Early chest tube removal after video-assisted thoracic surgery lobectomy with serous fluid production up to 500 ml/day

Bjerregaard, Lars S; Jensen, Katrine; Petersen, René Horsleben; Hansen, Henrik Jessen

doi:10.1093/ejcts/ezt376

Cited by 109 publications

(61 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In recent years several studies on early chest tube removal from the pleural cavity following pulmonary resection and cardiac surgery have been published. Bjerregaard et al 6 reported it was safe to remove chest tubes despite drainage of 450 mL/day after lobectomy by video-assisted thoracic surgery. Xie et al 1 performed a prospective randomized study and found that a 300 mL/day volume threshold for chest tube removal after video-assisted thoracic surgery lobectomy was feasible and safe and that a 450 mL/ day volume threshold for chest tube removal increased the risk of thoracentesis.…”

Section: Discussionmentioning

confidence: 99%

Early Chest Tube Removal After Thoracoscopic Esophagectomy with High Output

Yao

Wang

Yao

et al. 2016

Journal of Laparoendoscopic & Advanced Surgical Techniques

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Early Chest Tube Removal After Thoracoscopic Esophagectomy with High Output

Yao

Wang

Yao

et al. 2016

Journal of Laparoendoscopic & Advanced Surgical Techniques

View full text Add to dashboard Cite

show abstract

“…To date, drainage systems have only been compared with relation to postoperative air leak (11)(12)(13)(14)(15). Whilst this is an important aspect of the decision to remove chest tubes, the volume of fluid extracted is another major determinant, that continues to garner increased attention amongst research circles (2,(16)(17)(18). Pleural fluid formation is greatly influenced by pleural permeability and shift in oncotic and hydrostatic pressures.…”

Section: Discussionmentioning

confidence: 99%

Does the usage of digital chest drainage systems reduce pleural inflammation and volume of pleural effusion following oncologic pulmonary resection?—A prospective randomized trial

Waele¹,

Agzarian²,

Hanna³

et al. 2017

J. Thorac. Dis.

View full text Add to dashboard Cite

Background: Prolonged air leak and high-volume pleural drainage are the most common causes for delays in chest tube removal following lung resection. While digital pleural drainage systems have been successfully used in the management of post-operative air leak, their effect on pleural drainage and inflammation has not been studied before. We hypothesized that digital drainage systems (as compared to traditional analog continuous suction), using intermittent balanced suction, are associated with decreased pleural inflammation and postoperative drainage volumes, thus leading to earlier chest tube removal. Methods: One hundred and three [103] patients were enrolled and randomized to either analog (n=50) or digital (n=53) drainage systems following oncologic lung resection. Chest tubes were removed according to standardized, pre-defined protocol. Inflammatory mediators [interleukin-1B (IL-1B), 6, 8, tumour necrosis factor-alpha (TNF-α)] in pleural fluid and serum were measured and analysed. The primary outcome of interest was the difference in total volume of postoperative fluid drainage. Secondary outcome measures included duration of chest tube in-situ, prolonged air-leak incidence, length of hospital stay and the correlation between pleural effusion formation, degree of inflammation and type of drainage system used.Results: There was no significant difference in total amount of fluid drained or length of hospital stay between the two groups. A trend for shorter chest tube duration was found with the digital system when compared to the analog (P=0.055). Comparison of inflammatory mediator levels revealed no significant differences between digital and analog drainage systems. The incidence of prolonged post-operative air leak was significantly higher when using the analog system (9 versus 2 patients; P=0.025). Lobectomy was associated with longer chest tube duration (P=0.001) and increased fluid drainage when compared to sublobar resection (P<0.001), regardless of drainage system. Conclusions: Use of post-lung resection digital drainage does not appear to decrease pleural fluid formation, but is associated with decreased prolonged air leaks. Total pleural effusion volumes did not differ with the type of drainage system used. These findings support previously established benefits of the digital system in decreasing prolonged air leaks, but the advantages do not appear to extend to decreased pleural fluid formation.

show abstract

“…250 ml/Tag als Grenze für die Entfernung der Thoraxdrainagen gesehen. Große Studien konnten jedoch nachweisen, dass Fördermengen zwischen 450 und 500 ml/Tag nicht automatisch zu einer erhöhten Inzidenz an interventionsbedürftigen Pleuraergüssen führten und daher akzeptiert werden können [3,7,8]. In einer prospektiven Studie konnte zusätzlich gezeigt werden, dass eine postoperative Manipulation am Drainageschlauch ("milking") zu einer vermehrten Fördermenge der Pleuradrainage ohne klinische Verbesserung führt und daher nicht empfohlen wird [9].…”

Section: Drainagemanagement Nach Lungenoperationenunclassified