Comparison of the results of two chest tube managements during an enhanced recovery program after video-assisted thoracoscopic lobectomy: A randomized trial

Zihan Cui, Yuejuan Zhang, Chun Xu, Cheng Ding, Jun Chen, Chang Li, Jun Zhao, Zihan Cui, Yuejuan Zhang, Chun Xu, Cheng Ding, Jun Chen, Chang Li, Jun Zhao

Abstract

Background: This study compared the results of the application of two different chest tube management systems; a drainage ball with low negative pressure and the more commonly used chest tube with water-sealed bottle, after video-assisted thoracoscopic (VATS) lobectomy.

Methods: A total of 60 patients undergoing lobectomy were enrolled into this prospective open label randomized clinical trial and equally divided into two groups. The data collected in the trial included age, gender, forced expiratory volume in 1 second (FEV1), blood loss, operation time, drainage volume, drainage time, length of stay, postoperative pain score according to the Visual Analogue Scale (VAS) within 24 hours after surgery and chest tube removal. This study was registered at ClinicalTrials.gov (NCT03598296).

Results: The characteristics of the patients were similar in both groups. Group ball patients had a lower pain score (after operation: 3.47 ± 1.80 vs. 6.20 ± 1.56, P < 0.001; after removal of chest tube: 1.47 ± 1.28 vs. 3.00 ± 1.29, P < 0.001); less analgesic used (2.83 ± 2.09 times vs. 5.00 ± 3.24 times, P = 0.003); less drainage time (upper tube: 3.89 ± 1.63 days vs. 5.10 ± 2.02 days, P = 0.048; lower tube: upper lobe 4.84 ± 1.61 days vs. 5.90 ± 1.52 days, P = 0.041; lower lobe: 3.82 ± 1.08 days vs. 5.70 ± 2.63 days, P = 0.042) and shorter length of stay (5.40 ± 1.65 days vs. 6.37 ± 1.99 days, P = 0.045). All other related parameters were similar in both groups.

Conclusions: For patients undergoing lobectomy, using a drainage ball with negative pressure could reduce hospitalization days and postoperative pain compared with the more commonly used chest tube with water-sealed bottle when a strict postoperative curative procedure was performed.

Keywords: Chest tube; ERAS; non-small cell lung cancer; video-assisted thoracoscope lobectomy.

© 2019 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.

Figures

Figure 1
Figure 1
(a) Chest tube (28F). (b) Drainage ball.
Figure 2
Figure 2
(a) Patient accepted left upper lobectomy in Group tube. Two commonly used chest tubes (28F, arrow) were inserted. (b) Patient accepted left lower lobectomy in Group tube. One commonly used chest tube (28F, arrow) was inserted.
Figure 3
Figure 3
(a) Patient accepted left upper lobectomy in Group ball. One commonly used chest tube (28F, arrow) and one drainage ball (arrowhead) were inserted. (b) Patient accepted right lower lobectomy in Group ball. One drainage ball (arrowhead) was inserted.

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