Postoperative Drainage with 16 French Urinary Catheter for Video-assisted Thoracoscopic Surgery Lobectomy: A Prospective Cohort Study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHOUHong-xia ¹ , YANGMei ¹ , LIAOHu ¹ , LAIYu-tian ¹ , JIYan-li ¹ , QIUFang ¹ , LIWei-min ² ,  CHEGuo-wei

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

Corresponding author：

CHEGuo-wei, Email: guowei_che@yahoo.com

Keywords：

16F urinary catheter; Video-assisted thoracoscopic surgery (VATS) lobectomy; Fast track rehabilitation

DOI：

10.7507/1007-4848.20160078

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Objective To explore the advantages of postoperative chest drainage with 16F urinary catheter for video- assisted thoracoscopic surgery (VATS) lobectomy. Methods Data of 102 patients (October to December 2015) who under- went VATS lobectomy of lung disease with insertion of catheter (16 F urinary catheter or 28 F chest tube) were analyzed. The patients were divided into two groups including a 16F group (49 patients, with 16 F urinary catheter) and a 18F group (53 patients, with 18F chest drainage tube).The following post-operative data were evaluated: primary healing of tube inci- sion, chest X ray abnormalities (pneumothorax, pleural effusion, subcutaneous emphysema, and hematoma), drainage time, re-insert the drainage tube, and wound healing at the site of insertion. Results Both groups were similar in age, gender, co-morbidity and pathological evaluation of resected specimens. After adjustment, no statistically significant difference was found between the two groups in pulmonary complications (30.6% vs. 28.3%, P=0.102), subcutaneous emphysema (60.0% vs. 6.7%, P=0.011), required intervention (2.0% vs. 5.7%, P=0.048). The average total drainage volume in the 16F group (587.3±323.7 ml) was less than that of the 28 F group (824.1±444.3 ml, P=0.000). The rate of primary healing at the site of insertion in the 16 F group (100.0%) was higher than that in the 28F group (58.5%, P=0.014). A significant difference was found in the drainage time and post-operative length of stay between the two groups (54.2±28.6 h vs. 95.6±65.5 h，4.2±1.4 d vs. 6.5±3.0 d). Conclusion Since 16F urinary catheter has advantage in fast track rehabilitation and low risk of pulmonary complications, the use of 16F urinary catheter is appropriate after VATS pulmonary lobectomy.

Citation： ZHOUHong-xia, YANGMei, LIAOHu, LAIYu-tian, JIYan-li, QIUFang, LIWei-min, CHEGuo-wei. Postoperative Drainage with 16 French Urinary Catheter for Video-assisted Thoracoscopic Surgery Lobectomy: A Prospective Cohort Study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(4): 334-340. doi: 10.7507/1007-4848.20160078 Copy

1.	Shah RD, D’Amico TA. Modern impact of video assisted thoracic surgery. J Thorac Dis, 2014, 6(Suppl 6): S631-S636.
2.	Kim SS, Khalpey Z, Daugherty SL, et al. Factors in the selection and management of chest tubes after pulmonary lobectomy: results of a national survey of thoracic surgeons. Ann Thorac Surg, 2016, 101(3): 1082-1088.
3.	Shi H, Mei L, Che G. The current concepts of closed chest drainage in lobectomy of lung cancer. Zhongguo Fei Ai Za Zhi, 2010,13(11): 999-1003.
4.	Rahman NM, Pepperell J, Rehal S, et al. 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 time randomized clinical trial. JAMA, 2015, 314(24): 2641-2653.
5.	Kamiyoshihara M, Nagashima T, Ibe T, et al. A proposal for management after lung resection, using a flexible silastic drain. Asian Cardiovasc Thorac Ann, 2010, 18(5): 435-442.
6.	Utter GH. The rate of pleural fluid drainage as a criterion for the timing of chest tuberemoval: theoretical and practical considerations. Ann Thorac Surg, 2013, 96(6): 2262-2267.
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.	Zhi XY, Yu JM, Shi YK. Chinese guidelines on the diagnosis and treatment of primary lung cancer (2015 version). Cancer, 2015, 121(Suppl 17): 3165-3181.
9.	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.
10.	杨梅,樊骏,周红霞,等. 胸腔镜肺癌肺叶切除术后16F较28F胸腔引流管应用的临床优势. 中国肺癌杂志, 2015, 18(8): 512-517.
11.	鲍珊, 苏建华, 廖虎, 等. 合并慢性阻塞性肺病和手术方式对肺癌患者术后快速康复及治疗费用的影响. 中国胸心血管外科临床杂志, 2014, 21(1): 7-20.
12.	沈春辉, 梅龙勇, 喻鹏铭, 等. 术前肺康复对肺癌合并中-重度慢性阻塞性肺疾病患者运动耐力影响. 中国胸心血管外科临床杂志, 2011, 18(6): 514-517.
13.	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.
14.	宋志芳, 韩兆杰, 林琳, 等. SF-36 量表评价胸外科住院患者生活质量的信度和效度. 中国胸心血管外科临床杂志, 2014, 21(2): 164-167.
15.	杜恒, 廖虎, 宋志芳, 等. 胸腔镜手术在中国地市级医院胸外科应用现状的问卷调查. 中国胸心血管外科临床杂志, 2013, 20(3): 347-351.
16.	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.
17.	车国卫, 梅龙勇, 梅建东, 等. 单操作孔电视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): 116-119.
18.	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.
19.	Zardo P, Busk H, Kutschka I. Chest tube management: state of the art. Curr Opin Anaesthesiol, 2015, 28(1): 45-49.
20.	Bjerregaard LS, Jensen K, Petersen RH, et al. Early chest tube removal after video-assisted thoracic surgery lobectomy with serous fluid production up to 500 ml/day. Eur J Cardiothorac Surg, 2014, 45(2): 241-246.
21.	Nadlonek NA, Acker SN, Deterding RR, et al. Intraoperative chest tube removal following thoracoscopic lung biopsy results in improved outcomes. J Pediatr Surg, 2014, 49(11): 1573-1576.
22.	Lijkendijk M, Licht PB, Neckelmann K, et al. Electronic versus traditional chest tube drainage following lobectomy: a randomized trial. Eur J Cardiothorac Surg, 2015, 48(6): 893-898.
23.	Dumans-Nizard V, Guezennec J, Parquin F, et al. Feasibility and results of a fast-track protocol in thoracic surgery. Minerva Anestesiol, 2016, 82(1): 15-21.
24.	McGuire AL, Gilbert S. Calculation of individual expected pleural drainage from total body lymph flow: a guide for fast-tracking removal of chest drains. Eur J Cardiothorac Surg, 2015, 47(1): 199.
25.	Cerfolio RJ, Bryant AS, Skylizard L, et al. Optimal technique for the removal of chest tubes after pulmonary resection. J Thorac Cardiovasc Surg, 2013, 145(6): 1535-1539.
26.	Martin K, Emil S, Zavalkoff S, et al. Transitioning from stiff chest tubes to soft pleural catheters: prospective assessment of a practice change. Eur J Pediatr Surg, 2013, 23(5): 389-393.

1. Shah RD, D’Amico TA. Modern impact of video assisted thoracic surgery. J Thorac Dis, 2014, 6(Suppl 6): S631-S636.
2. Kim SS, Khalpey Z, Daugherty SL, et al. Factors in the selection and management of chest tubes after pulmonary lobectomy: results of a national survey of thoracic surgeons. Ann Thorac Surg, 2016, 101(3): 1082-1088.
3. Shi H, Mei L, Che G. The current concepts of closed chest drainage in lobectomy of lung cancer. Zhongguo Fei Ai Za Zhi, 2010,13(11): 999-1003.
4. Rahman NM, Pepperell J, Rehal S, et al. 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 time randomized clinical trial. JAMA, 2015, 314(24): 2641-2653.
5. Kamiyoshihara M, Nagashima T, Ibe T, et al. A proposal for management after lung resection, using a flexible silastic drain. Asian Cardiovasc Thorac Ann, 2010, 18(5): 435-442.
6. Utter GH. The rate of pleural fluid drainage as a criterion for the timing of chest tuberemoval: theoretical and practical considerations. Ann Thorac Surg, 2013, 96(6): 2262-2267.
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. Zhi XY, Yu JM, Shi YK. Chinese guidelines on the diagnosis and treatment of primary lung cancer (2015 version). Cancer, 2015, 121(Suppl 17): 3165-3181.
9. 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.
10. 杨梅,樊骏,周红霞,等. 胸腔镜肺癌肺叶切除术后16F较28F胸腔引流管应用的临床优势. 中国肺癌杂志, 2015, 18(8): 512-517.
11. 鲍珊, 苏建华, 廖虎, 等. 合并慢性阻塞性肺病和手术方式对肺癌患者术后快速康复及治疗费用的影响. 中国胸心血管外科临床杂志, 2014, 21(1): 7-20.
12. 沈春辉, 梅龙勇, 喻鹏铭, 等. 术前肺康复对肺癌合并中-重度慢性阻塞性肺疾病患者运动耐力影响. 中国胸心血管外科临床杂志, 2011, 18(6): 514-517.
13. 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.
14. 宋志芳, 韩兆杰, 林琳, 等. SF-36 量表评价胸外科住院患者生活质量的信度和效度. 中国胸心血管外科临床杂志, 2014, 21(2): 164-167.
15. 杜恒, 廖虎, 宋志芳, 等. 胸腔镜手术在中国地市级医院胸外科应用现状的问卷调查. 中国胸心血管外科临床杂志, 2013, 20(3): 347-351.
16. 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.
17. 车国卫, 梅龙勇, 梅建东, 等. 单操作孔电视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): 116-119.
18. 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.
19. Zardo P, Busk H, Kutschka I. Chest tube management: state of the art. Curr Opin Anaesthesiol, 2015, 28(1): 45-49.
20. Bjerregaard LS, Jensen K, Petersen RH, et al. Early chest tube removal after video-assisted thoracic surgery lobectomy with serous fluid production up to 500 ml/day. Eur J Cardiothorac Surg, 2014, 45(2): 241-246.
21. Nadlonek NA, Acker SN, Deterding RR, et al. Intraoperative chest tube removal following thoracoscopic lung biopsy results in improved outcomes. J Pediatr Surg, 2014, 49(11): 1573-1576.
22. Lijkendijk M, Licht PB, Neckelmann K, et al. Electronic versus traditional chest tube drainage following lobectomy: a randomized trial. Eur J Cardiothorac Surg, 2015, 48(6): 893-898.
23. Dumans-Nizard V, Guezennec J, Parquin F, et al. Feasibility and results of a fast-track protocol in thoracic surgery. Minerva Anestesiol, 2016, 82(1): 15-21.
24. McGuire AL, Gilbert S. Calculation of individual expected pleural drainage from total body lymph flow: a guide for fast-tracking removal of chest drains. Eur J Cardiothorac Surg, 2015, 47(1): 199.
25. Cerfolio RJ, Bryant AS, Skylizard L, et al. Optimal technique for the removal of chest tubes after pulmonary resection. J Thorac Cardiovasc Surg, 2013, 145(6): 1535-1539.
26. Martin K, Emil S, Zavalkoff S, et al. Transitioning from stiff chest tubes to soft pleural catheters: prospective assessment of a practice change. Eur J Pediatr Surg, 2013, 23(5): 389-393.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Postoperative Drainage with 16 French Urinary Catheter for Video-assisted Thoracoscopic Surgery Lobectomy: A Prospective Cohort Study

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