Feasibility and safety of early chest tube removal after complete video-assisted thoracic lobectomy

Jiang, Hua; Wang, Jianfeng; Yuan, Dandan; Fang, Jie; Li, Z

doi:10.4103/0019-509x.151987

Cited by 8 publications

(6 citation statements)

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“…Excessively late removal of the thoracostomy tube may prolong patient discomfort associated with the thoracostomy tube itself, increase the risk of thoracostomy tube-related complications, and increase the cost of care and duration of hospitalization. Prospective studies of early removal protocols [20][21][22][23] in people have shown that thoracostomy tubes may be safely removed even with fluid production rates of 500 ml/day.…”

Section: Discussionmentioning

confidence: 99%

“…It is not routine at our institution to perform thoracic imaging or to evaluate the fluid cytologically prior to thoracostomy tube removal. In people, routine postoperative thoracic radiographs rarely lead to intervention, 21 and omitting this routine use has not been associated with an increase in morbidity or mortality. 39 The potential benefit of monitoring the cytological characteristics of pleural fluid could not be evaluated in this study due to inconsistent submission of samples to the laboratory, but there may be additional clinical value in this information that should be investigated in a future study.…”

Section: Discussionmentioning

confidence: 99%

“…Despite using a higher fluid production threshold of 400-500 mL/day, these studies found no increase in adverse events. [20][21][22][23] Given these findings, some investigators hypothesized that carefully selected patients can be managed without the use of a thoracostomy tube after thoracic surgery, with encouraging results. 24,25 Overall, aggregate evidence in the human medical literature suggests that higher drainage volume thresholds for thoracostomy tube removal, compared to current conventions, may be well tolerated and safe in certain patient populations.…”

Section: Introductionmentioning

confidence: 99%

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Retrospective evaluation of fluid production at the time of thoracostomy tube removal following elective and emergency surgery in dogs (2010–2017): 185 cases

Racette

Sharkey

Heinrich

et al. 2021

J Vet Emergen Crit Care

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Objective: To report the rate of fluid production at the time of removal of thoracostomy tubes placed intraoperatively and to determine the association of this rate with specific patient factors, surgical factors, or clinical diagnosis. The secondary objective was to determine whether identification of pleural effusion within 2 weeks of thoracostomy tube removal was associated with the same variables.Design: Retrospective study.Setting: University teaching hospital. Animals:One hundred eighty-five client-owned dogs with thoracostomy tubes placed intraoperatively between January 2010 and March 2017. Interventions: None.Measurements and Main Results: Thoracostomy tubes were removed at a median fluid production of 0.09 mL/kg/h (range, 0-7.0 m L/kg/h). Median fluid production at the time of thoracostomy tube removal was significantly higher in dogs with preoperative pleural effusion compared to dogs without preoperative pleural effusion (0.21 vs 0.05 mL/kg/h; P = 0.0001) and in dogs that had a median sternotomy compared to dogs that had a lateral thoracotomy (0.14 vs 0.09 mL/kg/h; P = 0.04). Of the 169 dogs available for follow-up, 12 (7.1%) had pleural effusion within 2 weeks of removal of the thoracostomy tube. Detection of pleural effusion during the follow-up period was significantly associated with the presence of preoperative pleural effusion (P = 0.0019) and the diagnosis (P = 0.01). A greater proportion of dogs with a lung lobe torsion (4/9, 44.4%) and idiopathic chylothorax (2/7, 28.5%) had pleural effusion within 2 weeks compared to other diagnoses. Reintervention was performed in 4.7% of dogs.Conclusions: Thoracostomy tubes were removed at pleural fluid production rates that frequently exceeded current veterinary guidelines. However, the fluid production rate at the time of thoracostomy tube removal was not associated with the detection of

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Retrospective evaluation of fluid production at the time of thoracostomy tube removal following elective and emergency surgery in dogs (2010–2017): 185 cases

Racette

Sharkey

Heinrich

et al. 2021

J Vet Emergen Crit Care

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“…The application of thoracic drainage after lobectomy has been in the clinic for many years. By placing a closed chest drainage tube, it can achieve the effects of draining gas and fluids from the chest cavity, promoting lung expansion, preventing chest infections, and rebuilding negative pressure [27,28]. Meanwhile, by observing the amount, characteristics of drainages, and the fluctuation of the water column, some abnormal conditions can be found and treated in time [29].…”

Section: Discussionmentioning

confidence: 99%

Single versus double chest drains after pulmonary lobectomy: a systematic review and meta-analysis

You

Zhang

et al. 2020

World J Surg Onc

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“…1). [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] We searched the PubMed database with the following terms: VATS, video thoracoscopy, robot assisted, length of stay, complications, lung cancer, lung resection, and lobectomy. Only articles written in English were considered.…”

Section: End Pointmentioning

confidence: 99%

The Interest of Performing “On-Demand Chest X-rays” after Lung Resection by Minimally Invasive Surgery

Haddad

Bubenheim

Bernard

et al. 2017

Thorac cardiovasc Surg

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There is a lack of consensus in hospital centers regarding costly daily routine chest X-rays after lung resection by minimally invasive surgery. Indeed, there is no evidence that performing daily chest X-rays prevents postoperative complications. Our objective was to compare chest X-rays performed on demand when there was clinical suspicion of postoperative complications and chest X-rays performed systematically in daily routine practice. This prospective single-center study compared 55 patients who had on-demand chest X-rays and patients in the literature who had daily routine chest X-rays. Our primary evaluation criterion was length of hospitalization. The length of hospitalization was 5.3 ± 3.3 days for patients who had on-demand X-rays, compared with 4 to 9.7 days for patients who had daily routine X-rays. Time to chest tube removal (4.34 days), overall complication rate (27.2%), reoperation rate (3.6%), and mortality rate (1.8%) were comparable to those in the literature. On average, our patients only had 1.22 ± 1.8 on-demand X-rays, compared with 3.3 X-rays if daily routine protocol had been applied. Patients with complications had more X-rays (3.4 ± 1.8) than patients without complications (0.4 ± 0.7). On-demand chest X-rays do not seem to delay the diagnosis of postoperative complications or increase morbidity-mortality rates. Performing on-demand chest X-rays could not only simplify surgical practice but also have a positive impact on health care expenses. However, a broader randomized study is warranted to validate this work and ultimately lead to national consensus.

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Feasibility and safety of early chest tube removal after complete video-assisted thoracic lobectomy

Abstract: Complete video-assisted thoracic lobectomy brings less drainage volume after operation. Early removal of chest tube in CVATL shows feasible and safe and demonstrates that it may reduce postoperative pain and help fast recovery.

Cited by 8 publications

References 0 publications

Retrospective evaluation of fluid production at the time of thoracostomy tube removal following elective and emergency surgery in dogs (2010–2017): 185 cases

Retrospective evaluation of fluid production at the time of thoracostomy tube removal following elective and emergency surgery in dogs (2010–2017): 185 cases

Single versus double chest drains after pulmonary lobectomy: a systematic review and meta-analysis

The Interest of Performing “On-Demand Chest X-rays” after Lung Resection by Minimally Invasive Surgery

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