Abstract
BACKGROUND: Mediastinal mass resection commonly requires postoperative drainage to prevent complications including pleural effusion, pneumothorax, and hematoma. Traditional chest closed drainage (TCCD) remains the standard approach, yet limitations in drainage efficiency, patient comfort, and recovery time have prompted exploration of alternatives. Negative-pressure suction devices (NPSD) offer enhanced drainage capabilities and may reduce postoperative complications, but comparative evidence on their clinical effectiveness, safety, and patient outcomes remains scarce. This retrospective cohort study aimed to systematically compare NPSD versus TCCD following mediastinal mass resection, focusing on chest tube duration, length of stay, and patient recovery outcomes. METHODS: A total of 174 patients from a single Chinese center (September 2021 to February 2025) were included and assigned to TCCD group (n=111) or NPSD group (n=63) based on postoperative drainage choice. Outcomes included chest tube duration, length of stay, tube reinsertion, postoperative fever, pain scores, and other drainage parameters; baseline and perioperative variables were systematically collected. RESULTS: Groups were similar in demographics and most comorbidities; the NPSD group had higher body mass index (BMI) and fewer myasthenia gravis cases. The NPSD group reduced chest tube duration and length of stay versus TCCD group (57.43±18.99 vs. 66.54±20.40 hours, P=0.002; 3.52±1.02 vs. 4.02±1.21 days, P=0.002). Pain, fever, total drainage, and reinsertion rates were comparable, with no increase in drainage-related complications. CONCLUSIONS: The NPSD group shortens drainage duration and length of stay without increasing major complications, supporting its feasibility within enhanced recovery after surgery (ERAS) protocols.