It is Time to Replace Large Drains with Small Ones After Fixation of Rib Fractures: A Prospective Observational Study

Wu, Ching‐Shuang; Liu, Yuan-Yuarn; Tarng, Yih-Wen; Huang, Fong-Dee; Chou, Yi-Pin; Chuang, Jung-Fang

doi:10.1007/s12325-022-02182-6

Cited by 4 publications

(3 citation statements)

References 21 publications

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“…They conducted an observational study and concluded that the length of hospital stay was significantly less in patients with small chest tubes than those with large tubes. 18 We did not compare hospital stays. However, obstruction, dislodgment, and infection rates were not statistically significantly different in patients with large or small chest tubes.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Morbidity Associated with the use of Large Versus Small-Bore Chest Tubes in Patients Managed for Stage-I Empyema Thoracis

Usman,

Wyne,

Mir

et al. 2023

PAFMJ

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Objective: To compare pain and other complications with the use of large versus small-bore chest tubes in patients managed for Stage-I empyema thoracis. Study Design: Cross-sectional study. Place and Duration of Study: Combined Military Hospital, Multan Pakistan, from Jan 2015 to Jan 2022. Methodology: The study was conducted at the Trauma and Surgery Department. Files and charts of patients who were managed for Stage-I empyema thoracic in our hospital during the study period were assessed in detail. Patients were divided into two groups based on the size of the chest tube inserted to manage empyema thoracic. The presence of post-operative pain, obstruction, dislodgment and tube site infection were compared in both groups. Results: Out of 90 patients of Stage-I empyema thoracic, 43(47.8%) were inserted in small-bore chest tubes, while 47(52.2%) were inserted in large-bore chest tubes. Post-procedural pain was found significantly more in patients inserted in large chest tubes than those inserted in small bore tubes (p-value-0.018). All other complications did not differ statistically significantly in both groups. Conclusion: Most patients in both groups did not show significant complications after the chest tube insertion. Small chest tubes were better in terms of less post-procedural pain than large chest tubes, but other complications were not significantly different in both groups.Key words: Chest tube, Empyema, Pain, Thoracis.

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Section: Discussionmentioning

confidence: 99%

Comparison of Morbidity Associated with the use of Large Versus Small-Bore Chest Tubes in Patients Managed for Stage-I Empyema Thoracis

Usman,

Wyne,

Mir

et al. 2023

PAFMJ

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“…Traditionally, a large-bore chest tube, such as a 28-Fr or 32-Fr tube, is inserted into the chest wall at the proper depth after pneumonectomy (usually 4–5 cm) and clipped and opened intermittently according to the position of the trachea and mediastinum in order to maintain the pressure balance of the thorax [ 3 , 4 ]. Recently, small-hole drainage has been increasingly considered owing to the extensive use of VATS and ERAS [ 5 , 6 ]. We have therefore modified our chest tube management protocol from traditional drainage to a protocol combining one 8.5-Fr pigtail catheter with continuous open gravity drainage, starting in May 2016.…”

Section: Introductionmentioning

confidence: 99%

Safety of one 8.5-Fr pigtail catheter for postoperative continuous open gravity drainage after uniportal video-assisted thoracoscopic surgery pneumonectomy

Kong,

Zhang,

Jia

et al. 2024

J Cardiothorac Surg

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Objectives Uniportal video-assisted thoracoscopic surgery pneumonectomy (U-VATS-P) is feasible and safe from a perioperative standpoint. How to choose the proper chest tube and drainage method is important in enhanced recovery after surgery (ERAS) protocols. In this study, we aimed to assess the safety of one 8.5-Fr (1Fr = 0.333 mm) pigtail catheter for postoperative continuous open gravity drainage after U-VATS-P. Methods We retrospectively reviewed a single surgeon’s experience with U-VATS-P for lung cancer from May 2016 to September 2022. Patients were managed with one 8.5-Fr pigtail catheter for postoperative continuous open gravity drainage after U-VATS-P. The clinical characteristics and perioperative outcomes of the patients were retrospectively analyzed. Results In total, 77 patients had one 8.5-Fr pigtail catheter placed for postoperative continuous open gravity drainage after U-VATS-P for lung cancer. The mean age was 60.9$$\pm$$7.39 (40–76) years; The mean FEV1 was 2.1$$\pm$$0.6 (l/s), and the mean FEV1% was 71.2$$\pm$$22.7. The median operative time was 191.38$$\pm$$59.32 min; the mean operative hemorrhage was 109.46$$\pm$$96.56 ml; the mean duration of postoperative chest tube drainage was 6.80$$\pm$$2.33 days; the mean drainage volumes in the first three days after operation were 186.31$$\pm$$50.97, 321.97$$\pm$$52.03, and 216.44$$\pm$$35.67 ml, respectively; and the mean postoperative hospital stay was 7.90$$\pm$$2.58 days. No patient experienced complications resulting from chest tube malfunction. Ten patients experienced minor complications. One patient with nonlife-threatening empyema and bronchopleural fistula required short rehospitalization for anti-inflammatory therapy and reintubation. Three patients with chylothorax were treated with intravenous nutrition. Four patients had atrial fibrillation that was controlled by antiarrhythmic therapy. Two patients had more thoracic hemorrhagic exudation after the operation, which was found in time and was cured effectively, so they were discharged from the hospital uneventfully after early hemostatic therapy and nutritional support. Conclusions All patients in this study received early postoperative rehabilitation, and the rate of relevant complications was low. We therefore recommend a single 8.5-Fr pigtail catheter for postoperative continuous open gravity drainage as an effective, safe and reliable drainage method for the management of U-VATS-P.

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“…Traditionally, large-bore chest tube such as 28-Fr or 32-Fr tube is inserted into the chest wall in proper depth after pneumonectomy (usually 4-5 cm) and clipped and opened intermittently according to the position of trachea and mediastinum in order to maintain the pressure balance of the thorax [3][4]. Recently, small holes drainage has been increasingly considered owing to the extensive use of VATS and ERAS [5][6]. We have therefore modi ed our chest tube management protocol from traditional drainage to a protocol combining one 8.5-Fr pigtail catheter with continuous open gravity drainage since May 2016.…”

Section: Introductionmentioning

confidence: 99%

Safety of one 8.5-Fr pigtail catheter for postoperative continuous open gravity drainage after uniportal video-assisted thoracoscopic surgery pneumonectomy

Kong

Zhang

et al. 2023

Preprint

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OBJECTIVES Uniportal video-assisted thoracoscopic surgery pneumonectomy (U-VATS-P) is feasible and safe from a perioperative standpoint in clinical practice. How to choose proper chest tube and drainage method is an important step in enhanced recovery after surgery (ERAS) protocols. In this study, we aimed to assess the safety of one 8.5-Fr (1Fr = 0.333mm) pigtail catheter for postoperative continuous open gravity drainage after U-VATS-P. METHODS We retrospectively reviewed a single surgeon’s experience of U-VATS-P for lung cancer from May 2016 to September 2022. Patients were managed with one 8.5-Fr pigtail catheter for postoperative continuous open gravity drainage after U-VATS-P. The clinical characteristics and perioperative outcomes of the patients were retrospectively analyzed. RESULTS In total, 77 patients underwent the placement of one 8.5-Fr pigtail catheter for postoperative continuous open gravity drainage after U-VATS-P for lung cancer. The mean age was 60.9$\pm$7.39 (40–76) years old; the median operative time was 191.38$\pm$59.32min; the mean operative hemorrhage was 109.46$\pm$96.56ml; the mean duration of postoperative chest tube drainage was 6.80$\pm$2.33 days; the mean drainage volume in the first three days after operation was 186.31$\pm$50.97, 321.97$\pm$52.03, 216.44$\pm$35.67ml respectively; the mean postoperative hospital stay was 7.90$\pm$2.58 days. No patient experienced complications resulting from chest tube malfunction. Ten patients experienced minor complications. One patient with non-life-threatening empyema and bronchopleural fistula required short rehospitalization for anti-inflammatory therapy and re-intubation. Three patients with chylothorax were treated with intravenous nutrition. Four patients had atrial fibrillation that were controlled by antiarrhythmic therapy. Two patients had more thoracic hemorrhagic exudation after operation that could be found in time and were cured effectively and discharged from the hospital uneventfully after early hemostatic therapy and nutritional support. CONCLUSIONS Insertion of one 8.5-Fr pigtail catheter for postoperative continuous open gravity drainage after U-VATS-P is a safe and effective procedure in the treatment of lung cancer without a major increase in morbidity or mortality and should be popularized.

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It is Time to Replace Large Drains with Small Ones After Fixation of Rib Fractures: A Prospective Observational Study

Cited by 4 publications

References 21 publications

Comparison of Morbidity Associated with the use of Large Versus Small-Bore Chest Tubes in Patients Managed for Stage-I Empyema Thoracis

Comparison of Morbidity Associated with the use of Large Versus Small-Bore Chest Tubes in Patients Managed for Stage-I Empyema Thoracis

Safety of one 8.5-Fr pigtail catheter for postoperative continuous open gravity drainage after uniportal video-assisted thoracoscopic surgery pneumonectomy

Safety of one 8.5-Fr pigtail catheter for postoperative continuous open gravity drainage after uniportal video-assisted thoracoscopic surgery pneumonectomy

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