Enhanced recovery in lung surgery: coaxial versus conventional chest drains following video-assisted thoracoscopic surgery lobectomy—a prospective randomized trial

Mohamed Salama, Michael Rolf Mueller  |  November 30, 2025

This randomized trial compared conventional versus coaxial chest drains after VATS lobectomy using digital suction. Coaxial drains significantly reduced drainage duration, tube occlusion, and subcutaneous emphysema, with lower postoperative inflammatory markers. High early fluid output predicted prolonged drainage. These findings suggest that coaxial drains provide more reliable air and fluid evacuation, particularly in the setting of significant air leak, and may facilitate faster recovery and ERAS pathway adherence.

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