Single Chest Tube Application Promotes Fast Track Recovery after Lung Cancer Resection_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

HANZhao-jie ¹ , SONGZhi-Fang ¹ , SUJian-hua ² , LIULun-xu ¹ ,  CHEGuo-wei ¹

1. Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
2. Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

CHEGuo-wei, Email: cheguowei@yahoo.com.cn

Keywords：

Chest tube; Pulmonary lobectomy; Lung cancer

DOI：

10.7507/1007-4848.20140004

Video：

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Objective To compare clinical results between single and double chest tube applications after lung cancer resection, and explore the role of single chest tube in postoperative fast track recovery. Method Ninety-three patients with lung cancer who underwent lobectomy between March and December of 2009 in West China Hospital of Sichuan University were included in this study. All the patients were divided into a single-tube group including 46 patients (39 males and 7 females) with their age of 58.4±9.5 years, and a double-tube group including 47 patients (32 males and 15 females) with their age of 58.2±9.0 years. Drainage amount, duration, postoperative hospital stay, and incidences of pneumothorax and pleural effusion after removal of chest tubes were compared between the 2 groups. Results The percentage of patients undergoing complete video-assisted thoracic surgery (VATS) of the double-tube group was significantly higher than that of the single-tube group, and the percentage of patients undergoing thoracotomy of the double-tube group was significantly lower than that of the single-tube group (P < 0.05). Drainage amount of the double-tube group was significantly larger than that of the single-tube group (824.4±612.5 ml vs. 510.7±406.7 ml, P < 0.05). There was no statistical difference in drainage duration, postoperative hospital stay, the incidences of subcutaneous emphysema, pneumothorax, pleural effusion or re-insertion of chest drain between the 2 groups (P > 0.05). Conclusion Clinical results of single chest tube is better than or equivalent to those of double chest tubes after lung cancer resection, and drainage duration of single chest tube application might be shorter.

Citation： HANZhao-jie, SONGZhi-Fang, SUJian-hua, LIULun-xu, CHEGuo-wei. Single Chest Tube Application Promotes Fast Track Recovery after Lung Cancer Resection. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2014, 21(1): 7-10. doi: 10.7507/1007-4848.20140004 Copy

1.	Edward R.Thoracic Drainage.Ann Thorac Surg, 1997, 63:1497-1502.
2.	Jiwnani S, Mehta M, Karimundackal G, et al.Early removal of chest tubes after lung resection--VATS the reason? Eur J Cardiothorac Surg, 2012, 41 (2):464.
3.	时辉, 梅龙勇, 车国卫.肺癌术后胸腔闭式引流术应用的新观念.中国肺癌杂志, 2010, 13 (11):999-1003.
4.	Göttgens KW, Siebenga J, Belgers EH, et al.Early removal of the chest tube after complete video-assisted thoracoscopic lobectomies.Eur J Cardiothorac Surg, 2011, 39 (4):575-578.
5.	Liu L, Che G, Pu Q, et al.A new concept of endoscopic lung cancer resection:Single-direction thoracoscopic lobectomy.Surg Oncol, 2010, 19 (2):71-77.
6.	车国卫, 梅龙勇, 梅建东, 等.单操作孔胸腔镜手术治疗肺部疾病158例临床分析.中国胸心血管外科临床杂志, 2012, 19 (2):114-117.
7.	Coughlin SM, Emmerton-Coughlin HM, Malthaner R.Management of chest tubes after pulmonary resection:a systematic review and meta-analysis.Can J Surg, 2012, 55 (4):264-270.
8.	Gómez-Caro A, Roca MJ, Torres J, et al.Successful use of a single chest drain postlobectomy instead of two classical drains:a randomized study.Eur J Cardiothorac Surg, 2006, 29 (4):562-566.
9.	Icard P, Chautard J, Zhang X, et al.A single 24F Blake drain after wedge resection or lobectomy:a study on 100 consecutive cases.Eur J Cardiothorac Surg, 2006, 30 (4):649-651.
10.	Okur E, Baysungur V, Tezel C, et al.Comparison of the single or double chest tube applications after pulmonary lobectomies.Eur J Cardiothorac Surg, 2009, 35 (1):32-35.
11.	Pawelczyk K, Marciniak M, Kacprzak G, et al.One or two drains after lobectomy? A comparison of both methods in the immediate postoperative period.Thorac Cardiovasc Surg, 2007, 55 (5):313-316.
12.	Otake H, Yasunaga H, Horiguchi H, et al.Impact of hospital volume on chest tube duration, length of stay, and mortality after lobectomy.Ann Thorac Surg, 2011, 92 (3):1069-1074.
13.	Efstratios E, Apostolakis, Nikolaos G.Single or double drain after lung resections? Eur J Cardiothorac Surg, 2009, 36 (2):424.
14.	Saxena P, Kejriwal N, Newman MA.Use of blake drains following lung resection.Eur J Cardiothorac Surg, 2006, 30 (6):952-955.
15.	Rocco G, Romano V, Accardo R, et al.Awake single-access (uniportal)video-assisted thoracoscopic surgery for peripheral pulmonary nodules in a complete ambulatory setting.Ann Thorac Surg, 2010, 89 (5):1625-1627.

1. Edward R.Thoracic Drainage.Ann Thorac Surg, 1997, 63:1497-1502.
2. Jiwnani S, Mehta M, Karimundackal G, et al.Early removal of chest tubes after lung resection--VATS the reason? Eur J Cardiothorac Surg, 2012, 41 (2):464.
3. 时辉, 梅龙勇, 车国卫.肺癌术后胸腔闭式引流术应用的新观念.中国肺癌杂志, 2010, 13 (11):999-1003.
4. Göttgens KW, Siebenga J, Belgers EH, et al.Early removal of the chest tube after complete video-assisted thoracoscopic lobectomies.Eur J Cardiothorac Surg, 2011, 39 (4):575-578.
5. Liu L, Che G, Pu Q, et al.A new concept of endoscopic lung cancer resection:Single-direction thoracoscopic lobectomy.Surg Oncol, 2010, 19 (2):71-77.
6. 车国卫, 梅龙勇, 梅建东, 等.单操作孔胸腔镜手术治疗肺部疾病158例临床分析.中国胸心血管外科临床杂志, 2012, 19 (2):114-117.
7. Coughlin SM, Emmerton-Coughlin HM, Malthaner R.Management of chest tubes after pulmonary resection:a systematic review and meta-analysis.Can J Surg, 2012, 55 (4):264-270.
8. Gómez-Caro A, Roca MJ, Torres J, et al.Successful use of a single chest drain postlobectomy instead of two classical drains:a randomized study.Eur J Cardiothorac Surg, 2006, 29 (4):562-566.
9. Icard P, Chautard J, Zhang X, et al.A single 24F Blake drain after wedge resection or lobectomy:a study on 100 consecutive cases.Eur J Cardiothorac Surg, 2006, 30 (4):649-651.
10. Okur E, Baysungur V, Tezel C, et al.Comparison of the single or double chest tube applications after pulmonary lobectomies.Eur J Cardiothorac Surg, 2009, 35 (1):32-35.
11. Pawelczyk K, Marciniak M, Kacprzak G, et al.One or two drains after lobectomy? A comparison of both methods in the immediate postoperative period.Thorac Cardiovasc Surg, 2007, 55 (5):313-316.
12. Otake H, Yasunaga H, Horiguchi H, et al.Impact of hospital volume on chest tube duration, length of stay, and mortality after lobectomy.Ann Thorac Surg, 2011, 92 (3):1069-1074.
13. Efstratios E, Apostolakis, Nikolaos G.Single or double drain after lung resections? Eur J Cardiothorac Surg, 2009, 36 (2):424.
14. Saxena P, Kejriwal N, Newman MA.Use of blake drains following lung resection.Eur J Cardiothorac Surg, 2006, 30 (6):952-955.
15. Rocco G, Romano V, Accardo R, et al.Awake single-access (uniportal)video-assisted thoracoscopic surgery for peripheral pulmonary nodules in a complete ambulatory setting.Ann Thorac Surg, 2010, 89 (5):1625-1627.

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