Tuo Xing1,2,3, Xukai Li1,2,3, Jun Liu1,2,3, Ying Huang1,2,3, Shilong Wu1,2,3, Minzhang Guo1,2,3, Hengrui Liang1,2,3, Jianxing He1,2,3. 1. Department of Thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China. 2. Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease, Guangzhou 510120, China. 3. National Clinical Research Center for Respiratory Disease, Guangzhou 510120, China.
Abstract
BACKGROUND: Currently, some studies have shown that early removal of a chest tube after video-assisted thoracoscopic surgery (VATS) lobectomy is safe and can shorten the length of hospital stay. The purpose of our study was to retrospectively analyze the association between early chest tube removal and hospital stay in patients who have undergone lobectomy. METHODS: This retrospective analysis included patients undergoing different types of lung resections including lobectomy and wedge resection. Consecutive patients who underwent VATS lobectomy or wedge resection (March 2018 to April 2019) for lung tumor were analyzed. Patients were divided into two groups according to the drainage time: those in whom the chest tube was removed within 48 hours and the traditional management group. RESULTS: All 931 patients were included. After propensity score matching (PSM). There are no statistically significant differences between the two groups. Compared with the traditional management group, the hospital stay in the early removal group was significantly shorter (5.05±2.27 vs. 7.17±3.03; P<0.001). Regarding complications, compared with the traditional management group, the rates of both lung infection and no complication in the early removal group were less (0.2% vs. 2.3%, 93.0% vs. 91.1%; P=0.005), and the necessity of re-operation was also less (0% vs. 1.2%; P<0.001). Regarding both pleural effusion and thoracentesis, a slight increase in the patient number was observed in the early removal group compared with the traditional management group (4.7% vs. 4.0%, 1.2% vs. 0.9%; P=0.005). CONCLUSIONS: Compared with the traditional management group, early removal of the chest tube after VATS lobectomy and wedge resection is safe and feasible, and could decrease morbidity and postoperative complications, importantly, resulting in a shorter hospital stay. 2020 Annals of Translational Medicine. All rights reserved.
BACKGROUND: Currently, some studies have shown that early removal of a chest tube after video-assisted thoracoscopic surgery (VATS) lobectomy is safe and can shorten the length of hospital stay. The purpose of our study was to retrospectively analyze the association between early chest tube removal and hospital stay in patients who have undergone lobectomy. METHODS: This retrospective analysis included patients undergoing different types of lung resections including lobectomy and wedge resection. Consecutive patients who underwent VATS lobectomy or wedge resection (March 2018 to April 2019) for lung tumor were analyzed. Patients were divided into two groups according to the drainage time: those in whom the chest tube was removed within 48 hours and the traditional management group. RESULTS: All 931 patients were included. After propensity score matching (PSM). There are no statistically significant differences between the two groups. Compared with the traditional management group, the hospital stay in the early removal group was significantly shorter (5.05±2.27 vs. 7.17±3.03; P<0.001). Regarding complications, compared with the traditional management group, the rates of both lung infection and no complication in the early removal group were less (0.2% vs. 2.3%, 93.0% vs. 91.1%; P=0.005), and the necessity of re-operation was also less (0% vs. 1.2%; P<0.001). Regarding both pleural effusion and thoracentesis, a slight increase in the patient number was observed in the early removal group compared with the traditional management group (4.7% vs. 4.0%, 1.2% vs. 0.9%; P=0.005). CONCLUSIONS: Compared with the traditional management group, early removal of the chest tube after VATS lobectomy and wedge resection is safe and feasible, and could decrease morbidity and postoperative complications, importantly, resulting in a shorter hospital stay. 2020 Annals of Translational Medicine. All rights reserved.
Entities:
Keywords:
Video-assisted thoracoscopic surgery (VATS); chest tube; complications; short term outcome