Clinical comparison of two thoracic drainage methods after thoracoscopic pneumonectomy_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

CHEN Bei , DING Junrong , WANG Hua , CHEN Jian ,  JIANG Lei

Shanghai Pulmonary Hospital, Tongji University, Shanghai, 200433, P.R.China;

Corresponding author：

JIANG Lei, Email: jiangleiem@aliyun.com

Keywords：

Pneumonectomy; thoracoscopy; lung cancer; drainage

DOI：

10.7507/1007-4848.201901047

Video：

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Objective To explore an effective and safe drainage method, by comparing open thoracic drainage and conventional thoracic drainage for lung cancer patients after thoracoscopic pneumonectomy.Methods The clinical data of 147 patients who underwent thoracoscopic pneumonectomy from January 2015 to March 2018 in our hospital were retrospectively analyzed, including 128 males and 19 females. Based on drainage methods, they were divided into an open drainage group (open group) and a conventional drainage group (regular group). The incidence of postoperative complications, chest tube duration, drainage volume at postoperative 3 days, postoperative hospital stay, hospitalization cost and quality of life were compared between the two groups.Results Postoperative complication rate was lower in the open group than that in the regular group (10.20% vs. 23.47%, P=0.04). The chest tube duration of the open group was longer compared with the regular group (5.57±2.36 d vs. 3.22±1.23 d, P<0.001). The drainage volume at postoperative 3 days was less in the regular group. In the open group, ambulation was earlier, thoracocentesis was less and re-intubation rate was lower (all P<0.001). The postoperative hospital stay in the regular group was significantly longer than that in the open group (8.37±2.56 d vs. 6.35±1.87 d, P<0.001) and hospitalization cost was significantly higher (66.2±5.4 thousand yuan vs. 59.6±7.3 thousand yuan, P<0.001). Besides, quality of life in 1 and 3 months after operation was significantly better than that in the open group (P<0.001).Conclusion Compared with the regular chest drainage, the effect of open thoracic drainage is better, which can help reduce postoperative complications, shorten the length of hospital stay, reduce the hospitalization cost and improve the quality of postoperative life. It is worthy of clinical promotion.

Citation： CHEN Bei, DING Junrong, WANG Hua, CHEN Jian, JIANG Lei. Clinical comparison of two thoracic drainage methods after thoracoscopic pneumonectomy. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2019, 26(11): 1088-1091. doi: 10.7507/1007-4848.201901047 Copy

1.	Hennon MW, Kumar A, Devisetty H, et al. Minimally invasive approaches do not compromise outcomes for pneumonectomy: a comparison using the national cancer database. J Thorac Oncol, 2019, 14(1): 107-114.
2.	Verma V, Ahern CA, Berlind CG, et al. National cancer database report on pneumonectomy versus lung-sparing surgery for malignant pleural mesothelioma. J Thorac Oncol, 2017, 12(11): 1704-1714.
3.	Higuchi M, Takagi H, Ozaki Y, et al. Comparison of surgical outcomes after pneumonectomy and pulmonary function-preserving surgery for non-small cell lung cancer. Fukushima J Med Sci, 2018, 64(1): 30-37.
4.	Petrella F, Spaggiari L. Therapeutic options following pneumonectomy in non-small cell lung cancer. Expert Rev Respir Med, 2016, 10(8): 919-925.
5.	Rodríguez M, Gómez Hernández MT, Novoa NM, et al. Poorer survival in stage ⅠB lung cancer patients after pneumonectomy. Arch Bronconeumol, 2015, 51(5): 223-226.
6.	Sugarbaker DJ, Haywood-Watson RJ, Wald O. Pneumonectomy for non-small cell lung cancer. Surg Oncol Clin N Am, 2016, 25(3): 533-551.
7.	Ayub A, Rehmani SS, Al-Ayoubi AM, et al. Pulmonary resection for second lung cancer after pneumonectomy: a population-based study. Ann Thorac Surg, 2017, 104(4): 1131-1137.
8.	Dhanasopon AP, Salazar MC, Hoag JR, et al. Fate of pneumonectomy patients variably captured by non-small cell lung cancer staging system. Ann Thorac Surg, 2017, 104(6): 1829-1836.
9.	Wang L, Pei Y, Li S, et al. Left sleeve lobectomy versus left pneumonectomy for the management of patients with non-small cell lung cancer. Thorac Cancer, 2018, 9(3): 348-352.
10.	Gilbert S, McGuire AL, Maghera S, et al. Randomized trial of digital versus analog pleural drainage in patients with or without a pulmonary air leak after lung resection. J Thorac Cardiovasc Surg, 2015, 150(5): 1243-1249.
11.	Lijkendijk M, Licht PB, Neckelmann K. Electronic versus traditional chest tube drainage following lobectomy: a randomized trial. Eur J Cardiothorac Surg, 2015, 48(6): 893-898.
12.	Novoa NM, Jiménez MF, Varela G. When to remove a chest tube. Thorac Surg Clin, 2017, 27(1): 41-46.
13.	Zhou D, Deng XF, Liu QX, et al. Single chest tube drainage is superior to double chest tube drainage after lobectomy: a meta-analysis. J Cardiothorac Surg, 2016, 11(1): 88.
14.	Pompili C, Detterbeck F, Papagiannopoulos K, et al. Multicenter international randomized comparison of objective and subjective outcomes between electronic and traditional chest drainage systems. Ann Thorac Surg, 2014, 98(2): 490-496.
15.	Takamochi K, Imashimizu K, Fukui M, et al. Utility of objective chest tube management after pulmonary resection using a digital drainage system. Ann Thorac Surg, 2017, 104(1): 275-283.

1. Hennon MW, Kumar A, Devisetty H, et al. Minimally invasive approaches do not compromise outcomes for pneumonectomy: a comparison using the national cancer database. J Thorac Oncol, 2019, 14(1): 107-114.
2. Verma V, Ahern CA, Berlind CG, et al. National cancer database report on pneumonectomy versus lung-sparing surgery for malignant pleural mesothelioma. J Thorac Oncol, 2017, 12(11): 1704-1714.
3. Higuchi M, Takagi H, Ozaki Y, et al. Comparison of surgical outcomes after pneumonectomy and pulmonary function-preserving surgery for non-small cell lung cancer. Fukushima J Med Sci, 2018, 64(1): 30-37.
4. Petrella F, Spaggiari L. Therapeutic options following pneumonectomy in non-small cell lung cancer. Expert Rev Respir Med, 2016, 10(8): 919-925.
5. Rodríguez M, Gómez Hernández MT, Novoa NM, et al. Poorer survival in stage ⅠB lung cancer patients after pneumonectomy. Arch Bronconeumol, 2015, 51(5): 223-226.
6. Sugarbaker DJ, Haywood-Watson RJ, Wald O. Pneumonectomy for non-small cell lung cancer. Surg Oncol Clin N Am, 2016, 25(3): 533-551.
7. Ayub A, Rehmani SS, Al-Ayoubi AM, et al. Pulmonary resection for second lung cancer after pneumonectomy: a population-based study. Ann Thorac Surg, 2017, 104(4): 1131-1137.
8. Dhanasopon AP, Salazar MC, Hoag JR, et al. Fate of pneumonectomy patients variably captured by non-small cell lung cancer staging system. Ann Thorac Surg, 2017, 104(6): 1829-1836.
9. Wang L, Pei Y, Li S, et al. Left sleeve lobectomy versus left pneumonectomy for the management of patients with non-small cell lung cancer. Thorac Cancer, 2018, 9(3): 348-352.
10. Gilbert S, McGuire AL, Maghera S, et al. Randomized trial of digital versus analog pleural drainage in patients with or without a pulmonary air leak after lung resection. J Thorac Cardiovasc Surg, 2015, 150(5): 1243-1249.
11. Lijkendijk M, Licht PB, Neckelmann K. Electronic versus traditional chest tube drainage following lobectomy: a randomized trial. Eur J Cardiothorac Surg, 2015, 48(6): 893-898.
12. Novoa NM, Jiménez MF, Varela G. When to remove a chest tube. Thorac Surg Clin, 2017, 27(1): 41-46.
13. Zhou D, Deng XF, Liu QX, et al. Single chest tube drainage is superior to double chest tube drainage after lobectomy: a meta-analysis. J Cardiothorac Surg, 2016, 11(1): 88.
14. Pompili C, Detterbeck F, Papagiannopoulos K, et al. Multicenter international randomized comparison of objective and subjective outcomes between electronic and traditional chest drainage systems. Ann Thorac Surg, 2014, 98(2): 490-496.
15. Takamochi K, Imashimizu K, Fukui M, et al. Utility of objective chest tube management after pulmonary resection using a digital drainage system. Ann Thorac Surg, 2017, 104(1): 275-283.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical comparison of two thoracic drainage methods after thoracoscopic pneumonectomy

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