A prospective randomized control study about indication of chest tube removal following a VATS lobectomy / 中华胸心血管外科杂志

ABSTRACT

Objective This study assesses a feasible and safe volume threshold for chest tube removal following a VATS lobectomy.Methods The study included 168 consecutive patients who underwent VATS lobectomy or bilobectomy with two insicion between August 2012 and February 2014.Eligible patients were randomized into 3 groupsGroup A (chest tube removal at the drainage volume of 150 ml/d or less.n =49) ; Group B (chest tube was removed when the drainage volume was less than 300 ml/d.n =50) ; Group C(chest tube removal when the drainage was less than 450 ml/d.n =51).And there were 18 patients who were excluded.All patients got the same postoperative care with a clinical pathway,and all patients were followedup 7 days after discharge from hospital.The time of extracting drainage tube,postoperative hospital stay,postoperative VAS values,dosage of analgesic,incidence of complications and thoracocentesis were measured.Results There were no statistically significant differences among 3 groups with general information and incidence of complication (P ＞ 0.05).And there were statistically significant differences between Group A and Group B with the time of extracting drainage tube,postoperative hospital stay,postoperative VAS values,dosage of analgesic(P ＜ 0.05).But there were no statistically significant differences between Group A and Group B with incidence of thoracocentesis(P ＞0.05).Analysis of data showed no statistically significant differences between Group B and Group C with postoperative hospital stay,postoperative VAS values and dosage of analgesic (P ＞ 0.05),but there were statistically significant differences for incidence of thoracocentesis (P ＜ 0.05).Conclusion A 300 ml/d volume threshold for chest tube removoal after VATS lobectomy is feasible and safe,and it can bring more advantages than the 150 ml/d volume threshold.On the other hand,a 450 ml/d volume threshold for chest tube removoal after VATS lobectomy may increase the risk of thoracocentesis.