Abstract
Purpose
Chest drains are usually placed following thoracoscopic surgery but they cause significant post-operative pain. Some data suggests they may not be required but there is little evidence in the paediatric population. We aimed to assess whether it is safe to perform thoracoscopic bullectomy and pleurectomy (BP), for Spontaneous Pneumothorax (SP) without a chest drain and the impact on length of stay and opiate usage.
Methods
A retrospective case notes review of all patients having a thoracoscopic BP between March 2018 to March 2022 in a single tertiary unit was performed. Data was gathered on demographics, length of stay, opiate use (oramorph in mg/kg, PCA length and intravenous morphine dose in mg/kg) and complications. A comparison was made between those with and without a chest drain using a Mann Whitney U.
Results
Fifteen patients were identified and there were 19 BPs during the study period. Eleven had a chest drain and 8 did not. Those that had a chest drain had a significantly higher intravenous morphine use (1.635mg/kg vs 0.34 mg/kg) and length of PCA (46.5 vs 13-h). Those without a chest drain were discharged significantly quicker (1 vs 2 days).
Conclusion
In line with recent literature, in most circumstances it is safe to perform a thoracoscopic BP without a chest drain and it is likely to reduce length of stay and opiate use.
Similar content being viewed by others
References
Rahman NM, Pepperll J, Rehal S et al (2015) Effect of opioids vs NSAIDs and larger vs smaller chest tube size on pain control and pleurodesis efficacy among patients with malignant pleural effusion: the TIME1 randomized clinical trial. JAMA 314:2641–2653
Rahman NM, Maskell NA, Davies CWH, Hedley EL, Nunn AJ, Gleeson FV, Davies RJO (2010) The relationship between chest tube size and clinical outcome in pleural infection. Chest 137:536–543
Ueda K, Hayashi M, Tanaka T, Hamano K (2013) Omitting chest tube drainage after thoracoscopic major lung resection. Eur J Cardiothorac Surg 44:225–229
Koc T, Routledge T, Chambers A, Scarci M (2010) Do patient undergoing lung biopsy need a postoperative chest drain at all? Interact Cardiovasc Thorac Surg 10:1022–1025
Ponsky TA, Rothenberg SS, Tsao K, Ostlie DJ, St Peter SD, Holcomb GW 3rd (2009) Thoracoscopy in children: is a chest tube necessary? J Laparoendosc Adv Surg Tech 19:S23–S25
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
None of the authors have any competing interests.
Financial disclosure
None.
Ethical concerns with the study
None.
Rights and permissions
About this article
Cite this article
Harris, A.C.V., Soccorso, G. & Singh, M. Should a chest drain be left in post thoracoscopic bullectomy and pleurectomy in children?. J Ped Endosc Surg 6, 13–15 (2024). https://doi.org/10.1007/s42804-023-00212-w
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s42804-023-00212-w