Evaluation of the necessity for chest drain placement following thoracoscopic wedge resection

Ting-Yu Lu, Jian-Xun Chen, Pin-Ru Chen, Yu-Sen Lin, Chien-Kuang Chen, Pei-Yu Kao, Tzu-Ming Huang, Hsin-Yuan Fang, Ting-Yu Lu, Jian-Xun Chen, Pin-Ru Chen, Yu-Sen Lin, Chien-Kuang Chen, Pei-Yu Kao, Tzu-Ming Huang, Hsin-Yuan Fang

Abstract

Purpose: To evaluate the outcomes of patients who underwent thoracoscopic wedge resection without chest drain placement.

Methods: The subjects of this retrospective study were 89 patients, who underwent thoracoscopic wedge resection at our hospital between January, 2013 and July, 2015. A total of 45 patients whose underlying condition did not meet the following criteria were assigned to the "chest drain placement group" (group A): peripheral lesions, healthy lung parenchyma, no intraoperative air leaks, hemorrhage or effusion accumulation, and no pleural adhesion. The other 44 patients whose underlying condition met the criteria were assigned to the "no chest drain placement group" (group B). Patient characteristics, specimen data, and postoperative conditions were analyzed and compared between the groups.

Results: Group A patients had poorer forced expiratory volume in one second (FEV1) values, less normal spirometric results, significantly higher resected lung volume, a greater maximum tumor-pleura distance, and a larger maximum tumor size. They also had a longer postoperative hospital stay. There was no difference between the two groups in postoperative complications.

Conclusions: Avoiding chest drain placement after a thoracoscopic wedge resection appears to be safe and beneficial for patients who have small peripheral lesions and healthy lung parenchyma.

Keywords: Chest tubes; Drainage; Pulmonary surgical procedure; Video-assisted thoracoscopic surgery.

Conflict of interest statement

We declare no conflicts of interest.

Figures

Fig. 1
Fig. 1
In group B (no chest drain), air evacuation was achieved by temporarily inserting a nasogastric (NG) tube into the pleural cavity with a bowl of aseptic water as the water seal system. The NG tube was removed when there was no air leak during lung inflation

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