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J Thorac Cardiovasc Surg 2009;137:1394-1399
© 2009 The American Association for Thoracic Surgery

General Thoracic Surgery

A prospective study of the association between drainage volume within 24 hours after thoracoscopic lobectomy and postoperative morbidity

Ryoichi Nakanishi, MD, PhDa,*, Yoshihisa Fujino, MD, MPH, PhDb, Toshihiro Yamashita, MDa, Soichi Oka, MDa

a Department of Thoracic Surgery, Shin-Kokura Hospital, Federation of National Public Service Personnel Mutual Aid Associations, Kitakyusyu, Japan
b Department of Preventive Medicine and Community Health, University of Occupational and Environmental Health, Kitakyusyu, Japan

Received for publication August 1, 2008; revisions received September 17, 2008; accepted for publication October 26, 2008.

* Address for reprints: Ryoichi Nakanishi, MD, PhD, Chief, Department of Thoracic Surgery, Shin-Kokura Hospital, Federation of National Public Service Personnel Mutual Aid Associations, 1-3-1 Kanada, Kokurakita-ku, Kitakyusyu 803-8505, Japan. (Email: ryoichi{at}med.uoeh-u.ac.jp).

Objectives: We prospectively analyzed the association between drainage volume and development of complications to clarify the safety of early removal of chest tube after thoracoscopic lobectomy.

Methods: Between November 2001 and October 2007, 136 patients with suspected or histologically documented lung cancer were enrolled. Patients with no air leak and increased drainage underwent removal of the chest tube on the day after thoracoscopic lobectomy independent of the drainage volume. Patients were classified into three groups as tertiles according to the drainage volume. Demographic and perioperative variables were compared among the three groups. Age–sex adjusted odds ratios of the clinical variables associated with development of complications were estimated. In addition, the odds ratios of the drainage volume for development of complications were estimated after adjusting for potentially important factors.

Results: One hundred patients underwent early removal of the chest tube. Almost all demographic and perioperative variables showed no differences among the three groups (0–289 mL, n = 33; 290–399 mL, n = 33; and ≥400 mL, n = 34). Tumors in a lower lobe, preoperative stage II or higher, 5 or more anatomic segments resected, and advanced disease were all factors that were associated with higher odds ratios for complications. The drainage volume was not associated with an increased morbidity, even after adjusting for these factors.

Conclusions: Early removal of chest tube on the day after thoracoscopic lobectomy, independently of the drainage volume, appears to be safe in well-selected patients.

Abbreviation and Acronym VATS = video-assisted thoracic surgery






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