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Is it still necessary to leave a chest tube after video-assisted pulmonary wedge resection?

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Indian Journal of Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Background

The controversy whether or not leaving a chest tube in the pleural cavity after pulmonary resection has been under debate. A chest tube could negatively influence the postoperative course and diminish the possible benefits of video-assisted thoracoscopic surgery (VATS). The aim of this study was to evaluate our protocol of omitting a chest tube in the pleural cavity after pulmonary wedge resection in a selected group of patients.

Methods

Between September 2011 and November 2014, 49 pulmonary wedge resections by VATS without conversion were performed. A chest tube was omitted if there was no air leak after performing the air leak test and patients did not have bullous/emphysematous lesions or dense pleural adhesions. If patients did not meet these criteria, a chest tube was placed. Primary outcome was postoperative morbidity and the secondary outcome was hospital stay.

Results

We omitted a chest tube in 28 patients and left a chest tube in the pleural cavity in 21 patients after VATS pulmonary wedge resection. Three reinterventions were necessary postoperatively because of pneumothorax or hematopneumothorax, all in the group without a chest tube. Hospital stay was 1 day shorter in the group without chest tube placement.

Conclusions

Omitting a chest tube can decrease hospital stay but we have to be vigilant regarding postoperative complications. Quick removal of the chest tube in the recovery room could be a good alternative to prevent unnecessary reinterventions and to play it real safe.

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Authors and Affiliations

  1. Department of Pulmonary Surgery, Amphia Hospital Breda, Breda, The Netherlands

    Bastiaan E. Steunenberg, Bart A. C. Aerts, Hans G. W. de Groot, Piet J. H. J. Romme, Conny A. Boot & Eelco J. Veen

  2. Department of Surgery, Molengracht 21, 4818 CK, Breda, The Netherlands

    Eelco J. Veen

Authors
  1. Bastiaan E. Steunenberg
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  2. Bart A. C. Aerts
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  3. Hans G. W. de Groot
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  4. Piet J. H. J. Romme
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  5. Conny A. Boot
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  6. Eelco J. Veen
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Corresponding author

Correspondence to Bastiaan E. Steunenberg.

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The authors declare that they have no conflict of interest.

Human and animal rights and informed consent

This study was not funded. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

Additional information

Poster presentation at the ESTS annual meeting Copenhagen 15–18 June 2014

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Steunenberg, B.E., Aerts, B.A.C., de Groot, H.G.W. et al. Is it still necessary to leave a chest tube after video-assisted pulmonary wedge resection?. Indian J Thorac Cardiovasc Surg 33, 132–136 (2017). https://doi.org/10.1007/s12055-017-0508-z

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  • DOI: https://doi.org/10.1007/s12055-017-0508-z

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