Optimized Thoracic Drainage Strategy After Da Vinci Robot-assisted Thoracic Surgery_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

HEZhe-hao , YANGYun-hai , ZHANGChong , WANGLu-ming , Azmat·Rustam, , LVWang ,  HUJian

Department of Thoracic Surgery, The First Affiliated Hospital, Zhejiang University, Hangzhou 310003, P. R. China;

Corresponding author：

HUJian, Email: hujian_med@163.com

Keywords：

Robot surgery; Chest surgery; Chest drainage; Pain score

DOI：

10.7507/1007-4848.20150230

Video：

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Objective We aimed to further investigate the feasibility of using small bore chest tubes or even without chest tube insertion after da Vinci robot-assisted thoracic surgery. Methods We retrospectively analyzed initial 70 patients between September 12, 2014 and March 30, 2015 as a control group at the department of thoracic surgery, the First Affiliated Hospital of Zhejiang University, and proposed four schemes. There are 31 males and 39 females with mean age of 57.1±9.8 (ranged from 30-80 years). We applied those four schemes for the last 30 patients as an experimental group. There are 12 males and 18 females with mean age of 58.8±8.1 (ranged 42-73 years). Results The days in hospital after surgery ranged 2-25 days and there was no severe complication. After the surgery, the pain scores of the trial group are lower than that of the control group. And the schemes 1 and schemes 2 of trial group reduced significantly than the control group (P<0.05). There is no significant difference of the rate of the complication caused by poor drainage between the trial group and the control group (P>0.05). But the pain score after surgery is lower than that of the control group (P<0.05). Conclusion Optimizing thoracic drainage strategy after da Vinci robot-assisted thoracic surgery is safe, possible and helpful to relieve postoperative pain.

Citation： HEZhe-hao, YANGYun-hai, ZHANGChong, WANGLu-ming, Azmat·Rustam,, LVWang, HUJian. Optimized Thoracic Drainage Strategy After Da Vinci Robot-assisted Thoracic Surgery. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(10): 919-922. doi: 10.7507/1007-4848.20150230 Copy

1.	王述民,许世广,童向东等.机器人肺叶切除术治疗非小细胞肺癌.中国胸心血管外科临床杂志,2013,20(3):308-311.
2.	叶波,冯键,陈铭等.达芬奇机器人纵隔肿物切除术23例临床分析.中国微创外科杂志,2013,13(5):392-393,397.
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6.	Edward R.Thoracic drainage.Ann ThoracSurg,1997,63(5):1497-1502.
7.	Mao M,Hughes R,Papadimos TJ,et al.Complications of chest tubes:a focused clinical synopsis.CurrOpinPulm Med,2015,21(4):376-386.
8.	Cerfolio RJ,Bryant AS.The management of chest tubes after pulmonary resection.Thorac Surg Clin,2010,20(3):299-405.
9.	涂远荣,杨劼,刘彦国等.中国手汗症微创治疗专家共识.中华胸心血管外科杂志,2011,27(8):449-451.
10.	Zardo P,Busk H,Kutschka I.Chest tube management:state of the art.Curr Opin Anaesthesiol,2015,28(1):45-49.
11.	Giuseppe Spinoglio.Robotic SurgeryCurrent Applications and New Trends.Robotic Surgery,2015:15-176.
12.	Byrn JC,Schluender S,Divino CM,et al.Three-dimensional imaging improves surgical performance for both novice an experienced operators using the da Vinci Robot System.Am J Surg,2007,193(4):519-522.
13.	Bodner J,Wykypiel H,Greiner A,et al.Early experience with robotassisted surgery for mediastinal masses.Ann Thorac Surg,2004,78(1):259-265.
14.	张大坤,许世广,丁仁泉等.达芬奇机器人手术与胸腔镜辅助小切口手术对肺手术患者创伤对比分析.创伤与急危重病医学,2014,2(5):296-300.
15.	Kehlet H,Wilmore D W.Evidence-based surgical care and the evolution of fast-track surgery.Ann Surg,2008,248(2):189-198.
16.	Jiang K,Cheng L,Wang JJ,et al.Fast track clinical pathway implications in esophagogastrectomy.World J Gastroenterol,2009,15(4):496-501.
17.	Burckhardt CS,Jones KD.Adult measures of pain:The McGill Pain Questionnaire(MPQ),Rheumatoid Arthritis Pain Scale(RAPS),Short-Form McGill Pain Questionnaire(SF-MPQ),Verbal Descriptive Scale(VDS),Visual Analog Scale(VAS),and West Haven-Yale Multidisciplinary Pain Inventory(WHYMPI).Arthritis Rheu 2003,49:S96-S104.
18.	Wall PD,主编.疼痛学.沈阳:辽宁教育出版社,2000.283-294.

1. 王述民,许世广,童向东等.机器人肺叶切除术治疗非小细胞肺癌.中国胸心血管外科临床杂志,2013,20(3):308-311.
2. 叶波,冯键,陈铭等.达芬奇机器人纵隔肿物切除术23例临床分析.中国微创外科杂志,2013,13(5):392-393,397.
3. 刘伦旭,车国卫,蒲强,等.单向式全胸腔镜肺叶切除术.中华胸心血管外科杂志,2008,24(3):156-158.
4. McCormack HM,Horne DJ,Sheather S.Clinical applications of visual analogue scales:a critical review.Psychol Med 1988,18:1007-19.
5. Bejjani J,Fiore JF Jr,Lee L,et al.Validity of the EuroQol-5 dimensions as a measure of recovery after pulmonary resection.J Surg Res,2015,194(1):281-288.
6. Edward R.Thoracic drainage.Ann ThoracSurg,1997,63(5):1497-1502.
7. Mao M,Hughes R,Papadimos TJ,et al.Complications of chest tubes:a focused clinical synopsis.CurrOpinPulm Med,2015,21(4):376-386.
8. Cerfolio RJ,Bryant AS.The management of chest tubes after pulmonary resection.Thorac Surg Clin,2010,20(3):299-405.
9. 涂远荣,杨劼,刘彦国等.中国手汗症微创治疗专家共识.中华胸心血管外科杂志,2011,27(8):449-451.
10. Zardo P,Busk H,Kutschka I.Chest tube management:state of the art.Curr Opin Anaesthesiol,2015,28(1):45-49.
11. Giuseppe Spinoglio.Robotic SurgeryCurrent Applications and New Trends.Robotic Surgery,2015:15-176.
12. Byrn JC,Schluender S,Divino CM,et al.Three-dimensional imaging improves surgical performance for both novice an experienced operators using the da Vinci Robot System.Am J Surg,2007,193(4):519-522.
13. Bodner J,Wykypiel H,Greiner A,et al.Early experience with robotassisted surgery for mediastinal masses.Ann Thorac Surg,2004,78(1):259-265.
14. 张大坤,许世广,丁仁泉等.达芬奇机器人手术与胸腔镜辅助小切口手术对肺手术患者创伤对比分析.创伤与急危重病医学,2014,2(5):296-300.
15. Kehlet H,Wilmore D W.Evidence-based surgical care and the evolution of fast-track surgery.Ann Surg,2008,248(2):189-198.
16. Jiang K,Cheng L,Wang JJ,et al.Fast track clinical pathway implications in esophagogastrectomy.World J Gastroenterol,2009,15(4):496-501.
17. Burckhardt CS,Jones KD.Adult measures of pain:The McGill Pain Questionnaire(MPQ),Rheumatoid Arthritis Pain Scale(RAPS),Short-Form McGill Pain Questionnaire(SF-MPQ),Verbal Descriptive Scale(VDS),Visual Analog Scale(VAS),and West Haven-Yale Multidisciplinary Pain Inventory(WHYMPI).Arthritis Rheu 2003,49:S96-S104.
18. Wall PD,主编.疼痛学.沈阳:辽宁教育出版社,2000.283-294.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Optimized Thoracic Drainage Strategy After Da Vinci Robot-assisted Thoracic Surgery

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