), as well as lower cumulative 72-hour drainage volume (612.48 vs. 743.52 mL, P = 0.001). Patients in the UVATS group reported remarkably lower VAS scores at 24 h (3.52 vs. 5.08, P<0.001), 48 h (2.98 vs. 4.22, P<0.001) and postoperative day 7 (2.21 vs. 2.75, P = 0.002), alongside reduced 48-hour opioid consumption (28.46 vs. 42.73 mg, P<0.001). Moreover, the UVATS group had shorter chest tube indwelling time (3.47 vs. 4.85 days, P<0.001) and shorter postoperative hospitalization (5.63 vs. 6.76 days, P = 0.001). The overall complication rate was also markedly lower in the UVATS group (14.46% vs. 27.12%, P = 0.033). CONCLUSION: Compared with MVATS, UVATS for NSCLC anatomical resection is associated with decreased postoperative pleural drainage, alleviated surgical pain, shortened chest tube indwelling and hospitalization duration, as well as reduced perioperative complications.