Prophylactic air‐extraction strategy after thoracoscopic wedge resection

Zhang, Jiatao; Tang, Yichun; Lin, Jun‐Tao; Dong, Song; Nie, Qiang; Jiang, Ben‐Yuan; Yan, Hong‐Hong; Wen, Zheng-Wei; Wu, Yue; Yang, Xue‐Ning; Wu, Yi‐Long

doi:10.1111/1759-7714.12850

Cited by 17 publications

(45 citation statements)

References 23 publications

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“…However, the main pitfall of omitting chest tube placement was residual pneumothorax. [7][8][9] Although the incidence of postoperative pneumothorax has been reported to range from 7.6 to $20% in the literature, a relatively higher percentage of postoperative pneumothorax (40%) has been observed in previous studies. 9,10 In thymectomy, the pulmonary is intact in most cases, and the incidence of pneumothorax is rare.…”

Section: Discussionmentioning

confidence: 88%

Omitting Chest Tube Drainage after Subxiphoid Thoracoscopic Thymectomy

Guo

et al. 2019

Thorac Cardiovasc Surg

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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.

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Section: Discussionmentioning

confidence: 88%

Omitting Chest Tube Drainage after Subxiphoid Thoracoscopic Thymectomy

Guo

et al. 2019

Thorac Cardiovasc Surg

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“…The concerns associated with omitting chest tube drainage after pulmonary resection refer to the risk of pneumothorax, bleeding, and pleural effusions (4) . Risk of large pneumothorax, symptomatic bleeding, and effusions is low in patients with normal pulmonary function who underwent wedge resection (5) .…”

Section: Discussionmentioning

confidence: 99%

Tubeless Uniportal Thoracoscopic Wedge Resection with Modified Air Leak Test and Chest Tube Drainage

Liu

Yang

Sun

2020

Preprint

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Background: To investigate whether tubeless uniportal thoracoscopic wedge resection has better short-term outcomes than non-intubated approach with chest tube drainage.Methods: Data were collected retrospectively from January 2017 and December 2019. Tubeless group included 55 patients with pulmonary nodules underwent tubeless uniportal thoracoscopic wedge resection, 211 patients underwent non-intubated uniportal thoracoscopic wedge resection with chest tube drainage were included in drainage group. Perioperative outcomes between two groups were compared. Results: After 1:1 matching, 110 patients remained for analysis, baseline demographic and clinical variables were comparable between the two groups. Mean incision size was 3 cm in both group. Mean operative time was 59.3 minutes in tubeless group and 52.8 minutes in drainage group. The detectable mean lowest SpO2 and mean peak EtCO2 during operation was acceptable in both groups. Conversion to intubated ventilation or thoracotomy was not required. No patient failed the air leak test and did not undergo a tubeless procedure. Mean postoperative hospital stay was 1.5 days in tubeless group and 2.5 days in drainage group. Residual pneumothorax or subcutaneous emphysema was not frequent and mild in tubeless group. The postoperative pain VAS score was pain score was significantly lower in tubeless group in post-operative day 1 and 3. Side effects were rare and mild, including cough and hemoptysis. No reintervention or readmission occurred.Conclusions: Tubeless uniportal thoracoscopic wedge resection with modified air leak test and chest tube drainage is feasible and safe for selected patients with peripheral pulmonary nodules, it might reduce post-operation pain and lead to faster recovery.

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“…The concerns associated with omitting chest tube drainage after pulmonary resection refer to the risk of pneumothorax, bleeding, and pleural effusions [ 5 ]. Risk of large pneumothorax, symptomatic bleeding, and effusions is low in patients with normal pulmonary function who underwent wedge resection [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Tubeless uniportal thoracoscopic wedge resection with modified air leak test and chest tube drainage

2020

View full text Add to dashboard Cite

Background To investigate whether tubeless uniportal thoracoscopic wedge resection with modified air leak test and chest tube drainage has better short-term outcomes than non-intubated approach with chest tube drainage. Methods Data were collected retrospectively from January 2017 and December 2019. Tubeless group included 55 patients with pulmonary nodules underwent tubeless uniportal thoracoscopic wedge resection, 211 patients underwent non-intubated uniportal thoracoscopic wedge resection with chest tube drainage were included in drainage group. Peri-operative outcomes between two groups were compared. Results After 1:1 matching, 110 patients remained for analysis, baseline demographic and clinical variables were comparable between the two groups. Mean incision size was 3 cm in both group. Mean operative time was 59.3 min in tubeless group and 52.8 min in drainage group. The detectable mean lowest SpO2 and mean peak EtCO2 during operation was acceptable in both groups. Conversion to intubated ventilation or thoracotomy was not required. No patient failed the air leak test and did not undergo a tubeless procedure. Mean postoperative hospital stay was 1.5 days in tubeless group and 2.5 days in drainage group. Residual pneumothorax or subcutaneous emphysema was not frequent and mild in tubeless group. Side effects were rare and mild, including cough and hemoptysis. No re-intervention or readmission occurred. The postoperative VAS score was significantly lower in tubeless group. Conclusions Tubeless uniportal thoracoscopic wedge resection with modified air leak test and chest tube drainage is feasible and safe for selected patients with peripheral pulmonary nodules, it might reduce post-operation pain and lead to faster recovery.

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Prophylactic air‐extraction strategy after thoracoscopic wedge resection

Cited by 17 publications

References 23 publications

Omitting Chest Tube Drainage after Subxiphoid Thoracoscopic Thymectomy

Omitting Chest Tube Drainage after Subxiphoid Thoracoscopic Thymectomy

Tubeless Uniportal Thoracoscopic Wedge Resection with Modified Air Leak Test and Chest Tube Drainage

Tubeless uniportal thoracoscopic wedge resection with modified air leak test and chest tube drainage

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