Omitting Chest Tube Drainage after Subxiphoid Thoracoscopic Thymectomy

Abstract

Background This study investigated the feasibility and safety of omitting chest tube drainage after subxiphoid thoracoscopic thymectomy. Methods From July 2018 through October 2018, 20 patients underwent subxiphoid thoracoscopic thymectomy without chest tube drainage. The clinical characteristics and perioperative outcomes of these patients are presented. Results All patients (10 males, 10 females; average age: 53.25 ± 12.50 years old) completed the operation. Chest tube drainage was omitted in a total of 20 patients. The operative time was 89.45 ± 49.80 minutes. No adverse events were observed. The bed-side ultrasound examination of the pleural cavity on the day of surgery showed a thimbleful of effusion and did not require thoracentesis. A postoperative chest roentgenogram on the next morning showed full expansion without pneumothorax in all patients. None of the patients required reintervention with chest drainage through the time of discharge. Conclusion The omission of chest tube drainage may be an alternative procedure for selected patients undergoing thoracoscopic thymectomy. The omission of chest tubes in thymectomy is safe, but further investigation is required.

A chest tube after robotic thymectomy is unnecessary

“… 1 Several studies have shown the safety of omitting chest tubes after thoracoscopic lung biopsy or wedge resections, 6 , 7 , 8 and other retrospective studies have evaluated the safety and feasibility of omitting chest tubes after minimally invasive thymectomy. 9 Xu and colleagues 10 reported a retrospective case series of 20 patients who underwent thoracoscopic thymectomy without chest tube placement, in which no patients experienced postoperative complications and no patients required a postoperative drainage procedure. Li and colleagues 11 reported a comparative retrospective study of 205 patients who underwent subxiphoid thoracoscopic thymectomy, in which chest tubes were placed in 115 patients and omitted in 90 patients.…”

Is chest tube drainage necessary after subxiphoid thoracoscopic thymectomy?

“…Most surgeons believe that leaving the chest tube after surgery will enable monitoring of early postoperative complications such as pneumothorax or retained hemothorax. Xu et al reported their experience in omitting chest tube drainage after subxiphoid thoracoscopic thymectomy [17]. However, no case-control studies have been conducted on patients with MG who underwent subxiphoid thoracoscopic thymectomy without chest drainage.…”

Efficacy and safety of omitting chest drains after video-assisted thoracoscopic surgery: a systematic review and meta-analysis

“…One systematic review (18) published in 2010 including one randomized controlled trial (RCT) (19) and three observational studies (20)(21)(22), and another with meta-analysis (23) of nine observational studies (20,(24)(25)(26)(27)(28)(29)(30)(31) was published in 2018. Subsequently, additional three RCTs (32)(33)(34) and six observational studies (35)(36)(37)(38)(39)(40) were published.…”