One or Two Drains after Lobectomy? A Comparison of Both Methods in the Immediate Postoperative Period

Abstract

Background: The conventional method of double chest tube drainage after lobectomy is well established. The aim of the study was to compare the efficacy of the two-drain versus the single-drain approach after this procedure. Methods: The data of 183 consecutive patients who underwent lobectomy between January 2000 and May 2005 were analyzed: 93 had two drains and 90 had a single, midposition drain. All patients were operated on by one surgeon with the same surgical technique. Results: Patients with one drain had a shorter hospital stay (7.6 days vs. 9.0 days; p = 0.001). There were no significant differences in the amount of drainage, the necessity of redrainage or broncho-aspiration, and postoperative mortality or complications. The period in which opioids (4.8 days vs. 5.6 days; p = 0.0001) and nonsteroidal anti-inflammatory drugs (6.8 days vs. 7.7 days; p = 0.002) were required was shorter in patients with one drain. The fourth postoperative day was more painful for patients with a double drain. The cost savings in the one-drain group were approximately 125 Euros per patient. Conclusion: A single-drain method is effective, reduces hospitalization times and the cost of treatment in patients who undergo lobectomy.

Key words

lobectomy - dainage - redrainage

References

• 1 Shields T W, LoCicero 3rd J, Ponn R B. General Thoracic Surgery. Philadelphia; Lippincott, Williams, and Wilkins 2000: 433-457
• 2 Pearson F G, Deslauriers J, Ginsberg R J, Hiebert C A, McKneally M F, Urschell H C. Thoracic Surgery. New York, Edinburgh, London, Melbourne, Tokyo; Churchill Livingstone 2002: 981-990
• 3 Gomez-Caro A, Roca M J, Torres J. et al . Successful use of a single chest drain postlobectomy instead of two classical drains: a randomized study.  Eur J Cardiothorac Surg. 2006;  29 562-566
• 4 Alex J, Ansari J, Bahalkar P. et al . Comparison of the immediate postoperative outcome of using the conventional two drains versus a single drain after lobectomy.  Ann Thorac Surg. 2003;  76 1046-1049
• 5 Kim E A, Lee K S, Shim Y M. et al . Radiographic and CT findings in complications following pulmonary resection.  Radiographics. 2002;  22 67-86
• 6 Gordon P A, Norton J M, Guerra J M, Perdue S T. Positioning of chest tubes: effects on pressure and drainage.  Am J Crit Care. 1997;  6 33-38
• 7 Reilly Jr J J. Benefits of aggressive perioperative management in patients undergoing thoracotomy.  Chest. 1995;  107 312S-315S