Safety and advantage of no drain policy after thoracoscopic major lung resection

It is my great honor to express my opinion on the editorial commentary (1,2) regarding our paper, “No drain after thoracoscopic major lung resection for cancer helps preserve the physical function” (3). First of all, we could achieve a satisfactory outcome with our no drain strategy after major lung resection for cancer (4), partly because of comprehensive coverage by the national medical insurance system in Japan: most of the materials to seal air leaks, such as endostaplers, fibrin sealant, and bioabsorbable mesh, are covered by the Japanese national insurance system.