Brief Summary
The goal of this clinical trial is to evaluate the safety and recovery outcomes of different tubeless strategies in adult patients undergoing uniportal video-assisted thoracoscopic (VATS) wedge resection who are confirmed to have no persistent air leak intraoperatively.
The main questions it aims to answer are:
Does double intraoperative aspiration tubeless strategy reduce the rate of postoperative pleural re-intervention within 30 days compared with single intraoperative aspiration tubeless strategy?
Do different intraoperative pleural space management strategies affect early postoperative recovery quality and pain?
If there is a comparison group:
Researchers will compare conventional chest tube drainage, single intraoperative aspiration tubeless, and double intraoperative aspiration tubeless strategies to determine their effects on postoperative pleural re-intervention and recovery outcomes.
Participants will:
Undergo uniportal VATS wedge resection
Receive a standardized intraoperative air leak test before chest closure
Be randomly assigned intraoperatively to one of three pleural space management strategies
Complete postoperative assessments including chest imaging, pain evaluation, and recovery quality questionnaires
Be followed for 30 days after surgery for safety outcomes
Age 18 to 80 years
Scheduled to undergo uniportal video-assisted thoracoscopic (VATS) wedge resection
Able to tolerate general anesthesia and single-lung ventilation
Passed a standardized intraoperative water-seal air leak test, confirming absence of persistent air leak before chest closure
Planned anatomical lung resection (segmentectomy or lobectomy) or combined complex thoracic procedures
Extensive pleural adhesions, severe emphysema, bullous lung disease, or other conditions associated with high risk of air leak
Positive intraoperative air leak test indicating persistent air leak
Requirement for additional intraoperative procedures that may significantly affect pleural air leak or lung re-expansion