(Press-News.org) Background: Chest drains are routinely used after video-assisted thoracoscopic surgery (VATS) lung resections to evacuate fluid and air from the pleural space. We compared the impact of coaxial silicone (SIL) drains vs. standard polyvinyl chloride (PVC) drains on postoperative pain, drainage efficacy, and short-term treatment outcome following VATS lobectomy.
Methods: The prospective randomized study included 80 patients who underwent VATS lobectomy for lung cancer between September 2020 and June 2023. Patients were randomized into two groups based on the type of chest drain used postoperatively: 40 in the experimental group (coaxial SIL drain Fr 24) and 40 in the control group (standard PVC drain Fr 24). The researchers collecting the data and the caregivers were not blinded to the group allocation. The primary objective was to evaluate pain over the initial 2 postoperative days by assessing analgesic consumption, respiratory muscle strength [measured as maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP)], and pain intensity using the visual analog scale (VAS). MIP, MEP, and VAS were measured both at rest and during physical activity.
Results: Sixty-nine patients were included in the final analysis: 35 in the experimental group and 34 in the control group. The groups were comparable in terms of drainage efficacy and short-term treatment outcome, but pain was significantly lower in the experimental group (coaxial SIL drain). Diclofenac consumption was significantly lower in the experimental group (P=0.004), with a trend toward lower consumption of other analgesics. All respiratory muscle strength measurements were higher in the experimental group, with significant differences in static MIP on the second postoperative day (P=0.046), both static (P=0.02) and dynamic (P=0.050) MEP on the first postoperative day, and static MEP on the second postoperative day (P=0.02). Static VAS (S-VAS) on the first postoperative day was statistically significantly lower in the experimental group (P=0.003). Dynamic VAS (D-VAS) was comparable between the groups.
Conclusions: This study confirmed the hypothesis that coaxial SIL drains, owing to their softer material, cause less pain while maintaining efficacy comparable to standard PVC drains.
Trial Registration: The study was registered at ClinicalTrial.gov (NCT06425601).
Keywords: Video-assisted thoracoscopic surgery (VATS); lobectomy; postoperative pain; chest tube; analgesia
Highlight box
Key findings
• Patients with coaxial silicone (SIL) drains demonstrated lower analgesic consumption and better-preserved respiratory muscle strength during the first 2 postoperative days.
What is known and what is new?
• Several studies have demonstrated the efficacy of SIL drains in fluid management and suggested potential pain reduction following video-assisted thoracoscopic surgery (VATS).
• This study demonstrated that coaxial SIL drains can reduce postoperative pain and improve patient comfort and recovery following VATS lobectomy.
What is the implication, and what should change now?
• Coaxial SIL drains may optimize chest drain materials to enhance patient comfort and recovery following VATS.
END
Impact of chest tube type on pain, drainage efficacy, and short-term treatment outcome following video-assisted thoracoscopic surgery lobectomy: a randomized controlled trial comparing coaxial silicon
2025-04-09
ELSE PRESS RELEASES FROM THIS DATE:
Pregnancy-related deaths in the US, 2018-2022
2025-04-09
About The Study: In this cross-sectional analysis of pregnancy-related deaths in the U.S., rates increased during 2018 to 2022, with large variations by state and race and ethnicity. The concerning rates in the U.S. should be an urgent public health priority.
Corresponding Author: To contact the corresponding author, Yingxi Chen, MD, PhD, email yingxi.chen@nih.gov.
To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/
(doi:10.1001/jamanetworkopen.2025.4325)
Editor’s Note: Please see the article for additional information, including other authors, author contributions ...
Opioid cap laws and opioid prescriptions after total joint replacements in older adults
2025-04-09
About The Study: The findings of this study suggest that the New York opioid restriction law was associated with reductions in opioid quantities in the immediate total joint replacement postoperative period. Additional refinements may further reduce opioid prescribing in New York, and these findings may serve as a foundation for refining laws in other states that may not achieve their intended targets or have not implemented similar laws.
Corresponding Author: To contact the corresponding author, Caroline P. Thirukumaran, MBBS, MHA, PhD, email caroline.thirukumaran@northwestern.edu.
To ...
Potential Alzheimer’s disease therapeutic target identified in brain immune cells
2025-04-09
Tim-3 is an immune checkpoint molecule involved in immunity and inflammation recently linked to late-onset Alzheimer’s disease (AD), but its role in the brain was unknown until now. In a paper published in Nature, researchers from Mass General Brigham used preclinical models to uncover Tim-3’s role in microglia, the brain's resident immune cells, and have identified it as a promising therapeutic target for Alzheimer’s disease.
“Immune checkpoint inhibitors have revolutionized cancer immunotherapy, and it is exciting that we might be able to repurpose them to treat Alzheimer’s disease,” said senior author Vijay Kuchroo, ...
New gene editing tool shows promise for treating diseases with multiple mutations
2025-04-09
Investigators from Mass General Brigham and Beth Israel Deaconess Medical Center have developed STITCHR, a new gene editing tool that can insert therapeutic genes into specific locations without causing unwanted mutations. The system can be formulated completely as RNA, dramatically simplifying delivery logistics compared to traditional systems that use both RNA and DNA. By inserting an entire gene, the tool offers a one-and-done approach that overcomes hurdles from CRISPR gene editing technology—which is programmed to correct individual mutations—offering a promising step forward for gene therapy. Results are published in Nature.
“CRISPR ...
Longest known seafaring venture 8,500 years ago brings hunter-gatherers to Malta before early farmers
2025-04-09
Seafaring hunter-gatherers were accessing remote, small islands such as Malta thousands of years before the arrival of the first farmers, a new international study has found.
Published in Nature, the research team – led by Professor Eleanor Scerri of the Max Planck Institute of Geoanthropology (MPI-GEA) and the University of Malta – found hunter-gatherers were crossing at least 100km of open water to reach the Mediterranean island of Malta 8,500 years ago, a thousand years before the arrival of agricultural practises.
This ...
How human cells repair damaged DNA
2025-04-09
The DNA of human cells consists of a sequence of about 3.1 billion building blocks. Cells go to great lengths to maintain the integrity of this vast store of information. They constantly untangle knots in the DNA strand and create new chemical bonds when a strand of DNA breaks somewhere in the nucleus.
“When people read about repairing genetic material, they often think of it being in response to exposure to toxins or radiation,” says Jacob Corn, Professor of Genome Biology at ETH Zurich. However, repair mechanisms not only defend against external threats; they also play a crucial role in helping cells survive the challenges they ...
Your skin is breathing. New wearable device can measure it.
2025-04-09
Northwestern University researchers have developed the first wearable device for measuring gases emitted from and absorbed by the skin.
By analyzing these gases, the device offers an entirely new way to assess skin health, including monitoring wounds, detecting skin infections, tracking hydration levels, quantifying exposure to harmful environmental chemicals and more.
The new technology comprises a collection of sensors that precisely measure changes in temperature, water vapor, carbon dioxide (CO2) and volatile organic compounds (VOCs), which each give valuable ...
Serendipitous discovery could lead to more efficient catalysts
2025-04-09
PULLMAN, Wash. – Preparing catalysts by sending hot, steamy car exhaust over them could improve their efficiency and reduce the amount of rare and expensive metals required in vehicle catalytic converters and many other emission control and industrial processes.
Reporting in the journal, Nature, an international team of researchers found that the hot car exhaust containing nitrogen oxides and carbon monoxide caused a previously unknown reaction that, used proactively, can significantly improve catalytic activity. Catalysts are substances that increase the rate of chemical reactions.
The researchers found that hot exhaust encouraged ceria particles, one of the components of the ...
Engineering smart delivery for gene editors
2025-04-09
Overcoming Delivery Challenges in Gene Editing
Modern genome editing techniques, including CRISPR systems, hold great potential for treating genetic diseases. However, delivering these molecular tools reliably to their target cells remains a significant challenge.
“Previous viral and non-viral delivery systems such as adeno-associated viruses (AAVs), lipid nanoparticles (LNPs), and other virus-like particles (VLPs), have been valuable but face limitations,” says Dr. Dong-Jiunn Jeffery Truong, last author ...
Six ape genomes sequenced telomere-to-telomere
2025-04-09
Comprehensive reference genomes have now been assembled for six ape species: siamang (a Southeast Asian gibbon), Sumatran orangutan, Bornean orangutan, gorilla, bonobo and chimpanzee. Areas of their genomes previously inaccessible because of structural complexity have now mostly been resolved.
The resource is already lending itself to comparative studies that offer new insights into human and ape evolution, and into what underlies the functional differences among these species.
A report on how the telomere-to-telomere ape genome references were developed, and what scientists are learning from it, appears in the April 9 edition ...