{"title":"Objective Evaluation of Tubeless Thoracic Surgery in Early-stage Lung Cancer Patients Using Multi-modal Digital Device: A Prospective Study.","authors":"Runchen Wang, Qixia Wang, Rong Xu, Wenwei Guo, Haiqi Huang, Bo Liu, Ailifeire Aihemaiti, Kaishen Chen, Zihao Liu, Ying Chen, Jianxing He, Hengrui Liang","doi":"10.1016/j.athoracsur.2025.09.008","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Limited research has objectively assessed perioperative outcomes of tubeless thoracic surgery. This prospective study compared perioperative outcomes between tubeless and intubated surgery using a multimodal digital platform integrating a wearable device and electronic patient-reported outcomes (ePROs).</p><p><strong>Methods: </strong>Of 337 patients, 263 were enrolled and instructed to wear a wearable device and complete ePROs. Propensity score matching (PSM) was applied to balance baseline characteristics.</p><p><strong>Results: </strong>After PSM, 80 patients were included in each group. Compared with the intubation group, the tubeless group had shorter length of hospital stay (2.78 vs. 3.91 days, p < 0.001), shorter chest tube duration (0.93 vs. 2.26 days, p < 0.001), and lower drainage volume (128.90 vs. 313.88 mL, p < 0.001). Wearable devices captured significant differences, with the tubeless group showing lower body temperature (36.68 vs. 36.79 °C, P <0.01) and heart rate (78.96 vs. 85.23 bpm; P < 0.001) on the second postoperative day. Oxygen saturation was higher in the tubeless group on the first postoperative day (96.71 vs. 95.95 %, P < 0.001) and day 2 (96.39 vs. 95.81 %, P = 0.05). Sleep quality was better the day before (78.59 vs. 75.74, P = 0.01) and on surgery day (85.48 vs. 83.15, P < 0.001). ePROs reported less pain, coughing, dyspnea, and distress in the tubeless group.</p><p><strong>Conclusions: </strong>We validated a multimodal digital platform for perioperative assessment. Wearable-derived metrics showed modest variation, supporting feasibility rather than clinical superiority, while ePROs revealed differences suggesting tubeless surgery may offer a more favorable experience.</p>","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.9000,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Thoracic Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.athoracsur.2025.09.008","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Limited research has objectively assessed perioperative outcomes of tubeless thoracic surgery. This prospective study compared perioperative outcomes between tubeless and intubated surgery using a multimodal digital platform integrating a wearable device and electronic patient-reported outcomes (ePROs).
Methods: Of 337 patients, 263 were enrolled and instructed to wear a wearable device and complete ePROs. Propensity score matching (PSM) was applied to balance baseline characteristics.
Results: After PSM, 80 patients were included in each group. Compared with the intubation group, the tubeless group had shorter length of hospital stay (2.78 vs. 3.91 days, p < 0.001), shorter chest tube duration (0.93 vs. 2.26 days, p < 0.001), and lower drainage volume (128.90 vs. 313.88 mL, p < 0.001). Wearable devices captured significant differences, with the tubeless group showing lower body temperature (36.68 vs. 36.79 °C, P <0.01) and heart rate (78.96 vs. 85.23 bpm; P < 0.001) on the second postoperative day. Oxygen saturation was higher in the tubeless group on the first postoperative day (96.71 vs. 95.95 %, P < 0.001) and day 2 (96.39 vs. 95.81 %, P = 0.05). Sleep quality was better the day before (78.59 vs. 75.74, P = 0.01) and on surgery day (85.48 vs. 83.15, P < 0.001). ePROs reported less pain, coughing, dyspnea, and distress in the tubeless group.
Conclusions: We validated a multimodal digital platform for perioperative assessment. Wearable-derived metrics showed modest variation, supporting feasibility rather than clinical superiority, while ePROs revealed differences suggesting tubeless surgery may offer a more favorable experience.
背景：客观评价无管胸外科围手术期疗效的研究有限。这项前瞻性研究使用集成可穿戴设备和电子患者报告结果（ePROs）的多模式数字平台，比较了无管和插管手术的围手术期结果。方法：在337名患者中，263名患者被招募并被指示佩戴可穿戴设备并完成ePROs。倾向评分匹配（PSM）用于平衡基线特征。结果：经PSM治疗后，每组均纳入80例患者。与插管组相比，无管组住院时间较短（2.78 vs. 3.91 d, p < 0.001），胸管时间较短（0.93 vs. 2.26 d, p < 0.001），引流量较低（128.90 vs. 313.88 mL, p < 0.001）。可穿戴设备获得了显著的差异，无管组的体温较低（36.68°C vs. 36.79°C）， P结论：我们验证了围手术期评估的多模式数字平台。可穿戴设备衍生的指标显示出适度的差异，支持可行性而不是临床优势，而ePROs显示的差异表明无管手术可能提供更有利的体验。
期刊介绍：
The mission of The Annals of Thoracic Surgery is to promote scholarship in cardiothoracic surgery patient care, clinical practice, research, education, and policy. As the official journal of two of the largest American associations in its specialty, this leading monthly enjoys outstanding editorial leadership and maintains rigorous selection standards.
The Annals of Thoracic Surgery features:
• Full-length original articles on clinical advances, current surgical methods, and controversial topics and techniques
• New Technology articles
• Case reports
• "How-to-do-it" features
• Reviews of current literature
• Supplements on symposia
• Commentary pieces and correspondence
• CME
• Online-only case reports, "how-to-do-its", and images in cardiothoracic surgery.
An authoritative, clinically oriented, comprehensive resource, The Annals of Thoracic Surgery is committed to providing a place for all thoracic surgeons to relate experiences which will help improve patient care.
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