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Early chest tube removal after thoracoscopic lobectomy with the aid of an additional thin tube: a prospective multi-institutional study

General Thoracic and Cardiovascular Surgery volume 66, pages 723–730 (2018)Cite this article

Abstract

Objectives

There is no evidence concerning the appropriate drainage volume for indicating chest tube removal after pulmonary lobectomy. A prospective multi-institutional cohort study was designed to elucidate the safety of early chest tube removal after thoracoscopic lobectomy.

Methods

Between April 2009 and November 2011, 310 patients with suspected or histologically documented lung cancer were screened. Patients without air leakage or bloody, chylous, or purulent pleural effusion underwent chest tube removal on the day after thoracoscopic lobectomy, independent of the drainage volume. The subjects were classified into three groups as tertiles according to the drainage volume that was observed for approximately 24 h after surgery. The associations between the drainage volume and the development of complications were investigated, with several clinical factors taken into account.

Results

The 162 patients who were enrolled underwent early chest tube removal via this protocol and were classified into three groups according to their drainage volume (0–219 mL, n = 52; 220–349 mL, n = 56; and ≥ 350 mL, n = 54). A 7F backup tube placed within the dead space to prevent troubles was removed by postoperative day 4 in all patients because nothing happened. Univariate and multivariate analyses showed that the drainage volume was not associated with the risk of complications.

Conclusions

Early removal of the chest tube on the day after thoracoscopic lobectomy appears to be a safe treatment protocol in patients without air leakage or bloody, chylous, or purulent pleural effusion; however, careful surveillance is needed for patients who have a drainage volume of ≥ 350 mL/day.

Clinical registration number

University Hospital Medical Information Network Clinical Trials Registry, 000028971 (Japan).

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Funding

This study was supported by research grants from the Kyosai Medical Society (No. 20–27 to Ryoichi Nakanishi).

Author information

Authors and Affiliations

  1. Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan

    Ryoichi Nakanishi, Risa Oda, Keisuke Yokota, Katsuhiro Okuda & Hiroshi Haneda

  2. Department of Thoracic Surgery, Shin-Kokura Hospital, Kitakyushu, Japan

    Ryoichi Nakanishi & Manabu Yasuda

  3. Department of Preventive Medicine and Community Health, University of Occupational and Environmental Health, Kitakyushu, Japan

    Yoshihisa Fujino

  4. Department of Thoracic Surgery, Hamanomachi Hospital, Fukuoka, Japan

    Masato Kato

  5. Department of Thoracic Surgery, Shin-Bepp Hospital, Oita, Japan

    Takashi Miura

Authors
  1. Ryoichi Nakanishi
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  2. Yoshihisa Fujino
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  3. Masato Kato
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  4. Takashi Miura
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  5. Manabu Yasuda
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  6. Risa Oda
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  7. Keisuke Yokota
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  8. Katsuhiro Okuda
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  9. Hiroshi Haneda
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Corresponding author

Correspondence to Ryoichi Nakanishi.

Additional information

This article is based on the data of a study first reported in the Kyosai Medical Journal 2013; 62:206–10 (article in Japanese).

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Nakanishi, R., Fujino, Y., Kato, M. et al. Early chest tube removal after thoracoscopic lobectomy with the aid of an additional thin tube: a prospective multi-institutional study. Gen Thorac Cardiovasc Surg 66, 723–730 (2018). https://doi.org/10.1007/s11748-018-0993-z

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  • DOI: https://doi.org/10.1007/s11748-018-0993-z

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