Single chest tube drainage is superior to double chest tube drainage after lobectomy: a meta-analysis

Abstract

BackgroundIn this meta-analysis, we conducted a pooled analysis of clinical studies comparing the efficacy of single chest tube versus double chest tube after a lobectomy.MethodsAccording to the recommendations of the Cochrane Collaboration, we established a rigorous study protocol. We performed a systematic electronic search of the PubMed, Embase, Cochrane Library and Web of Science databases to identify articles to include in our meta-analysis. A literature search was performed using relevant keywords. A meta-analysis was performed using RevMan© software.ResultsFive studies, published between 2003 and 2014, including 630 patients (314 patients with a single chest tube and 316 patients with a double chest tube), met the selection criteria. From the available data, the patients using a single tube demonstrated significantly decreased postoperative pain [weighted mean difference [WMD] −0.60; 95 % confidence intervals [CIs] −0.68–− 0.52; P < 0.00001], duration of drainage [WMD −0.70; 95 % CIs −0.90–− 0.49; P < 0.00001] and hospital stay [WMD −0.51; 95 % CIs −0.91–− 0.12; P = 0.01] compared to patients using a double tube after a pulmonary lobectomy. However, there were no significant differences in postoperative complications [OR 0.91; 95 % CIs 0.57–1.44; P = 0.67] and re-drainage rates [OR 0.81; 95 % CIs 0.42–1.58; P = 0.54].ConclusionOur results showed that a single-drain method is effective, reducing postoperative pain, hospitalization times and duration of drainage in patients who undergo a lobectomy. Moreover, the single-drain method does not increase the occurrence of postoperative complications and re-drainage rates.

Chest tube drainage versus needle aspiration for primary spontaneous pneumothorax: which is better?

“…Generally speaking, chest tube drainages were usually applied for patients suffering from pneumothorax who should be admitted to hospital following the failure of needle aspiration (3). And other indications for chest tube drainage included hemothorax (49,50), pleural effusion (51-53), pleural empyema (54,55), and major thoracic surgery (56)(57)(58). The approaches to insert chest tube drainage into body parts include axillary or anterior approach.…”

Chest drain management post‐oesophagectomy: a survey of Australian and New Zealand surgeons

“…However, they did not find any significant relationship between surgeon experience and tube size, only that 28‐Fr was most common. It is also noteworthy that a meta‐analysis by Zhou et al . found that using a single ICC post‐lobectomy did not increase post‐operative complication and re‐drainage rates compared to using two ICCs, but did reduce post‐operative pain and hospitalization times.…”

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

“…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]. At present, it is common that SCD is placed after lobectomy of upper lung tissue in China, while DCD are placed after lobectomy of lower lung tissue [14]. The potential reason is that the closure of the residual cavity after lobectomy depends on adequate drainage with aims to promote lung expansion and avoid mediastinum displacement [30].…”