Chest tube management following pulmonary lobectomy: change of protocol results in fewer air leaks

Interact Cardiovasc Thorac Surg. 2011 Jan;12(1):28-31. doi: 10.1510/icvts.2010.248716. Epub 2010 Oct 6.

Abstract

Much controversy exists regarding the management of chest tubes following pulmonary lobectomy. The objective of this study was to analyse the effect of a new chest tube management protocol on clinical features, such as postoperative air leak, drain characteristics, 30-day postoperative complications and length of hospital stay. We retrospectively analysed 133 patients who underwent pulmonary lobectomy, from January 2005 to December 2008. A new chest tube protocol was introduced on 1 January 2007 and included placement of a single chest tube and early conversion to water seal. The chest tube was removed when air leak had resolved and (non-chylous) fluid drainage was <400 ml/day. The results of patients in the old (n=68) and the new protocol (n=65) were compared. In the new protocol group the median duration of air leak and duration of chest tube drainage declined significantly. Also the length of hospital stay decreased significantly to a median of eight days. The number of reinterventions and 30-day morbidity and mortality rates did not differ significantly. Our data suggest that placement of a single chest tube and early conversion to water seal decreases the duration of air leak and chest tube drainage and length of hospital stay.

MeSH terms

  • Aged
  • Chest Tubes*
  • Drainage / adverse effects
  • Drainage / instrumentation*
  • Female
  • Humans
  • Length of Stay
  • Lung Neoplasms / pathology
  • Lung Neoplasms / secondary
  • Lung Neoplasms / surgery*
  • Male
  • Middle Aged
  • Netherlands
  • Pleural Effusion / etiology
  • Pleural Effusion / surgery*
  • Pneumonectomy* / adverse effects
  • Pneumothorax / etiology
  • Pneumothorax / prevention & control*
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome