Comfort Level of Chest Tube Size in Lung Cancer Patients with Video-assisted Thoracoscopic Surgery Lobectomy: A Prospective Cohort Study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

MADan ¹ , YANGMei ¹ , FANJun ¹ , ZHOUHong-xia ¹ , DUHeng ¹ , LINLin ¹ , LIULun-xu ¹ , LIWei-min ² ,  CHEGuo-wei ¹

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

Corresponding author：

CHEGuo-wei, Email: chebenben2005@163.com

Keywords：

Thoracic close drainage; Comfort level; Video-assisted thoracoscopic surgery(VATS)

DOI：

10.7507/1007-4848.20150232

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To determine if comfort level was associated with chest tube size(16F or 28F) among lung cancer patients with video-assisted thoracoscopic surgery (VATS) lobectomy. Methods We performed VATS lobectomy for 163 patients with lung cancer in our hospital between February and May 2014. There were 70 males 93 females. The patients were allocated into two groups including a 28F group and a 16F group. There were 75 patients at age of 53.18±14.73 years with insertion of one chest drain of 28F in the 28F group. And there were 88 patients at age of 56.62±12.62 years with insertion of one chest drain of 16F in the 16F group. Heart rate and variation of pulse, breathing rate and variation of breathing rate, pain scores, comfort level, and activities daily living (ADL) of the two groups were compared. Results There was no significant difference in the patient characteristics and operation data between the two groups. There were statistical differences in variation of heart rates on the 1st day, 2nd day, and 3rd day after operation between the 16Fgroup and the 28F group (9.67±3.33 times/min vs.18.54±5.33 times/min, P=0.037; 7.89±2.88 times/min vs. 19.01±4.67 times/min, P=0.045; 7.67±3.01 times/min vs. 20.88±5.34 times/min, P=0.021). The percentage patients of mild pain in the 16F group (77.65%) was higher than that in the 28F group (49.78%, P=0.023) with a statistical difference. The independent ambulation and comfort level in the 16F group(67.05%, 67.05%) were significant higher than those in the 28F group (45.78%,55.11%, P=0.023, P=0.026). Conclusion Our findings suggest that drainage via a small-bore chest tube provides meaningful postoperative comfort level in the patients with VATS lobectomy.

Citation： MADan, YANGMei, FANJun, ZHOUHong-xia, DUHeng, LINLin, LIULun-xu, LIWei-min, CHEGuo-wei. Comfort Level of Chest Tube Size in Lung Cancer Patients with Video-assisted Thoracoscopic Surgery Lobectomy: A Prospective Cohort Study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(10): 928-931. doi: 10.7507/1007-4848.20150232 Copy

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3.	韩兆杰,宋志芳,苏建华,等.单胸腔引流管在肺癌术后快速康复中的应用.中国胸心血管外科临床杂志,2014,21(1):17-20.
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6.	Andreetti C,Menna C,Ibrahim M,et al.Postoperative pain control:videothoracoscopic versus conservative mini-thoracotomic approach.Eur J Cardiothorac Surg,2014,46(5):907-912.
7.	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):e71-e77.
8.	Qiu T,Shen Y,Wang MZ,et al.External suction versus water seal after selective pulmonary resection for lung neoplasm:a systematic review.PLoS One,20138(7):e68087.
9.	Deng B,Tan QY,Zhao YP,et al.Suction or non-suction to the underwater seal drains following pulmonary operation:metaanalysis of randomised controlled trials.Eur J Cardiothorac Surg,2010,38(2):210-215.
10.	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.
11.	Xie HY,Xu K,Tang JX,et al.A prospective randomized,controlled trial deems a drainage of 300 ml/day safe before removal of the last chestdrain after video-assisted thoracoscopic surgery lobectomy.Interact Cardiovasc Thorac Surg,2015,21(2):200-205.
12.	Liu FF,Liu XM,Liu XY,et al.Postoperative continuous wound infusion of ropivacaine has comparable analgesic effects and fewer complications as compared to traditional patient-controlled analgesia with sufentanil in patients undergoing non-cardiac thoracotomy.Int J Clin Exp Med,2015,8(4):5438-5445.
13.	Palade E,Guenter J,Kirschbaum A,et al.Postoperative pain in the acute phase after surgery:VATS lobectomy vs.open lung resectionresults of a prospective randomised trial.Zentralbl Chir,2014,139(Suppl 1):S59-S66.
14.	邱舫,杨梅,王维,等.肺叶切除术后患者无尿管留置的前瞻性队列研究.中国胸心血管外科临床杂志,2015,22(7):634-637.
15.	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.
16.	Tanaka M,Sagawa M,Usuda K,et al.Postoperative drainage with one chest tube is appropriate for pulmonary lobectomy:a randomized trial.Tohoku J Exp Med,2014,232(1):55-61.
17.	Sakakura N,Usami N,Taniguchi T,et al.Assessment of long-term postoperative pain in open thoracotomy patients:pain reduction by the edge closure technique.Ann Thorac Surg,2010,89(4):1064-1070.
18.	Ravindran V,David J,Mc Cormackb,et al.Are intracostal sutures better than pericostal sutures for closing a thoracotomy?Interactive Cardiovasc Thoracic Surgery,2012,14(6):807-815.
19.	周渝斌,刘伦旭,喻鹏铭,等.胸腔镜肺叶切除术后心肺功能的快速康复.中国胸心血管外科临床杂志,2013,20(2):168-171.
20.	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.
21.	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.
22.	Rizk NP,Ghanie A,Hsu M,et al.A prospective trial comparing pain and quality of life measures after anatomic lung resection using thoracoscopy or thoracotomy.Ann Thorac Surg,2014,98(4):1160-1166.

1. [Baltayiannis N,Michail C,Lazaridis G,et al.Minimally invasive procedures.Ann Transl Med,2015,3(4):55-61.
2. 时辉,梅龙勇,车国卫.肺癌术后胸腔闭式引流的新观念.中国肺癌杂志,2010,13(11):999-1003.
3. 韩兆杰,宋志芳,苏建华,等.单胸腔引流管在肺癌术后快速康复中的应用.中国胸心血管外科临床杂志,2014,21(1):17-20.
4. 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.
5. Zardo P,Busk H,Kutschka I.Chest tube management:state of the art.Curr Opin Anaesthesiol,2015,28(1):45-49.
6. Andreetti C,Menna C,Ibrahim M,et al.Postoperative pain control:videothoracoscopic versus conservative mini-thoracotomic approach.Eur J Cardiothorac Surg,2014,46(5):907-912.
7. 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):e71-e77.
8. Qiu T,Shen Y,Wang MZ,et al.External suction versus water seal after selective pulmonary resection for lung neoplasm:a systematic review.PLoS One,20138(7):e68087.
9. Deng B,Tan QY,Zhao YP,et al.Suction or non-suction to the underwater seal drains following pulmonary operation:metaanalysis of randomised controlled trials.Eur J Cardiothorac Surg,2010,38(2):210-215.
10. 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.
11. Xie HY,Xu K,Tang JX,et al.A prospective randomized,controlled trial deems a drainage of 300 ml/day safe before removal of the last chestdrain after video-assisted thoracoscopic surgery lobectomy.Interact Cardiovasc Thorac Surg,2015,21(2):200-205.
12. Liu FF,Liu XM,Liu XY,et al.Postoperative continuous wound infusion of ropivacaine has comparable analgesic effects and fewer complications as compared to traditional patient-controlled analgesia with sufentanil in patients undergoing non-cardiac thoracotomy.Int J Clin Exp Med,2015,8(4):5438-5445.
13. Palade E,Guenter J,Kirschbaum A,et al.Postoperative pain in the acute phase after surgery:VATS lobectomy vs.open lung resectionresults of a prospective randomised trial.Zentralbl Chir,2014,139(Suppl 1):S59-S66.
14. 邱舫,杨梅,王维,等.肺叶切除术后患者无尿管留置的前瞻性队列研究.中国胸心血管外科临床杂志,2015,22(7):634-637.
15. 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.
16. Tanaka M,Sagawa M,Usuda K,et al.Postoperative drainage with one chest tube is appropriate for pulmonary lobectomy:a randomized trial.Tohoku J Exp Med,2014,232(1):55-61.
17. Sakakura N,Usami N,Taniguchi T,et al.Assessment of long-term postoperative pain in open thoracotomy patients:pain reduction by the edge closure technique.Ann Thorac Surg,2010,89(4):1064-1070.
18. Ravindran V,David J,Mc Cormackb,et al.Are intracostal sutures better than pericostal sutures for closing a thoracotomy?Interactive Cardiovasc Thoracic Surgery,2012,14(6):807-815.
19. 周渝斌,刘伦旭,喻鹏铭,等.胸腔镜肺叶切除术后心肺功能的快速康复.中国胸心血管外科临床杂志,2013,20(2):168-171.
20. 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.
21. 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.
22. Rizk NP,Ghanie A,Hsu M,et al.A prospective trial comparing pain and quality of life measures after anatomic lung resection using thoracoscopy or thoracotomy.Ann Thorac Surg,2014,98(4):1160-1166.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Comfort Level of Chest Tube Size in Lung Cancer Patients with Video-assisted Thoracoscopic Surgery Lobectomy: A Prospective Cohort Study

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