Feasibility and safety of postoperative management without chest tube placement after thoracoscopic wedge resection of the lung

Nakashima, Shinji; Watanabe, Atsushi; Mishina, Taijiro; Obama, Takuro; Mawatari, Tohru; Higami, Tetsuya

doi:10.1007/s00595-010-4346-5

Cited by 38 publications

(60 citation statements)

References 11 publications

(26 reference statements)

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“…However, Satherley et al 16 reported that the use of an intercostal chest drain after lung biopsy increases the period of hospitalization. In contrast, Nakashima et al 17 reported that omitting chest tube placement did not increase postoperative morbidity after thoracoscopic lung wedge resection in 76 patients. Similarly, Luckraz et al 18 performed a randomized control trial in 60 patients and found that there is no need for an intercostal chest drain in patients receiving VATS lung resection if no air leak is noted at surgery.…”

Section: Discussionmentioning

confidence: 93%

Feasibility of Transumbilical Lung Wedge Resection in a Canine Model

Lin

Chu

et al. 2013

Journal of Laparoendoscopic & Advanced Surgical Techniques

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Section: Discussionmentioning

confidence: 93%

Feasibility of Transumbilical Lung Wedge Resection in a Canine Model

Lin

Chu

et al. 2013

Journal of Laparoendoscopic & Advanced Surgical Techniques

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“…Chest drain use remains controversial, as thoracotomy incisions may damage the intercostal nerves and lead to chronic neuropathy (39). Satherley et al (40) reported that the use of an intercostal chest drain following lung biopsy increased the period of hospitalization and Nakashima et al (41) reported that postoperative morbidity did not increase following thoracoscopic lung wedge resection without a chest tube. Luckraz et al (42) demonstrated that there was no requirement for an intercostal chest drain in patients that had received VATS lung resection if no air leakage was noted during surgery.…”

Section: Discussionmentioning

confidence: 99%

Comparison of acute phase protein and hemodynamic variables in dogs undergoing video-assisted thoracoscopic vs. open pneumonectomy

Liu

Ren

Wang

et al. 2017

Experimental and Therapeutic Medicine

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Abstract. It has been demonstrated that video-assisted thoracoscopic surgery (VATS) is feasible and safe in humans and animal models. The aim of the present study was to compare the surgical outcome using VATS with that of the standard transthoracic approach for pneumonectomy in dogs, to determine the acute-phase reaction in VATS pneumonectomy, and to analyze the difference between VATS and the standard transthoracic approach. A total of 14 dogs were divided into two groups (n=7); one group underwent VATS and the other group underwent a transthoracic pneumonectomy. Pre-, intraand post-operative physiologic parameters were monitored, in addition to the blood cell count and serum acute-phase protein (APP) concentrations. The APP and hemodynamic changes between the two approaches were analyzed. Mean surgical time in the VATS group (176.7 min) was significantly longer compared with the open group (132.4 min). All APP concentrations were significantly increased at day 1 postoperation and gradually decreased to preoperative concentrations. The serum concentration of C-reactive protein on day 3 and the white blood cell count on day 1 were significantly higher following surgery in the open group compared with the VATS group (P<0.05). No differences were observed in the physiological parameters between the two groups. Although VATS took longer, animals experienced smaller incision and less stress. Therefore, the VATS approach was satisfactory for total pneumonectomy.

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“…Chest drain use is still controversial, as thoracotomy incisions could damage the intercostal nerves and lead to chronic neuropathy [20]. Satherley et al [21] reported that the use of an intercostal chest drain after lung biopsy increased the period of hospitalization, and Nakashima et al [22] reported that postoperative morbidity did not increase after thoracoscopic lung wedge resection without a chest tube. Luckraz et al [23] reported that an intercostal chest drain was not needed in patients that had received VATS lung resection if no air leakage was noted at surgery.…”

Section: Discussionmentioning

confidence: 99%

Comparison of acute phase reaction and postoperative stress in pigs undergoing video-assisted thoracoscopic versus thoracotomy pneumonectomy

et al. 2016

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BackgroundVideo-assisted thoracoscopic surgery (VATS) has been used for many thoracic diseases as an alternate approach to thoracotomy. The aim of this study was to compare the surgical outcome of pneumonectomy using VATS with that using thoracotomy pneumonectomy in pigs. Fourteen pigs were equally divided into two groups; one group underwent VATS and the other group underwent transthoracic pneumonectomy. We monitored pre-, intra-, and post-operative physiologic parameters, along with blood cell count, serum C-reactive protein (CRP), serum amyloid A (SAA), interleukin-6 (IL-6) and cortisol. The differences between the two approaches were analyzed.ResultsMean surgical time in the VATS group (160.6 ± 16.2 min) was significantly longer than that in the thoracotomy group (123.7 ± 13.2 min). In both groups, CRP and IL-6 concentrations were significantly increased at postoperative 4 h, and then gradually decreased to preoperative levels. CRP and IL-6 at postoperative day 1 were significant lower in the VATS group compared with the thoracotomy group. SAA was significantly increased at postoperative days 1 and 3 in both groups compared with preoperative levels. Cortisol was significantly increased immediately after surgery in both groups compared with preoperative levels, and was significantly higher in the thoracotomy group than the VATS group at postoperative 4 h and 1 day.ConclusionsThere was no difference between the two groups in physiologic parameters and blood cell count. However, the results indicate that VATS resulted in a smaller incision, less acute-phase reaction, less stress and less pain compared with thoracotomy pneumonectomy.

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Feasibility and safety of postoperative management without chest tube placement after thoracoscopic wedge resection of the lung

Abstract: Our improved criteria are therefore considered to positively contribute to a safe and definite clinical decision regarding postoperative patient management.

Cited by 38 publications

References 11 publications

Feasibility of Transumbilical Lung Wedge Resection in a Canine Model

Feasibility of Transumbilical Lung Wedge Resection in a Canine Model

Comparison of acute phase protein and hemodynamic variables in dogs undergoing video-assisted thoracoscopic vs. open pneumonectomy

Comparison of acute phase reaction and postoperative stress in pigs undergoing video-assisted thoracoscopic versus thoracotomy pneumonectomy

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