Efficacy and outcomes of total tubeless single-port thoracoscopic wedge resection for peripheral pulmonary nodules.

Background: Total tubeless (TT) single-port thoracoscopic wedge resection is a novel minimally invasive surgical technique for treating peripheral pulmonary nodules. This study aims to evaluate its safety, efficacy, and patient satisfaction in comparison with partial tubeless (PT) surgery. Methods: This retrospective study analyzed data from 89 patients with peripheral pulmonary nodules, who underwent tubeless single-port thoracoscopic wedge resection at the Department of Thoracic Surgery I, Fujian Medical University Union Hospital between July 2023 and September 2024. Patients were divided into two groups based on the presence or absence of a chest puncture drainage tube: the TT group and the PT group. Results: The TT group consisted of 49 patients with a mean age of 44.16±11.03 years, while the PT group comprised 40 patients with a mean age of 51.33±13.66 years. After 1:1 propensity score matching (PSM), 68 patients were analyzed. No significant difference in intraoperative blood loss was observed (10.00±2.13 vs. 11.47±4.85 mL, P>0.05), but the TT group had shorter operative time (65.65±16.38 vs. 79.65±24.78 minutes, P<0.05). The TT group exhibited a higher degree of pneumothorax on day 1 (15.00%±9.53% vs. 10.15%±10.26%, P<0.05), but no significant differences in body temperature, inflammatory markers, or pleural effusion were found (P>0.05). Cough and pain incidence on days 1, 7, and 30 were similar between the groups (P>0.05), with high patient satisfaction (P>0.05). Conclusions: TT single-port thoracoscopic wedge resection is a safe and effective approach for treating peripheral pulmonary nodules.