Prophylactic Air-extraction Strategy After Thoracoscopic Wedge Resection

Overview

Journal Thorac Cancer

Specialties Oncology
Pulmonary Medicine

Date 2018 Sep 7

PMID 30187689

Citations 9

Authors

Jia-Tao Zhang

Yi-Chun Tang

Jun-Tao Lin

Song Dong

Qiang Nie

Ben-Yuan Jiang

Hong-Hong Yan

Zheng-Wei Wen

Yue Wu

Xue-Ning Yang

Yi-Long Wu

Wen-Zhao Zhong

Affiliations

Soon will be listed here.

Abstract

Background: Since the conception of enhanced recovery after surgery protocols, tubeless strategies have become popular. Herein, we introduce a previously unreported alternative air-extraction strategy for patients who have undergone thoracoscopic wedge resection and explore its feasibility and safety.

Methods: Between January 2015 and June 2017, 264 consecutive patients underwent thoracoscopic wedge resection with different drainage strategies. Patients were divided according to the postoperative drainage strategies used: routine chest tube drainage (RT group), complete omission of chest tube drainage (OT group), and prophylactic air-extraction catheter insertion procedure (PC group). Using the propensity score matching method, clinical parameters and objective operative qualities were compared among the three groups.

Results: Optimal 1:1 matching was used to form pairs of RT (n =36) and PC (n =36) groups and balance baseline characteristics among the three groups. The incidence rates of pneumothorax were 5.6% (2/36), 9.8% (5/51), and 19.4% (7/36) in the RT, OT, and PC groups, respectively (P = 0.07). Chest tube reinsertion incidence for postoperative pneumothorax was 19.4% (1/7) in the PC group and 60% (3/5) in the OT group. Other postoperative complications were comparable among these groups.

Conclusions: The prophylactic air-extraction strategy may be an alternative procedure for selected patients. Remedial air extraction may reduce the occurrence of chest tube reinsertion for pneumothorax patients, but further investigation is required.

Citing Articles

Safety and feasibility study of uniportal video-assisted thoracoscopic pulmonary wedge resection without postoperative chest tube drainage: a retrospective propensity score-matched study.

Yang Q, Lv S, Li Q, Lan L, Sun X, Feng X Interdiscip Cardiovasc Thorac Surg. 2023; 37(6).

PMID: 38092062 PMC: 10936903. DOI: 10.1093/icvts/ivad196.

Editorial: Early chest drain removal following lung resection.

Scarci M, Gkikas A, Patrini D, Minervini F, Cerfolio R Front Surg. 2023; 10:1185334.

PMID: 37066007 PMC: 10102361. DOI: 10.3389/fsurg.2023.1185334.

Chest tube-free video-assisted thoracoscopic surgery secured by quantitative air leak monitoring: a case series.

Li Q, Jiang Y, Ding J, Li H, Zhang W, Chen H J Thorac Dis. 2023; 15(1):146-154.

PMID: 36794133 PMC: 9922591. DOI: 10.21037/jtd-22-1749.

A novel drainage strategy using chest tube plus pleural catheter in uniportal upper lobectomy: A randomized controlled trial.

Yang F, Wang X, Xu H, Aramini B, Zhu Y, Jiang G Thorac Cancer. 2022; 14(4):399-406.

PMID: 36562112 PMC: 9891854. DOI: 10.1111/1759-7714.14759.

Comparison of perioperative outcomes with or without routine chest tube drainage after video-assisted thoracoscopic pulmonary resection: A systematic review and meta-analysis.

Li R, Qiu J, Qu C, Ma Z, Wang K, Zhang Y Front Oncol. 2022; 12:915020.

PMID: 36003771 PMC: 9393739. DOI: 10.3389/fonc.2022.915020.

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