Comparison of Tubeless Single-Port Thoracoscopic Surgery and Traditional Single-Port Thoracoscopic Surgery in High-Risk Patients with Early Lung Cancer: A Retrospective Study at a Single Center

Comparison of Tubeless Single-Port Thoracoscopic Surgery and Traditional Single-Port Thoracoscopic Surgery in High-Risk Patients with Early Lung Cancer: A Retrospective Study at a Single Center | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Comparison of Tubeless Single-Port Thoracoscopic Surgery and Traditional Single-Port Thoracoscopic Surgery in High-Risk Patients with Early Lung Cancer: A Retrospective Study at a Single Center Huan-Wei Qu, Ying Liu, Qiu-Yue Liu, Nan Zhang, Fan Wang, Fen Han This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8538582/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objective: To compare the clinical effectiveness of Tubeless single-port thoracoscopic lung segment resection with traditional intubation (double-lumen tracheal intubation + chest drainage tube) single-port thoracoscopic lung segment resection in high-risk patients for early lung cancer. Methods: A retrospective analysis was conducted on high-risk patients for early lung cancer who underwent Tubeless single-port thoracoscopic lung segment resection and traditional intubation single-port thoracoscopic surgery from February 2023 to March 2024. The postoperative 24-hour pain scores (NRS), hospitalization-related indicators, tube-related complications, surgery-related complications, and short-term postoperative outcomes were compared between the two groups. Results: This study included a total of 56 patients who were randomly divided into a Tubeless group (experimental group, n=28) and a traditional intubation group (control group, n=28). Significant differences were found between the two groups in postoperative 24-hour pain scores (NRS), pain relief rates, hospitalization-related indicators, rates of throat pain within 72 hours, hoarseness, pulmonary infection within 30 days, respiratory failure, quality of life scores one month post-surgery (SF-36 scale, including physical functioning and mental health), and patient satisfaction scores (P<0.05). Conclusion: Tubeless single-port thoracoscopic surgery for high-risk patients with early lung cancer can improve clinical effectiveness and enhance patients' quality of life, showing potential for wider use. Tubeless high-risk groups for early lung cancer 24-hour pain score (NRS Numeric Rating Scale) quality of life assessment Figures Figure 1 Figure 2 Background Lung cancer is one of the most common and deadly malignant tumors worldwide and remains a major health burden. Early diagnosis and accurate minimally invasive treatments are key to improving patient prognosis [ 1 – 2 ] . As imaging technology has improved, the detection rate of early non-small cell lung cancer (NSCLC) has significantly increased. Lung segmentectomy, which effectively preserves lung function and minimizes surgical trauma, has become a preferred surgical approach for this stage of lung cancer [ 3 – 4 ] . In traditional single-port thoracoscopic lung segment resection, double-lumen tracheal intubation provides unilateral lung ventilation and a clear surgical view. However, the pressure and friction from the tracheal tube on the throat lining can easily cause postoperative complications such as throat pain and hoarseness. These complications occur in about 30% to 60% of cases. The placement of a chest drainage tube can also continuously irritate the pleura and chest wall tissue, leading to severe pain, limiting early movement, and increasing the risk of complications such as pulmonary infections and deep vein thrombosis, which also adds financial strain on patients and prolongs hospital stays [5–6] .In recent years, "tubeless" thoracoscopic technology, which uses a laryngeal mask to maintain spontaneous breathing instead of double-lumen tracheal intubation, has gained considerable attention. This technique can really lower pain scores after surgery, shorten hospital stays, and decrease tube-related complications in ordinary early-stage lung cancer patients. However, studies focusing on high-risk groups, such as the elderly and those with low lung function, are still relatively scarce, especially missing large-scale randomized controlled trials (RCTs) with long-term follow-up to back up its effectiveness. Furthermore, how well tubeless technology fits with the Enhanced Recovery After Surgery (ERAS) approach can help improve perioperative care and speed up recovery, making it a great option for minimally invasive treatment in high-risk groups [ 7 ] .Based on the above clinical needs and research gaps, this study will perform a single-center, retrospective, randomized controlled trial. The trial will compare 24-hour postoperative pain scores (NRS), hospitalization metrics, tube-related complications, surgical complications, and long-term outcomes between the tubeless single-port thoracoscopic lung segment resection group and the traditional intubated group. Data and Methods Clinical Information A total of 56 patients with early-stage non-small cell lung cancer were enrolled. These patients were treated at Beijing Chest Hospital affiliated with Capital Medical University from February 2023 to March 2024, including 30 males and 26 females. The patients’ ages ranged from 61 to 77 years, with a mean of 67.13 ± 4.17 years. Among them, 27 cases were classified as T1a and 29 as T1b. This study was approved by the Ethics Committee of Beijing Chest Hospital affiliated with Capital Medical University (approval number [2023]-02031). Inclusion criteria were as follows: (1) Age ≥60 years or pulmonary function test showing forced expiratory volume in the first second (FEV1%) <60% of predicted, defining high-risk patients if either condition was met; (2) Preoperative diagnosis of early-stage NSCLC confirmed by chest CT, PET-CT, or biopsy, with tumor diameter ≤2 cm, and clinical stage T1a-T1bN0M0; (3) Feasibility of uniportal video-assisted thoracoscopic segmentectomy based on preoperative assessment, including tumor location in peripheral lung segments and absence of severe pleural adhesions or calcified/fused hilar lymph nodes; (4) American Society of Anesthesiologists (ASA) physical status classification II or III, where Class II indicates mild systemic disease without functional limitations, and Class III indicates moderate to severe systemic disease with partial functional limitations requiring caution in daily activities; (5) Signed informed consent from patients and their families, with willingness to cooperate in postoperative follow-up. Exclusion criteria: (1) Presence of distant metastases in other regions; (2) Severe preoperative cardiovascular or cerebrovascular diseases (e.g., unstable angina, acute cerebral infarction) or hepatic/renal failure (Child-Pugh Class C, creatinine clearance rate <30 ml/min); (3) History of prior thoracic surgery or pleurodesis; (4) Intraoperative anticipation of conversion to thoracotomy, extended resection (e.g, lobectomy), or high risk of severe bleeding (e.g., coagulation dysfunction); (5) Patients with psychiatric disorders or inability to cooperate with pain assessment and follow-up; (6) Withdrawal due to personal reasons after enrollment, loss to follow-up, or inability to complete the scheduled follow-up period postoperatively; (7) Intraoperative findings not meeting inclusion criteria (e.g., tumor upstaging during treatment), forced conversion to thoracotomy, or occurrence of serious adverse events requiring trial termination.We declare that all research procedures were conducted in accordance with the Declaration of Helsinki. The exact process is shown in our flowchart (Fig. 1). Grouping and Treatment Methods Patients were randomly assigned to two groups, each containing 28 cases. The control group included 17 males and 11 females, aged 63–74 years (mean 67.98±3.79 years). This group had 13 cases of T1a and 16 cases of T1b. The experimental group comprised 19 males and 9 females, aged 61–77 years (mean 64.73±3.92 years), with 14 cases of T1a and 13 cases of T1b. No statistically significant differences were observed between the groups, indicating comparability. Experimental group (Tubeless group) underwent uniportal thoracoscopic segmentectomy without endotracheal intubation (using a laryngeal mask to preserve spontaneous breathing), thoracic drainage tube, or urinary catheter. Control group (Traditional tube group) received uniportal thoracoscopic segmentectomy with double-lumen endotracheal intubation (mechanical ventilation) and thoracic drainage tube(Fig. 1).Both groups underwent surgery performed by the same team of experienced thoracic surgeons using a uniportal approach, which involved an incision at the 5th or 6th intercostal space along the midaxillary line with a length of 3–4 cm, adhering to the standard segmentectomy procedure. A 3D HD thoracoscope was used intraoperatively to ensure surgical precision. Anesthesia Methods and Airway Management Protocol Experimental Group (Tubeless Group): A laryngeal mask was inserted to preserve spontaneous breathing. Anesthesia induction included propofol (1.5–2 mg/kg), sufentanil (0.2–0.3 μg/kg), and rocuronium (0.3 mg/kg) to achieve shallow muscle relaxation. Intraoperative maintenance involved sevoflurane (1.0%–1.5%) combined with remifentanil (0.05–0.1 μg/(kg·min)). The spontaneous respiratory rate was maintained at 12–20 breaths per minute, with tidal volume at 5–7 ml/kg. SpO2 was kept at or above 95%. Excessive ventilation was avoided during surgery. β2 agonists were administered if necessary to improve oxygenation. No chest tube was placed after surgery. Routine lung recruitment was performed at the end of surgery, and the chest was closed once no significant air leakage was confirmed. Control Group (Traditional Intubation Group): Double-lumen tube intubation was performed for one-lung ventilation. Anesthesia induction included propofol (2 mg/kg), sufentanil (0.4 μg/kg), and rocuronium (0.6 mg/kg). Intraoperative maintenance used sevoflurane (1.5%–2.0%) combined with remifentanil (0.1–0.15 μg/(kg·min)). Mechanical ventilation parameters were set as follows: tidal volume 6–8 mL/kg, respiratory rate 12–15 breaths per minute, PEEP 5 cm H2O, and airway pressure was maintained below 30 cm H2O. A 24F chest tube was placed postoperatively (adjacent to the surgical site) and connected to a negative-pressure drainage bottle. The tube was removed when drainage was <100 ml/24h, no air bubbles were observed, and chest X-ray confirmed satisfactory lung re-expansion. Additionally, the urinary catheter was removed within 24–48 hours postoperatively. Postoperative Management Both groups received multimodal analgesia. This included an erector spinae block performed immediately after surgery and oral celecoxib (200 mg, twice daily for 3 days). Patients fasted for 6 hours postoperatively and then started a liquid diet. Early ambulation was encouraged within 24 hours. We administered routine antibiotic prophylaxis within 24 hours after surgery to prevent infection. Pain Score (NRS) Postoperative 24-hour pain score (NRS): 0 means no pain, while 10 represents the most severe pain.Blinded assessors evaluated patients face-to-face during ward follow-ups 24 hours after surgery. They recorded pain scores while patients were at rest. Pain relief rate: Calculated based on scores before and after analgesic treatment using the formula: Pain relief rate was calculated based on scores before and after analgesic treatment using the following formula: Pain relief rate = (Pre-treatment score - 24-hour post-treatment score) / Pre-treatment score × 100%. A relief rate ≥75% indicates significant relief; 50%-74% indicates partial relief; and <50% indicates ineffective relief. Hospitalization-related indicators Total length of hospital stay (days from admission to discharge) and time to first ambulation after surgery (hours from surgery to first walking). Comparison of Related Complications Tube-related complications include sore throat occurring within 72 hours postoperatively, hoarseness, and blockage or infection of the chest drainage tube.Surgery-related complications include pulmonary infection within 30 days postoperatively, diagnosed by pneumonia criteria such as fever, cough, and chest imaging showing inflammatory infiltration; hemorrhage, characterized by postoperative drainage exceeding 300 ml/24 hours or the need for reoperation for hemostasis; and respiratory failure requiring endotracheal intubation and mechanical ventilation. Recent Indicators One month after surgery, quality of life was assessed using the SF-36 scale. This scale measures two dimensions: physical function and mental health. Additionally, Postoperative patient satisfaction was scored from 0 to 10, with 10 indicating the highest satisfaction. Statistical Analysis Methods Statistical analysis was performed using SPSS 26.0 software (IBM Corp., Armonk, NY, USA).Continuous Normally distributed data were expressed as mean ± standard deviation (x̄ ± s) and compared using independent samples t-tests; non-normally distributed data were expressed as median (interquartile range, M [Q1, Q3]) and compared using the Mann-Whitney U test. Categorical data were expressed as frequency (percentage) [n (%)] and compared using the χ² test or Fisher's exact test. A P value < 0.05 indicated statistical significance. Results A total of 56 patients with early-stage non-small cell lung cancer were enrolled. Among them, 30 were males and 26 females, aged 61–77 years (mean: 67.13 ± 4.17 years). There were 27 cases of T1a and 29 cases of T1b. Detailed baseline data are shown( Table 1 ). The experimental group showed better outcomes than the control group in postoperative hospital stay (days), time to first ambulation (hours), and activities of daily living score on postoperative day 7 (points), with significant intergroup differences (P < 0.05; Table 2 ). Regarding complications, the incidence of postoperative sore throat and hoarseness within 72 hours was significantly higher in the experimental group than in the control group, with notable intergroup differences (P 0.05). Details are presented ( Table 3 ). The experimental group demonstrated significant improvements over the control group in postoperative anesthesia time (minutes), 24-hour postoperative pain score (NRS, points), SF-36 physical and mental health scores at 1 month postoperatively (points), patient satisfaction, and pain relief rate (%) (P < 0.05; Table 4 ). Table 1 The relevant baseline data of the two groups n Control group (n = 28) (%) Experimental group (n = 28) (%) Z/χ² p-value Age (years) 67.98 ± 3.79 64.73 ± 3.92 −0.635 0.4597 Gender n (%) −1.635 0.0576 male 17(60.71%) 19(67.85%) female 11(39.28%) 9(32.14%) Smoking history −1.926 0.8364 yes 16(57.14%) 24(85.71%) No 12(42.85%) 4(14.28%) clinical staging −0.782 0.7636 T1a stage 13(48.14%) 14(50%) T1b stage 16(59.25%) 13(46.42%) Tumor diameter/cm 1.75 ± 0.23 1.89 ± 0.34 −1.242 0.0810 Pathological type n (%) −0.675 0.2850 adenocarcinoma 14(50.00%) 13(46.44%) squamous cell carcinoma 9(32.17%) 11(39.28%) Adenosquamous carcinoma 4(14.28%) 4(14.28%) Large cell carcinoma 1(3.35%) 0(0%) Laboratory tests 1.875 0.4592 Carcinoembryonic antigen (CEA) 1.773 0.0897 >5µg/L 21(75.75%) 23(82.14%) ≤ 5µg/L 7(25.25%) 5(17.85%) Squamous Cell Carcinoma Antigen(SCC) 1.488 0.1692 <1.5 µg/L 16(57.14%) 12(42.85%) ≥ 1.5µg/L 12(42.85%) 16(57.14%) Neuron-specific enolas(NSE) 0.435 0.2877 50pg/ml 5(17.85%) 9(32.14%) Table 2 The comparison of postoperative hospital stay (days), time to first ambulation (hours), and self-care ability scores at 7 days postoperatively (points) between the two groups. n Experimental group (n = 28) Control group (n = 28) Z p-value Length of postoperative hospital stay (days) 3.2 ± 1.1 5.4 ± 1.5 23.634 P < 0.001 Time to first ambulation postoperatively (hours) 12.5 ± 3.2 24.3 ± 4.5 15.890 P < 0.001 Score of self-care ability on postoperative day 7 (points) 85.6 ± 6.3 72.4 ± 7.8 9.104 P < 0.001 Table 3 Comparison of postoperative complications between the two groups n Experimental group (n = 28) Control group (n = 28) χ² p-value sore throat 8(28.57) 21(75.00) 15.623 P < 0.001 Vocal cord paralysis 1(3.57) 6(21.42) 22.761 P < 0.001 Lung infection 3(10.71) 5(17.85) -1.426 0.468 wound infection 2(7.14) 3(10.71) 1.722 0.655 drainage tube infection 0(0.00) 4(14.28) 0.873 0.031 bleeding 0(0.00) 0(0.00) respiratory failure 4(14.28) 3(10.71) 1.239 0.480 Table 4 A comparison between the two groups in terms of postoperative anesthesia time (minutes), 24-hour postoperative pain score (NRS, points), SF-36 physical/mental health scores at 1 month postoperatively (points), postoperative patient satisfaction, and pain relief rate (%) showed that the experimental group exhibited statistically significant improvements over the control group (P < 0.05). n Experimental group (n = 28) Control group (n = 28) Z/χ² P值 Anesthesia time (minutes) 85.3 ± 12.6 102.5 ± 15.8 17.274 P < 0.001 Pain score at 24 hours postoperatively (NRS, score) 3.2 ± 1.1 5.4 ± 1.5 24.279 P < 0.001 SF-36 Physical Health Score (points) at 1 month post-operation 78.5 ± 5.6 65.3 ± 7.2 13.209 P < 0.001 SF-36 Mental Health Score (points) at 1 Month Postoperative 82.3 ± 4.8 73.6 ± 6.5 8.746 P < 0.001 Postoperative patient satisfaction 7.4 ± 1.2 5.7 ± 0.9 11.704 P < 0.001 Pain relief rate% significantly alleviated 17(60.71) 11(39.28) -19.426 P < 0.001 partial relief 7(25.00) 9(32.15) No relief 4(14.29) 8(28.57) Discussion This study focuses on high-risk populations with early lung cancer, defined as those aged ≥60 years or with a forced expiratory volume in 1 second (FEV1) less than 60% of the predicted value. It compares the clinical efficacy of Tubeless single-port thoracoscopic lung surgery with traditional intubated single-port thoracoscopic lung surgery. The results show that the Tubeless technique has significant advantages in postoperative analgesia, postoperative recovery, complication management, and improvement of quality of life, without increasing surgical safety risks, providing key clinical evidence for minimally invasive treatments in these high-risk groups. Firstly, pain is a major issue faced by patients after thoracic surgery, especially for elderly patients with low lung function. Furthermore, pain not only directly impacts quality of life but can also lead to serious complications like respiratory depression and difficulty clearing mucus, which may cause pulmonary infections and atelectasis, further exacerbating lung function damage [8-9] . In this study, the Tubeless group's 24-hour postoperative pain score (3.2±1.1) was significantly lower than the control group's (5.4±1.5), with a statistically significant difference (P<0.001), and the pain relief rate was better, which is consistent with the conclusions of Liu M's [10] research. The core mechanism behind the Tubeless technique’s pain control advantage is the elimination of invasive tubing. First, the experimental group used a laryngeal mask to maintain spontaneous breathing, avoiding mechanical friction, compression, and airway irritation caused by double-lumen endotracheal intubation. This significantly reduced throat pain (8 cases vs. 32 cases, P<0.001) and vocal cord paralysis (1 case vs. 6 cases, P=0.042). In contrast, the control group showed a high throat pain incidence of 75% (21/28), confirming the mucosal injury risk from tracheal intubation. Second, the experimental group did not place a postoperative chest drainage tube, thus avoiding irritation between the tube and pleura or chest wall and eliminating persistent pain from negative pressure suction. This also shortened chest tube exposure time, further reducing pain sources [11-13] . Both groups also used a pain management plan that combined erector spinae block with oral celecoxib, and on this basis, the Tubeless technique's pain relief benefits really show off its minimally invasive nature, laying the foundation for rapid recovery in high-risk populations post-surgery [14] . The core goal of the Enhanced Recovery After Surgery (ERAS) approach in thoracic surgery is to optimize perioperative interventions to reduce surgical stress and promote functional recovery. Tubeless technology is a key component of the ERAS approach in minimally invasive surgery [15-17] . In this study, patients in the Tubeless group mobilized earlier after surgery (12.5±3.2 hours) compared to the control group (24.3±4.5 hours). The total hospital stay was reduced by 2.2 days, averaging 3.2 days in the Tubeless group versus 5.4±1.5 days in the control group. The self-care score seven days after surgery (85.6±6.3 points) was notably higher than that of the control group (72.4±7.8 points), and all rehabilitation-related measures differed significantly (P<0.001).The main reason for this difference is pain reduction, which allows patients to begin active movement earlier. Not having chest tubes and catheters makes it easier for patients to move around, and anesthesia helps protect lung function, making it easier for patients to exercise [18] .For high-risk populations, particularly the elderly with low lung function, early movement is crucial, as it not only reduces the risk of complications such as deep vein thrombosis and pressure sores, but also promotes lung expansion and improves the ventilation/perfusion ratio. This, in turn, decreases the incidence of pulmonary infections, creating a positive cycle of "less pain, more movement, and better recovery" [19] . Additionally, shorter hospital stays not only ease the financial and mental stress on patients but also improve the turnover efficiency of medical resources, which fits well with the current push to improve healthcare quality [20-21] . For elderly lung cancer patients with underlying diseases, surgical treatment should balance the benefits of minimally invasive techniques with safety, as these patients have lower tolerance for surgical trauma and complications [22-24] . In this study, there was no statistically significant difference in the incidence of surgical complications (pulmonary infection, incision infection, bleeding, respiratory failure) between the two groups (P>0.05). The incidence of pulmonary infection was 10.7% (3/28) in the Tubeless group and 17.9% (5/28) in the control group, suggesting that the Tubeless technique did not increase the risk of surgical complications, supporting its safety in high-risk patients. Notably, the control group had 4 cases of drain-related infection (14.3%), while the Tubeless group had no drain-related infections (P=0.031). This difference is due to chest drain placement being an invasive procedure that carries a risk of infection at the drainage site. The Tubeless technique completely removes this infection pathway by omitting chest tube placement. Additionally, anesthesia time was significantly shorter in the Tubeless group (85.3±12.6 minutes) than in the control group (102.5±15.8 minutes) (P<0.001). This reduction saved time by avoiding intubation and chest tube placement and allowed the use of shallow muscle relaxation and spontaneous breathing anesthesia, thereby reducing anesthetic drug dosage. This lowered the risk of anesthesia-related adverse reactions (such as postoperative cognitive dysfunction and liver and kidney function damage) in elderly patients, further showing how well this technique works for high-risk patients [25] . For high-risk early lung cancer patients, the goal of surgery is not only to remove the tumor but also to preserve lung function as much as possible. Additionally, ensuring a good quality of life after the operation is essential [26-28] . This study used the SF-36 scale to assess quality of life across eight domains, including physical functioning, bodily pain, and social functioning.The results showed that the Tubeless group had scored significantly higher in physical health (78.5±5.6) and mental health (82.3±4.8) one week after surgery compared to the control group (P<0.001). These results indicate multiple benefits, including better pain control, faster recovery, and fewer complications. Physically, early mobilization and rapid improvement in lung function enabled patients to resume daily activities such as dressing, eating, and self-care more quickly, thereby reducing their reliance on others. Mentally, fewer tubes, shorter hospital stays, and improved physical condition alleviated patients' concerns about their prognosis and enhanced treatment satisfaction [29-31] . Compared to traditional surgery, the Tubeless technique cuts down on both the physical and mental stress for patients with its "tubeless" design, better aligning with the core demands for "minimally invasive treatment" in high-risk populations and giving cancer patients better support to get back to their normal lives after surgery. This study has several limitations. Firstly, it is a single-center retrospective study with a small sample size (56 cases). Although randomization was employed to reduce selection bias, the generalizability of data from a single center remains limited. Therefore, future multi-center, large-scale retrospective studies are necessary to further validate these findings. Secondly, the follow-up period was relatively short (1 month post-operation), assessing only short-term efficacy and quality of life. The long-term oncological outcomes, such as recurrence and survival rates, remain unclear. Extending the follow-up period will strengthen the evidence base. Additionally, subsequent studies should incorporate more relevant data to improve the analysis of underlying mechanisms. Conclusions In summary, tubeless single-port thoracoscopic lung surgery has shown significant clinical advantages in high-risk groups for early lung cancer. It provides benefits such as reduced postoperative pain, accelerated recovery, fewer tube-related complications, and improved quality of life, while maintaining safety comparable to traditional intubated surgery. Therefore, its clinical benefits and safety profile make it worth considering for wider application. Declarations Disclosure Acknowledgments The authors are grateful to the Molecular Pathology Laboratory of Beijing Chest Hospital, Capital Medical University&Beijing Tuberculosis and Thoracic Tumor Research Institute for their help and support for this experiment. Availability of data and material The data were from Beijing Chest Hospital, Capital Medical University&Beijing Tuberculosis and Thoracic Tumor Research Institute.the data supporting the findings of this study are available within the article and supplementary materials Funding support ： No funding Competing Interests The authors have no relevant financial or non-financial interests to disclose. Ethics approval Ethics approval and consent to Participate This investigation was conducted with the approval of the Ethics Committee of Beijing Chest Hospital, Capital Medical University&Beijing Tuberculosis and Thoracic Tumor Research Institute (approval number [2023]-02031).and informed consent was duly obtained in writing from all participants. We declare that all our research processes have been completed on the basis of the Declaration of Helsinki. Clinical trial number: Not applicable Authors’ contributions Huan-Wei Qu: Writing-review and editing, Writing-original draft, Visualization, Validation Project administration, Methodology, Investigation, Formal analysis, Data curation, Conceptualization. Ying Liu and Qiu-Yue Liu: Writing-review and editing, Project administration, Methodology, Formal analysis. :Writing-review and editing, Project administration, Methodology, Funding acquisition. Nan Zhang and Fan Wang: Methodology, Investigation. References Hisashi Saji, Morihito Okada, Masahiro Tsuboi,et al. Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/WJOG4607L): a multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial[J].Lancet. 2022;399(10335):1607-1617. DOI:10.1016/S0140-6736(21)02333-3. Tsubokawa N, Mimae T, Mimura T, et al. Clinical Significance of Preserving Pulmonary Function After Lung Resection in Early-Stage Non-Small-Cell Lung Cancer[J]. Clin Lung Cancer. 2024;25(4):329-335.DOI: 10.1016/j.cllc.2024.01.003 Blasberg JD, Pass HI, Donington JS. Sublobar resection: a movement from the Lung Cancer Study Group[J]. Thorac Oncol. 2010;5(10):1583-93. DOI: 10.1097/jto.0b013e3181e77604 Xu Z, Li C, Ni Y, et al. Retrospective comparative study of thoracoscopic lobectomy vs segmentectomy: Enhancing recovery and lung function in early-stage non-small cell lung cancer[J].Medicine (Baltimore).2025;104(47):e45655. DOI: 10.1097/MD.0000000000045655 Darren Lau1, Neesh Pannu1, Matthew T James, et al. Costs and consequences of acute kidney injury after cardiac surgery: A cohort study[J] Thorac Cardiovasc Surg.2021 Sep;162(3):880-887. DOI: 10.1016/j.jtcvs.2020.01.101 Chen Y, Kang S, Li R, et al. Enhanced recovery after surgery programs versus conventional rehabilitation for patients undergoing thoracoscopic radical resection of lung cancer in local regional hospitals: a prospective randomized controlled trial[J] . Surg Endosc. 2025;39(9):5811-5819. DOI: 10.1007/s00464-025-11877-0 Marco Nicolas Andreas , Tomasz Dziodzio, Karl-Herbert Hillebrandt, et al.[Current State of ERAS Implementation in Thoracic Surgery in Germany][J].Zentralbl Chir ;147(S01):S21-S28.DOI: 10.1055/a-1759-4375. Wang H, Li S, Liang N,et al.Postoperative pain experiences in Chinese adult patients after thoracotomy and video-assisted thoracic surgery[J].Clin Nurs. 2017;26(17-18):2744-2754. DOI: 10.1111/jocn.13789. Makkad B, Kachulis B. Challenges in acute postoperative pain management in thoracic surgery[J]. Best Pract Res Clin Anaesthesiol. 2024;38(1):64-73.DOI: 10.1016/j.bpa.2024.01.002. Liu M, Huang J, Lu J, et al. Selective tubeless minimally invasive percutaneous nephrolithotomy for upper urinary calculi. Minerva Urol Nefrol[J]. 2017;69(4):366-371. DOI: 10.23736/S0393-2249.16.02700-4. Song Y, Zheng C, Zhou S, et al. The application analysis of 8F ultrafine chest drainage tube for thoracoscopic lobectomy of lung cancer[J].Cardiothorac Surg. 2021;16(1):104. DOI: 10.1186/s13019-021-01479-x. Zheng W, Wang P, Cao Z. Clinical study on the role of modified chest drainage tube in enhanced recovery after uniportal VATS radical surgery for lung cancer[J]. BMC Pulm Med. 2025;25(1):369. DOI: 10.1186/s12890-025-03853-0. Yang Q, Lv S, Li Q, et al. Safety and feasibility study of uniportal video-assisted thoracoscopic pulmonary wedge resection without postoperative chest tube drainage: a retrospective propensity score-matched study[J]. Interdiscip Cardiovasc Thorac Surg. 2022;37(6).DOI: 10.1093/icvts/ivad196. Bang S, Chung K, Chung J,et al.The erector spinae plane block for effective analgesia after lung lobectomy: Three cases report[J].Medicine (Baltimore). 2019;98(29):e16262.DOI: 10.1097/MD.0000000000016262. Shen C, Che G. No drains in thoracic surgery with ERAS program[J]. Cardiothorac Surg. 2020;15(1):112. DOI: 10.1186/s13019-020-01164-5. Reeana Tazreean , Gregg Nelson , Rosie Twomey.Early mobilization in enhanced recovery after surgery pathways: current evidence and recent advancements[J]. Comp Eff Res. 2022;11(2):121-129.DOI: 10.2217/cer-2021-0258. Timothy J P Batchelor, Neil J Rasburn, Etienne Abdelnour-Berchtold, et al.Guidelines for enhanced recovery after lung surgery: recommendations of the Enhanced Recovery After Surgery (ERAS®) Society and the European Society of Thoracic Surgeons (ESTS)Eur[J].Cardiothorac Surg. 2019;55(1):91-115.DOI: 10.1093/ejcts/ezy301. Berninger MT, Friederichs J, Leidinger W, et al.Effect of local infiltration analgesia, peripheral nerve blocks, general and spinal anesthesia on early functional recovery and pain control in total knee arthroplasty[J]. BMC Musculoskelet Disord. 2018;19(1):232.DOI: 10.1186/s12891-018-2154-z. Petteys AR, Adoumie D. Mindfulness-Based Neurodevelopmental Care: Impact on NICU Parent Stress and Infant Length of Stay; A Randomized Controlled Pilot Study. Adv Neonatal Care. 2018;18(2):E12-E22. DOI: 10.1097/ANC.0000000000000474. Sulo S, Feldstein J, Partridge J, et al. Budget Impact of a Comprehensive Nutrition-Focused Quality Improvement Program for Malnourished Hospitalized Patients. Am Health Drug Benefits. 2017;10(5):262-270.DOI: 10.1136/bmjopen-2020-046402. Martsolf GR, Auerbach D, Benevent R, et al. Examining the value of inpatient nurse staffing: an assessment of quality and patient care costs[J].Med Care. 2014;52(11):982-8. DOI: 10.1097/MLR.0000000000000248. Basnet A, Alahmadi A, Gajra A,et al. Older Patients with Lung Cancer: a Summary of Seminal Contributions to Optimal Patient Care[J]. Curr Oncol Rep.2022;24(11):1607-1618. DOI: 10.1007/s11912-022-01307-y. Divisi D, De Vico A, Zaccagna G, et al. Lobectomy versus sublobar resection in patients with non-small cell lung cancer: a systematic review[J]. Thorac Dis. 2020;12(6):3357-3362.DOI: 10.1007/s11912-022-01307-y. Huang C, Ma C, Wu Q, et al. Surgical Treatment of Lung Cancer Combined with Interstitial Lung Disease[J]. Zhongguo Fei Ai Za Zhi. 2020;23(5):343-350. DOI: 10.3779/j.issn.1009-3419.2020.104.19. Chanan EL, Wagener G, Whitlock EL, et al. Perioperative Considerations in Older Kidney and Liver Transplant Recipients: A Review. Transplantation. 2024;108(11):e346-e356. DOI: 10.1097/TP.0000000000005000. Konno H, Ohde Y. Current Status of Limited Resection for Lung Cancer as Minimally Invasive Surgery[J]. Kyobu Geka. 2019;72(1):51-56.DOI: 10.1007/s00464-015-4312-9. Xu J, Huang L, Wang Y, et al.A Retrospective Study of Effectiveness of Thoracoscopic Lobectomy and Segmentectomy in Patients with Early-Stage Non-Small-Cell Lung Cancer. Dis Markers[J].2022;4(28):51-56. DOI:10.1155/2022/6975236. Yang SM, Hsu HH, Chen JS. Recent advances in surgical management of early lung cancer[J].Formos Med Assoc. 2017;116(12):917-923. DOI:10.1016/j.jfma.2017.07.009. Nielsen PR, Jørgensen LD, Dahl B, et al. Prehabilitation and early rehabilitation after spinal surgery: randomized clinical trial[J]. Clin Rehabil. 2010;24(2):137-48. DOI: 10.1177/0269215509347432. De Luca ML, Ciccarello M, Martorana M, et al. Pain monitoring and management in a rehabilitation setting after total joint replacement[J]. Medicine (Baltimore). 2018;97(40):e12484.DOI: 10.1097/MD.0000000000012484. Batchelor TJP, Ljungqvist O. A surgical perspective of ERAS guidelines in thoracic surgery[J].Curr Opin Anaesthesiol.2019;32(1):17-22.DOI: 10.1097/ACO.0000000000000685. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8538582","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":583777033,"identity":"708390cc-d8df-4d54-9500-8962fbc8879e","order_by":0,"name":"Huan-Wei Qu","email":"","orcid":"","institution":"Capital Medical University","correspondingAuthor":false,"prefix":"","firstName":"Huan-Wei","middleName":"","lastName":"Qu","suffix":""},{"id":583777035,"identity":"66fc1a39-50ec-4beb-87a6-a9220491a312","order_by":1,"name":"Ying Liu","email":"","orcid":"","institution":"Capital Medical University","correspondingAuthor":false,"prefix":"","firstName":"Ying","middleName":"","lastName":"Liu","suffix":""},{"id":583777040,"identity":"f90d7e25-847a-4421-b14b-954b2e02d75a","order_by":2,"name":"Qiu-Yue Liu","email":"","orcid":"","institution":"Capital Medical University","correspondingAuthor":false,"prefix":"","firstName":"Qiu-Yue","middleName":"","lastName":"Liu","suffix":""},{"id":583777043,"identity":"c75dde08-49b8-4b95-9ba3-6057a6b0abb2","order_by":3,"name":"Nan Zhang","email":"","orcid":"","institution":"Capital Medical University","correspondingAuthor":false,"prefix":"","firstName":"Nan","middleName":"","lastName":"Zhang","suffix":""},{"id":583777044,"identity":"cc5dd6cb-77c2-41bd-89d8-e50b5ecb6b20","order_by":4,"name":"Fan Wang","email":"","orcid":"","institution":"Capital Medical University","correspondingAuthor":false,"prefix":"","firstName":"Fan","middleName":"","lastName":"Wang","suffix":""},{"id":583777045,"identity":"3eb20174-cf3c-4b80-a1df-1a6bf717dd6d","order_by":5,"name":"Fen Han","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAoklEQVRIiWNgGAWjYBACPhCRUCEhJ0+0FjawljMWxoYNJGlhbKtIZDhAtBaxw4dfPJwnkcDYwPzw0Q2itEinpVkkbpPIY2dgMzbOIU5LjpkBUEsxYwMPkE2clvxvBolzJBIbDhCvJYf5QWIDaVrSzBgSjkkYGzYT6xd+6eTHH3/U1MnJszc/fEyUFpBFEmCKmUjlYLUfSFA8CkbBKBgFIxEAAKitKmCDlLlFAAAAAElFTkSuQmCC","orcid":"","institution":"Capital Medical University","correspondingAuthor":true,"prefix":"","firstName":"Fen","middleName":"","lastName":"Han","suffix":""}],"badges":[],"createdAt":"2026-01-07 08:23:12","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8538582/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8538582/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":101654287,"identity":"997880a9-b2c6-4660-9bec-162ab95164b0","added_by":"auto","created_at":"2026-02-02 09:43:21","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":70008,"visible":true,"origin":"","legend":"\u003cp\u003eThe flowchart illustrates the complete screening process\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-8538582/v1/ffcb82a35688eca4c5fae340.png"},{"id":101654290,"identity":"e433688c-a2c6-4a2d-bee1-f863c0e1e0e2","added_by":"auto","created_at":"2026-02-02 09:43:25","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":105974,"visible":true,"origin":"","legend":"\u003cp\u003eTraditional intubation group versus Tubeless group\u003c/p\u003e","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-8538582/v1/9e618e4fc7bab7296f84c6ec.png"},{"id":104727201,"identity":"3f3bbecb-8bd0-4d47-9669-43470da6e8eb","added_by":"auto","created_at":"2026-03-16 13:43:28","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":957651,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8538582/v1/30dc050f-b0d0-449b-8891-f6ebdf0ff004.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eComparison of Tubeless Single-Port Thoracoscopic Surgery and Traditional Single-Port Thoracoscopic Surgery in High-Risk Patients with Early Lung Cancer: A Retrospective Study at a Single Center\u003c/p\u003e","fulltext":[{"header":"Background","content":"\u003cp\u003eLung cancer is one of the most common and deadly malignant tumors worldwide and remains a major health burden. Early diagnosis and accurate minimally invasive treatments are key to improving patient prognosis\u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/sup\u003e. As imaging technology has improved, the detection rate of early non-small cell lung cancer (NSCLC) has significantly increased. Lung segmentectomy, which effectively preserves lung function and minimizes surgical trauma, has become a preferred surgical approach for this stage of lung cancer\u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eIn traditional single-port thoracoscopic lung segment resection, double-lumen tracheal intubation provides unilateral lung ventilation and a clear surgical view. However, the pressure and friction from the tracheal tube on the throat lining can easily cause postoperative complications such as throat pain and hoarseness. These complications occur in about 30% to 60% of cases. The placement of a chest drainage tube can also continuously irritate the pleura and chest wall tissue, leading to severe pain, limiting early movement, and increasing the risk of complications such as pulmonary infections and deep vein thrombosis, which also adds financial strain on patients and prolongs hospital stays\u003csup\u003e[5\u0026ndash;6]\u003c/sup\u003e.In recent years, \"tubeless\" thoracoscopic technology, which uses a laryngeal mask to maintain spontaneous breathing instead of double-lumen tracheal intubation, has gained considerable attention. This technique can really lower pain scores after surgery, shorten hospital stays, and decrease tube-related complications in ordinary early-stage lung cancer patients. However, studies focusing on high-risk groups, such as the elderly and those with low lung function, are still relatively scarce, especially missing large-scale randomized controlled trials (RCTs) with long-term follow-up to back up its effectiveness. Furthermore, how well tubeless technology fits with the Enhanced Recovery After Surgery (ERAS) approach can help improve perioperative care and speed up recovery, making it a great option for minimally invasive treatment in high-risk groups\u003csup\u003e[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e7\u003c/span\u003e]\u003c/sup\u003e.Based on the above clinical needs and research gaps, this study will perform a single-center, retrospective, randomized controlled trial. The trial will compare 24-hour postoperative pain scores (NRS), hospitalization metrics, tube-related complications, surgical complications, and long-term outcomes between the tubeless single-port thoracoscopic lung segment resection group and the traditional intubated group.\u003c/p\u003e"},{"header":"Data and Methods","content":"\u003cp\u003e\u003cstrong\u003eClinical Information\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA total of 56 patients with early-stage non-small cell lung cancer were enrolled. These patients were treated at Beijing Chest Hospital affiliated with Capital Medical University from February 2023 to March 2024, including 30 males and 26 females. The patients\u0026rsquo; ages ranged from 61 to 77 years, with a mean of 67.13 \u0026plusmn; 4.17 years. Among them, 27 cases were classified as T1a and 29 as T1b. This study was approved by the Ethics Committee of Beijing Chest Hospital affiliated with Capital Medical University (approval number [2023]-02031). Inclusion criteria were as follows: (1) Age \u0026ge;60 years or pulmonary function test showing forced expiratory volume in the first second (FEV1%) \u0026lt;60% of predicted, defining high-risk patients if either condition was met; (2) Preoperative diagnosis of early-stage NSCLC confirmed by chest CT, PET-CT, or biopsy, with tumor diameter \u0026le;2 cm, and clinical stage T1a-T1bN0M0; (3) Feasibility of uniportal video-assisted thoracoscopic segmentectomy based on preoperative assessment, including tumor location in peripheral lung segments and absence of severe pleural adhesions or calcified/fused hilar lymph nodes; (4) American Society of Anesthesiologists (ASA) physical status classification II or III, where Class II indicates mild systemic disease without functional limitations, and Class III indicates moderate to severe systemic disease with partial functional limitations requiring caution in daily activities; (5) Signed informed consent from patients and their families, with willingness to cooperate in postoperative follow-up. Exclusion criteria: (1) Presence of distant metastases in other regions; (2) Severe preoperative cardiovascular or cerebrovascular diseases (e.g., unstable angina, acute cerebral infarction) or hepatic/renal failure (Child-Pugh Class C, creatinine clearance rate \u0026lt;30 ml/min); \u0026nbsp;(3) History of prior thoracic surgery or pleurodesis; (4) Intraoperative anticipation of conversion to thoracotomy, extended resection (e.g, lobectomy), or high risk of severe bleeding (e.g., coagulation dysfunction); (5) Patients with psychiatric disorders or inability to cooperate with pain assessment and follow-up; (6) Withdrawal due to personal reasons after enrollment, loss to follow-up, or inability to complete the scheduled follow-up period postoperatively; \u0026nbsp; (7) Intraoperative findings not meeting inclusion criteria (e.g., tumor upstaging during treatment), forced conversion to thoracotomy, or occurrence of serious adverse events requiring trial termination.We declare that all research procedures were conducted in accordance with the Declaration of Helsinki. The exact process is shown in our flowchart (Fig. 1).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eGrouping and Treatment Methods \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePatients were randomly assigned to two groups, each containing 28 cases. The control group included 17 males and 11 females, aged 63\u0026ndash;74 years (mean 67.98\u0026plusmn;3.79 years). This group had 13 cases of T1a and 16 cases of T1b. The experimental group comprised 19 males and 9 females, aged 61\u0026ndash;77 years (mean 64.73\u0026plusmn;3.92 years), with 14 cases of T1a and 13 cases of T1b. No statistically significant differences were observed between the groups, indicating comparability. Experimental group (Tubeless group) underwent uniportal thoracoscopic segmentectomy without endotracheal intubation (using a laryngeal mask to preserve spontaneous breathing), thoracic drainage tube, or urinary catheter. Control group (Traditional tube group) received uniportal thoracoscopic segmentectomy with double-lumen endotracheal intubation (mechanical ventilation) and thoracic drainage tube(Fig. 1).Both groups underwent surgery performed by the same team of experienced thoracic surgeons using a uniportal approach, which involved an incision at the 5th or 6th intercostal space along the midaxillary line with a length of 3\u0026ndash;4 cm, adhering to the standard segmentectomy procedure. A 3D HD thoracoscope was used intraoperatively to ensure surgical precision.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAnesthesia Methods and Airway Management Protocol\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eExperimental Group (Tubeless Group): A laryngeal mask was inserted to preserve spontaneous breathing. Anesthesia induction included propofol (1.5\u0026ndash;2 mg/kg), sufentanil (0.2\u0026ndash;0.3 \u0026mu;g/kg), and rocuronium (0.3 mg/kg) to achieve shallow muscle relaxation. Intraoperative maintenance involved sevoflurane (1.0%\u0026ndash;1.5%) combined with remifentanil (0.05\u0026ndash;0.1 \u0026mu;g/(kg\u0026middot;min)). The spontaneous respiratory rate was maintained at 12\u0026ndash;20 breaths per minute, with tidal volume at 5\u0026ndash;7 ml/kg. SpO2 was kept at or above 95%. Excessive ventilation was avoided during surgery. \u0026beta;2 agonists were administered if necessary to improve oxygenation. No chest tube was placed after surgery. Routine lung recruitment was performed at the end of surgery, and the chest was closed once no significant air leakage was confirmed. Control Group (Traditional Intubation Group): Double-lumen tube intubation was performed for one-lung ventilation. Anesthesia induction included propofol (2 mg/kg), sufentanil (0.4 \u0026mu;g/kg), and rocuronium (0.6 mg/kg). Intraoperative maintenance used sevoflurane (1.5%\u0026ndash;2.0%) combined with remifentanil (0.1\u0026ndash;0.15 \u0026mu;g/(kg\u0026middot;min)). Mechanical ventilation parameters were set as follows: tidal volume 6\u0026ndash;8 mL/kg, respiratory rate 12\u0026ndash;15 breaths per minute, PEEP 5 cm H2O, and airway pressure was maintained below 30 cm H2O. A 24F chest tube was placed postoperatively (adjacent to the surgical site) and connected to a negative-pressure drainage bottle. The tube was removed when drainage was \u0026lt;100 ml/24h, no air bubbles were observed, and chest X-ray confirmed satisfactory lung re-expansion. Additionally, the urinary catheter was removed within 24\u0026ndash;48 hours postoperatively.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePostoperative Management\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBoth groups received multimodal analgesia. This included an erector spinae block performed immediately after surgery and oral celecoxib (200 mg, twice daily for 3 days). \u0026nbsp;Patients fasted for 6 hours postoperatively and then started a liquid diet. Early ambulation was encouraged within 24 hours. We administered routine antibiotic prophylaxis within 24 hours after surgery to prevent infection.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePain Score (NRS) \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePostoperative 24-hour pain score (NRS): 0 means no pain, while 10 represents the most severe pain.Blinded assessors evaluated patients face-to-face during ward follow-ups 24 hours after surgery. They recorded pain scores while patients were at rest. Pain relief rate: Calculated based on scores before and after analgesic treatment using the formula: Pain relief rate was calculated based on scores before and after analgesic treatment using the following formula: Pain relief rate = (Pre-treatment score - 24-hour post-treatment score) / Pre-treatment score \u0026times; 100%. A relief rate \u0026ge;75% indicates significant relief; 50%-74% indicates partial relief; and \u0026lt;50% indicates ineffective relief.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eHospitalization-related indicators\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTotal length of hospital stay (days from admission to discharge) and time to first ambulation after surgery (hours from surgery to first walking).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eComparison of Related Complications\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTube-related complications include sore throat occurring within 72 hours postoperatively, hoarseness, and blockage or infection of the chest drainage tube.Surgery-related complications include pulmonary infection within 30 days postoperatively, diagnosed by pneumonia criteria such as fever, cough, and chest imaging showing inflammatory infiltration; hemorrhage, characterized by postoperative drainage exceeding 300 ml/24 hours or the need for reoperation for hemostasis; and respiratory failure requiring endotracheal intubation and mechanical ventilation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRecent Indicators\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOne month after surgery, quality of life was assessed using the SF-36 scale. This scale measures two dimensions: physical function and mental health. Additionally, Postoperative patient satisfaction was scored from 0 to 10, with 10 indicating the highest satisfaction.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical Analysis Methods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eStatistical analysis was performed using SPSS 26.0 software (IBM Corp., Armonk, NY, USA).Continuous Normally distributed data were expressed as mean \u0026plusmn; standard deviation (x̄ \u0026plusmn; s) and compared using independent samples t-tests; non-normally distributed data were expressed as \u0026nbsp;median (interquartile range, M [Q1, Q3]) and compared using the Mann-Whitney U test. Categorical data were expressed as frequency (percentage) [n (%)] and compared using the \u0026chi;\u0026sup2; test or Fisher\u0026apos;s exact test. A P value \u0026lt; 0.05 indicated statistical significance.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 56 patients with early-stage non-small cell lung cancer were enrolled. Among them, 30 were males and 26 females, aged 61\u0026ndash;77 years (mean: 67.13\u0026thinsp;\u0026plusmn;\u0026thinsp;4.17 years). There were 27 cases of T1a and 29 cases of T1b. Detailed baseline data are shown( Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). The experimental group showed better outcomes than the control group in postoperative hospital stay (days), time to first ambulation (hours), and activities of daily living score on postoperative day 7 (points), with significant intergroup differences (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05; Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). Regarding complications, the incidence of postoperative sore throat and hoarseness within 72 hours was significantly higher in the experimental group than in the control group, with notable intergroup differences (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). No statistical significance was observed for pulmonary infection, surgical site infection, drainage tube infection, bleeding, or respiratory failure (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05). Details are presented ( Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). The experimental group demonstrated significant improvements over the control group in postoperative anesthesia time (minutes), 24-hour postoperative pain score (NRS, points), SF-36 physical and mental health scores at 1 month postoperatively (points), patient satisfaction, and pain relief rate (%) (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05; Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe relevant baseline data of the two groups\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eControl group (n\u0026thinsp;=\u0026thinsp;28)\u003c/p\u003e \u003cp\u003e(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eExperimental group (n\u0026thinsp;=\u0026thinsp;28)\u003c/p\u003e \u003cp\u003e(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eZ/χ\u0026sup2;\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e67.98\u0026thinsp;\u0026plusmn;\u0026thinsp;3.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e64.73\u0026thinsp;\u0026plusmn;\u0026thinsp;3.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;0.635\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.4597\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;1.635\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.0576\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003emale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e17(60.71%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19(67.85%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003efemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11(39.28%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9(32.14%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSmoking history\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;1.926\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.8364\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eyes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e16(57.14%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24(85.71%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12(42.85%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4(14.28%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eclinical staging\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;0.782\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.7636\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eT1a stage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13(48.14%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14(50%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eT1b stage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e16(59.25%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13(46.42%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTumor diameter/cm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.75\u0026thinsp;\u0026plusmn;\u0026thinsp;0.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.89\u0026thinsp;\u0026plusmn;\u0026thinsp;0.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;1.242\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.0810\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePathological type n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;0.675\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.2850\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eadenocarcinoma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14(50.00%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13(46.44%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003esquamous cell carcinoma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9(32.17%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11(39.28%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAdenosquamous carcinoma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4(14.28%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4(14.28%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLarge cell carcinoma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1(3.35%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0(0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLaboratory tests\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.875\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.4592\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCarcinoembryonic antigen (CEA)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.773\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.0897\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;5\u0026micro;g/L\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21(75.75%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23(82.14%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026le;\u0026thinsp;5\u0026micro;g/L\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7(25.25%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5(17.85%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSquamous Cell Carcinoma Antigen(SCC)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.488\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.1692\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;1.5 \u0026micro;g/L\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e16(57.14%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12(42.85%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;1.5\u0026micro;g/L\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12(42.85%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16(57.14%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeuron-specific enolas(NSE)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.435\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.2877\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;15 \u0026micro;g/L\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7(25.25%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4(14.28%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;15\u0026micro;g/L\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21(75.75%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24(85.72%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eprogastrin-releasing peptide(ProGRP)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.905\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.9792\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026le;\u0026thinsp;50pg/ml\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23(82.14%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19(67.85%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;50pg/ml\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5(17.85%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9(32.14%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe comparison of postoperative hospital stay (days), time to first ambulation (hours), and self-care ability scores at 7 days postoperatively (points) between the two groups.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eExperimental group (n\u0026thinsp;=\u0026thinsp;28)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eControl group (n\u0026thinsp;=\u0026thinsp;28)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eZ\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLength of postoperative hospital stay (days)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e3.2\u0026thinsp;\u0026plusmn;\u0026thinsp;1.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e5.4\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e23.634\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTime to first ambulation postoperatively (hours)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e12.5\u0026thinsp;\u0026plusmn;\u0026thinsp;3.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e24.3\u0026thinsp;\u0026plusmn;\u0026thinsp;4.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15.890\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eScore of self-care ability on postoperative day 7 (points)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e85.6\u0026thinsp;\u0026plusmn;\u0026thinsp;6.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e72.4\u0026thinsp;\u0026plusmn;\u0026thinsp;7.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9.104\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of postoperative complications between the two groups\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eExperimental group (n\u0026thinsp;=\u0026thinsp;28)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eControl group (n\u0026thinsp;=\u0026thinsp;28)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eχ\u0026sup2;\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003esore throat\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8(28.57)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21(75.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15.623\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVocal cord paralysis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1(3.57)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6(21.42)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e22.761\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLung infection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3(10.71)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5(17.85)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-1.426\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.468\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ewound infection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2(7.14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3(10.71)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.722\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.655\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003edrainage tube infection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0(0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4(14.28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.873\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.031\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ebleeding\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0(0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0(0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003erespiratory failure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4(14.28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3(10.71)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.239\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.480\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eA comparison between the two groups in terms of postoperative anesthesia time (minutes), 24-hour postoperative pain score (NRS, points), SF-36 physical/mental health scores at 1 month postoperatively (points), postoperative patient satisfaction, and pain relief rate (%) showed that the experimental group exhibited statistically significant improvements over the control group (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eExperimental group (n\u0026thinsp;=\u0026thinsp;28)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eControl group (n\u0026thinsp;=\u0026thinsp;28)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eZ/χ\u0026sup2;\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP值\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnesthesia time (minutes)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e85.3\u0026thinsp;\u0026plusmn;\u0026thinsp;12.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e102.5\u0026thinsp;\u0026plusmn;\u0026thinsp;15.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e17.274\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePain score at 24 hours postoperatively (NRS, score)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.2\u0026thinsp;\u0026plusmn;\u0026thinsp;1.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.4\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e24.279\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSF-36 Physical Health Score (points) at 1 month post-operation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e78.5\u0026thinsp;\u0026plusmn;\u0026thinsp;5.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e65.3\u0026thinsp;\u0026plusmn;\u0026thinsp;7.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13.209\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSF-36 Mental Health Score (points) at 1 Month Postoperative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e82.3\u0026thinsp;\u0026plusmn;\u0026thinsp;4.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e73.6\u0026thinsp;\u0026plusmn;\u0026thinsp;6.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8.746\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePostoperative patient satisfaction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7.4\u0026thinsp;\u0026plusmn;\u0026thinsp;1.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.7\u0026thinsp;\u0026plusmn;\u0026thinsp;0.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11.704\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePain relief rate%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003esignificantly alleviated\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e17(60.71)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11(39.28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-19.426\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003epartial relief\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7(25.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9(32.15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo relief\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4(14.29)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8(28.57)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study focuses on high-risk populations with early lung cancer, defined as those aged ≥60 years or with a forced expiratory volume in 1 second (FEV1) less than 60% of the predicted value. It compares the clinical efficacy of Tubeless single-port thoracoscopic lung surgery with traditional intubated single-port thoracoscopic lung surgery. The results show that the Tubeless technique has significant advantages in postoperative analgesia, postoperative recovery, complication management, and improvement of quality of life, without increasing surgical safety risks, providing key clinical evidence for minimally invasive treatments in these high-risk groups. Firstly, pain is a major issue faced by patients after thoracic surgery, especially for elderly patients with low lung function. Furthermore, pain not only directly impacts quality of life but can also lead to serious complications like respiratory depression and difficulty clearing mucus, which may cause pulmonary infections and atelectasis, further exacerbating lung function damage\u003csup\u003e[8-9]\u003c/sup\u003e. In this study, the Tubeless group's 24-hour postoperative pain score (3.2±1.1) was significantly lower than the control group's (5.4±1.5), with a statistically significant difference (P\u0026lt;0.001), and the pain relief rate was better, which is consistent with the conclusions of Liu M's \u003csup\u003e[10]\u003c/sup\u003eresearch. The core mechanism behind the Tubeless technique’s pain control advantage is the elimination of invasive tubing. First, the experimental group used a laryngeal mask to maintain spontaneous breathing, avoiding mechanical friction, compression, and airway irritation caused by double-lumen endotracheal intubation. This significantly reduced throat pain (8 cases vs. 32 cases, P\u0026lt;0.001) and vocal cord paralysis (1 case vs. 6 cases, P=0.042). In contrast, the control group showed a high throat pain incidence of 75% (21/28), confirming the mucosal injury risk from tracheal intubation. Second, the experimental group did not place a postoperative chest drainage tube, thus avoiding irritation between the tube and pleura or chest wall and eliminating persistent pain from negative pressure suction. This also shortened chest tube exposure time, further reducing pain sources\u003csup\u003e[11-13]\u003c/sup\u003e. Both groups also used a pain management plan that combined erector spinae block with oral celecoxib, and on this basis, the Tubeless technique's pain relief benefits really show off its minimally invasive nature, laying the foundation for rapid recovery in high-risk populations post-surgery\u003csup\u003e[14]\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003eThe core goal of the Enhanced Recovery After Surgery (ERAS) approach in thoracic surgery is to optimize perioperative interventions to reduce surgical stress and promote functional recovery. Tubeless technology is a key component of the ERAS approach in minimally invasive surgery\u003csup\u003e[15-17]\u003c/sup\u003e. In this study, patients in the Tubeless group mobilized earlier after surgery (12.5±3.2 hours) compared to the control group (24.3±4.5 hours). The total hospital stay was reduced by 2.2 days, averaging 3.2 days in the Tubeless group versus 5.4±1.5 days in the control group. The self-care score seven days after surgery (85.6±6.3 points) was notably higher than that of the control group (72.4±7.8 points), and all rehabilitation-related measures differed significantly (P\u0026lt;0.001).The main reason for this difference is pain reduction, which allows patients to begin active movement earlier. Not having chest tubes and catheters makes it easier for patients to move around, and anesthesia helps protect lung function, making it easier for patients to exercise\u003csup\u003e[18]\u003c/sup\u003e.For high-risk populations, particularly the elderly with low lung function, early movement is crucial, as it not only reduces the risk of complications such as deep vein thrombosis and pressure sores, but also promotes lung expansion and improves the ventilation/perfusion ratio. This, in turn, decreases the incidence of pulmonary infections, creating a positive cycle of \"less pain, more movement, and better recovery\"\u003csup\u003e[19]\u003c/sup\u003e. Additionally, shorter hospital stays not only ease the financial and mental stress on patients but also improve the turnover efficiency of medical resources, which fits well with the current push to improve healthcare quality\u003csup\u003e[20-21]\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003eFor elderly lung cancer patients with underlying diseases, surgical treatment should balance the benefits of minimally invasive techniques with safety, as these patients have lower tolerance for surgical trauma and complications\u003csup\u003e[22-24]\u003c/sup\u003e. In this study, there was no statistically significant difference in the incidence of surgical complications (pulmonary infection, incision infection, bleeding, respiratory failure) between the two groups (P\u0026gt;0.05). The incidence of pulmonary infection was 10.7% (3/28) in the Tubeless group and 17.9% (5/28) in the control group, suggesting that the Tubeless technique did not increase the risk of surgical complications, supporting its safety in high-risk patients. Notably, the control group had 4 cases of drain-related infection (14.3%), while the Tubeless group had no drain-related infections (P=0.031). This difference is due to chest drain placement being an invasive procedure that carries a risk of infection at the drainage site. The Tubeless technique completely removes this infection pathway by omitting chest tube placement. Additionally, anesthesia time was significantly shorter in the Tubeless group (85.3±12.6 minutes) than in the control group (102.5±15.8 minutes) (P\u0026lt;0.001). This reduction saved time by avoiding intubation and chest tube placement and allowed the use of shallow muscle relaxation and spontaneous breathing anesthesia, thereby reducing anesthetic drug dosage. This lowered the risk of anesthesia-related adverse reactions (such as postoperative cognitive dysfunction and liver and kidney function damage) in elderly patients, further showing how well this technique works for high-risk patients\u003csup\u003e[25]\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003eFor high-risk early lung cancer patients, the goal of surgery is not only to remove the tumor but also to preserve lung function as much as possible. Additionally, ensuring a good quality of life after the operation is essential\u003csup\u003e[26-28]\u003c/sup\u003e. This study used the SF-36 scale to assess quality of life across eight domains, including physical functioning, bodily pain, and social functioning.The results showed that the Tubeless group had scored significantly higher in physical health (78.5±5.6) and mental health (82.3±4.8) one week after surgery compared to the control group (P\u0026lt;0.001). These results indicate multiple benefits, including better pain control, faster recovery, and fewer complications. Physically, early mobilization and rapid improvement in lung function enabled patients to resume daily activities such as dressing, eating, and self-care more quickly, thereby reducing their reliance on others. Mentally, fewer tubes, shorter hospital stays, and improved physical condition alleviated patients' concerns about their prognosis and enhanced treatment satisfaction\u003csup\u003e[29-31]\u003c/sup\u003e. Compared to traditional surgery, the Tubeless technique cuts down on both the physical and mental stress for patients with its \"tubeless\" design, better aligning with the core demands for \"minimally invasive treatment\" in high-risk populations and giving cancer patients better support to get back to their normal lives after surgery. This study has several limitations. Firstly, it is a single-center retrospective study with a small sample size (56 cases). Although randomization was employed to reduce selection bias, the generalizability of data from a single center remains limited. Therefore, future multi-center, large-scale retrospective studies are necessary to further validate these findings. Secondly, the follow-up period was relatively short (1 month post-operation), assessing only short-term efficacy and quality of life. The long-term oncological outcomes, such as recurrence and survival rates, remain unclear. Extending the follow-up period will strengthen the evidence base. Additionally, subsequent studies should incorporate more relevant data to improve the analysis of underlying mechanisms.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eIn summary, tubeless single-port thoracoscopic lung surgery has shown significant clinical advantages in high-risk groups for early lung cancer. It provides benefits such as reduced postoperative pain, accelerated recovery, fewer tube-related complications, and improved quality of life, while maintaining safety comparable to traditional intubated surgery. Therefore, its clinical benefits and safety profile make it worth considering for wider application.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eDisclosure\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors are grateful to the Molecular Pathology Laboratory of Beijing Chest Hospital, Capital Medical University\u0026amp;Beijing Tuberculosis and Thoracic Tumor Research Institute for their help and support for this experiment.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and material\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data were from Beijing Chest Hospital, Capital Medical University\u0026amp;Beijing Tuberculosis and Thoracic Tumor Research Institute.the data supporting the findings of this study are available within the article and supplementary materials\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding support\u003c/strong\u003e\u003cstrong\u003e：\u003c/strong\u003eNo funding\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have no relevant financial or non-financial interests to disclose.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthics approval and consent to Participate This investigation was conducted with the approval of the Ethics Committee of Beijing Chest Hospital, Capital Medical University\u0026amp;Beijing Tuberculosis and Thoracic Tumor Research Institute\u0026nbsp;(approval number [2023]-02031).and informed consent was duly obtained in writing from all participants. We declare that all our research processes have been completed on the basis of the Declaration of \u0026nbsp;Helsinki.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eClinical trial number: Not applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors’ contributions\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eHuan-Wei Qu: Writing-review and editing, Writing-original draft, Visualization, Validation Project administration, Methodology, Investigation, Formal analysis, Data\u0026nbsp;\u003c/p\u003e\n\u003cp\u003ecuration, Conceptualization.\u0026nbsp;Ying Liu and Qiu-Yue Liu: Writing-review and editing, Project administration, Methodology, Formal analysis. :Writing-review and editing,\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eProject administration, Methodology, Funding acquisition.\u0026nbsp;Nan Zhang and Fan Wang: Methodology, Investigation.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eHisashi Saji, Morihito Okada, Masahiro Tsuboi,et al. Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/WJOG4607L): a multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial[J].Lancet. 2022;399(10335):1607-1617. DOI:10.1016/S0140-6736(21)02333-3.\u003c/li\u003e\n\u003cli\u003eTsubokawa N, Mimae T, Mimura T, et al. Clinical Significance of Preserving Pulmonary Function After Lung Resection in Early-Stage Non-Small-Cell Lung Cancer[J]. Clin Lung Cancer. 2024;25(4):329-335.DOI: 10.1016/j.cllc.2024.01.003\u003c/li\u003e\n\u003cli\u003eBlasberg JD, Pass HI, Donington JS. Sublobar resection: a movement from the Lung Cancer Study Group[J]. Thorac Oncol. 2010;5(10):1583-93. DOI: 10.1097/jto.0b013e3181e77604\u003c/li\u003e\n\u003cli\u003eXu Z, Li C, Ni Y, et al. Retrospective comparative study of thoracoscopic lobectomy vs segmentectomy: Enhancing recovery and lung function in early-stage non-small cell lung cancer[J].Medicine (Baltimore).2025;104(47):e45655. DOI: 10.1097/MD.0000000000045655\u003c/li\u003e\n\u003cli\u003eDarren Lau1, Neesh Pannu1, Matthew T James, et al. Costs and consequences of acute kidney injury after cardiac surgery: A cohort study[J] Thorac Cardiovasc Surg.2021 Sep;162(3):880-887. DOI: 10.1016/j.jtcvs.2020.01.101\u003c/li\u003e\n\u003cli\u003eChen Y, Kang S, Li R, et al. Enhanced recovery after surgery programs versus conventional rehabilitation for patients undergoing thoracoscopic radical resection of lung cancer in local regional hospitals: a prospective randomized controlled trial[J] . Surg Endosc. 2025;39(9):5811-5819. DOI: 10.1007/s00464-025-11877-0\u003c/li\u003e\n\u003cli\u003eMarco Nicolas Andreas , Tomasz Dziodzio, Karl-Herbert Hillebrandt, et al.[Current State of ERAS Implementation in Thoracic Surgery in Germany][J].Zentralbl Chir\u003c/li\u003e\n\u003cli\u003e;147(S01):S21-S28.DOI: 10.1055/a-1759-4375.\u003c/li\u003e\n\u003cli\u003eWang H, Li S, Liang N,et al.Postoperative pain experiences in Chinese adult patients after thoracotomy and video-assisted thoracic surgery[J].Clin Nurs. 2017;26(17-18):2744-2754. DOI: 10.1111/jocn.13789.\u003c/li\u003e\n\u003cli\u003eMakkad B, Kachulis B. Challenges in acute postoperative pain management in thoracic surgery[J]. Best Pract Res Clin Anaesthesiol. 2024;38(1):64-73.DOI: 10.1016/j.bpa.2024.01.002.\u003c/li\u003e\n\u003cli\u003eLiu M, Huang J, Lu J, et al. Selective tubeless minimally invasive percutaneous nephrolithotomy for upper urinary calculi. Minerva Urol Nefrol[J]. 2017;69(4):366-371. DOI: 10.23736/S0393-2249.16.02700-4.\u003c/li\u003e\n\u003cli\u003eSong Y, Zheng C, Zhou S, et al. The application analysis of 8F ultrafine chest drainage tube for thoracoscopic lobectomy of lung cancer[J].Cardiothorac Surg. 2021;16(1):104. DOI: 10.1186/s13019-021-01479-x.\u003c/li\u003e\n\u003cli\u003eZheng W, Wang P, Cao Z. Clinical study on the role of modified chest drainage tube in enhanced recovery after uniportal VATS radical surgery for lung cancer[J]. BMC Pulm Med. 2025;25(1):369. DOI: 10.1186/s12890-025-03853-0.\u003c/li\u003e\n\u003cli\u003eYang Q, Lv S, Li Q, et al. Safety and feasibility study of uniportal video-assisted thoracoscopic pulmonary wedge resection without postoperative chest tube drainage: a retrospective propensity score-matched study[J]. Interdiscip Cardiovasc Thorac Surg. 2022;37(6).DOI: 10.1093/icvts/ivad196.\u003c/li\u003e\n\u003cli\u003eBang S, Chung K, Chung J,et al.The erector spinae plane block for effective analgesia after lung lobectomy: Three cases report[J].Medicine (Baltimore). 2019;98(29):e16262.DOI: 10.1097/MD.0000000000016262.\u003c/li\u003e\n\u003cli\u003eShen C, Che G. No drains in thoracic surgery with ERAS program[J]. Cardiothorac Surg. 2020;15(1):112. DOI: 10.1186/s13019-020-01164-5.\u003c/li\u003e\n\u003cli\u003eReeana Tazreean , Gregg Nelson , Rosie Twomey.Early mobilization in enhanced recovery after surgery pathways: current evidence and recent advancements[J]. Comp Eff Res. 2022;11(2):121-129.DOI: 10.2217/cer-2021-0258.\u003c/li\u003e\n\u003cli\u003eTimothy J P Batchelor, Neil J Rasburn, Etienne Abdelnour-Berchtold, et al.Guidelines for enhanced recovery after lung surgery: recommendations of the Enhanced Recovery After Surgery (ERAS\u0026reg;) Society and the European Society of Thoracic Surgeons (ESTS)Eur[J].Cardiothorac Surg. 2019;55(1):91-115.DOI: 10.1093/ejcts/ezy301.\u003c/li\u003e\n\u003cli\u003eBerninger MT, Friederichs J, Leidinger W, et al.Effect of local infiltration analgesia, peripheral nerve blocks, general and spinal anesthesia on early functional recovery and pain control in total knee arthroplasty[J]. BMC Musculoskelet Disord. 2018;19(1):232.DOI: 10.1186/s12891-018-2154-z.\u003c/li\u003e\n\u003cli\u003ePetteys AR, Adoumie D. Mindfulness-Based Neurodevelopmental Care: Impact on NICU Parent Stress and Infant Length of Stay; A Randomized Controlled Pilot Study. Adv Neonatal Care. 2018;18(2):E12-E22. DOI: 10.1097/ANC.0000000000000474.\u003c/li\u003e\n\u003cli\u003eSulo S, Feldstein J, Partridge J, et al. Budget Impact of a Comprehensive Nutrition-Focused Quality Improvement Program for Malnourished Hospitalized Patients. Am Health Drug Benefits. 2017;10(5):262-270.DOI: 10.1136/bmjopen-2020-046402.\u003c/li\u003e\n\u003cli\u003eMartsolf GR, Auerbach D, Benevent R, et al. Examining the value of inpatient nurse staffing: an assessment of quality and patient care costs[J].Med Care. 2014;52(11):982-8. DOI: 10.1097/MLR.0000000000000248.\u003c/li\u003e\n\u003cli\u003eBasnet A, Alahmadi A, Gajra A,et al. Older Patients with Lung Cancer: a Summary of Seminal Contributions to Optimal Patient Care[J]. Curr Oncol Rep.2022;24(11):1607-1618. DOI: 10.1007/s11912-022-01307-y.\u003c/li\u003e\n\u003cli\u003eDivisi D, De Vico A, Zaccagna G, et al. Lobectomy versus sublobar resection in patients with non-small cell lung cancer: a systematic review[J]. Thorac Dis. 2020;12(6):3357-3362.DOI: 10.1007/s11912-022-01307-y.\u003c/li\u003e\n\u003cli\u003eHuang C, Ma C, Wu Q, et al. Surgical Treatment of Lung Cancer Combined with Interstitial Lung Disease[J]. Zhongguo Fei Ai Za Zhi. 2020;23(5):343-350. DOI: 10.3779/j.issn.1009-3419.2020.104.19.\u003c/li\u003e\n\u003cli\u003eChanan EL, Wagener G, Whitlock EL, et al. Perioperative Considerations in Older Kidney and Liver Transplant Recipients: A Review. Transplantation. 2024;108(11):e346-e356. DOI: 10.1097/TP.0000000000005000.\u003c/li\u003e\n\u003cli\u003eKonno H, Ohde Y. Current Status of Limited Resection for Lung Cancer as Minimally Invasive Surgery[J]. Kyobu Geka. 2019;72(1):51-56.DOI: 10.1007/s00464-015-4312-9.\u003c/li\u003e\n\u003cli\u003eXu J, Huang L, Wang Y, et al.A Retrospective Study of Effectiveness of Thoracoscopic Lobectomy and Segmentectomy in Patients with Early-Stage Non-Small-Cell Lung Cancer. Dis Markers[J].2022;4(28):51-56. DOI:10.1155/2022/6975236.\u003c/li\u003e\n\u003cli\u003eYang SM, Hsu HH, Chen JS. Recent advances in surgical management of early lung cancer[J].Formos Med Assoc. 2017;116(12):917-923. DOI:10.1016/j.jfma.2017.07.009.\u003c/li\u003e\n\u003cli\u003eNielsen PR, J\u0026oslash;rgensen LD, Dahl B, et al. Prehabilitation and early rehabilitation after spinal surgery: randomized clinical trial[J]. Clin Rehabil. 2010;24(2):137-48. DOI: 10.1177/0269215509347432.\u003c/li\u003e\n\u003cli\u003eDe Luca ML, Ciccarello M, Martorana M, et al. Pain monitoring and management in a rehabilitation setting after total joint replacement[J]. Medicine (Baltimore). 2018;97(40):e12484.DOI: 10.1097/MD.0000000000012484.\u003c/li\u003e\n\u003cli\u003eBatchelor TJP, Ljungqvist O. A surgical perspective of ERAS guidelines in thoracic surgery[J].Curr Opin Anaesthesiol.2019;32(1):17-22.DOI: 10.1097/ACO.0000000000000685.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Tubeless, high-risk groups for early lung cancer, 24-hour pain score (NRS, Numeric Rating Scale), quality of life assessment","lastPublishedDoi":"10.21203/rs.3.rs-8538582/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8538582/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eObjective: To compare the clinical effectiveness of Tubeless single-port thoracoscopic lung segment resection with traditional intubation (double-lumen tracheal intubation + chest drainage tube) single-port thoracoscopic lung segment resection in high-risk patients for early lung cancer.\u003c/p\u003e\n\u003cp\u003eMethods: A retrospective analysis was conducted on high-risk patients for early lung cancer who underwent Tubeless single-port thoracoscopic lung segment resection and traditional intubation single-port thoracoscopic surgery from February 2023 to March 2024. The postoperative 24-hour pain scores (NRS), hospitalization-related indicators, tube-related complications, surgery-related complications, and short-term postoperative outcomes were compared between the two groups.\u003c/p\u003e\n\u003cp\u003eResults: This study included a total of 56 patients who were randomly divided into a Tubeless group (experimental group, n=28) and a traditional intubation group (control group, n=28). Significant differences were found between the two groups in postoperative 24-hour pain scores (NRS), pain relief rates, hospitalization-related indicators, rates of throat pain within 72 hours, hoarseness, pulmonary infection within 30 days, respiratory failure, quality of life scores one month post-surgery (SF-36 scale, including physical functioning and mental health), and patient satisfaction scores (P\u0026lt;0.05).\u003c/p\u003e\n\u003cp\u003eConclusion: Tubeless single-port thoracoscopic surgery for high-risk patients with early lung cancer can improve clinical effectiveness and enhance patients' quality of life, showing potential for wider use.\u003c/p\u003e","manuscriptTitle":"Comparison of Tubeless Single-Port Thoracoscopic Surgery and Traditional Single-Port Thoracoscopic Surgery in High-Risk Patients with Early Lung Cancer: A Retrospective Study at a Single Center","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-02 09:43:01","doi":"10.21203/rs.3.rs-8538582/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"2f1dd35f-93fb-4e38-a2e6-2107316b9c55","owner":[],"postedDate":"February 2nd, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-03-16T13:42:01+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-02 09:43:01","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8538582","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8538582","identity":"rs-8538582","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}