Zhang Xuefei, Lv Desheng, Li Mo, Sun Ge, Liu Changhong
Department of Thoracic Surgery, The Second Hospital of Dalian Medical University, Dalian 116023, China.
J Cancer Res Ther. 2016 Dec;12(Supplement):C309-C316. doi: 10.4103/0973-1482.200743.
Draining of the chest cavity with two chest tubes after pulmonary lobectomy is a common practice. The objective of this study was to evaluate whether using two tubes after a pulmonary lobectomy is more effective than using a single tube.
We performed a meta-analysis of five randomized studies that compared the single chest tube with double chest tube application after pulmonary lobectomy. The primary end-point was amount of drainage and duration of chest tube drainage. The secondary end-points were the patient's numbers of new drain insertion after operation, hospital stay after operation, the patient's numbers of subcutaneous emphysema after operation, the patient's numbers of residual pleural air space, pain score, the number of patients who need thoracentesis, and cost.
Five randomized controlled trials totaling 502 patients were included. Meta-analysis results are as follows: There were statistically significant differences in amount of drainage (risk ratio [RR] = -0.15; 95% confidence interval [CI] = -3.17, -0.12, P = 0. 03), duration of chest tube drainage (RR = -0.43; 95% CI = -0.57, -0.19, P = 0.02), pain score (P < 0.05). Compared with patients receiving the double chest tube group, there were no statistically significant differences between the two groups with regard to the patient's numbers of new drain insertion after operation.
Compared with the double chest tube, the single chest tube significantly decreases amount of drainage, duration of chest tube drainage, pain score, the number of patients who need thoracentesis, and cost. Although there is convincing evidence to confirm the results mentioned herein, they still need to be confirmed by large-sample, multicenter, randomized, controlled trials.
肺叶切除术后用两根胸管进行胸腔引流是一种常见做法。本研究的目的是评估肺叶切除术后使用两根胸管是否比使用一根胸管更有效。
我们对五项随机研究进行了荟萃分析，这些研究比较了肺叶切除术后单根胸管与双根胸管的应用。主要终点是引流量和胸管引流持续时间。次要终点包括患者术后新置引流管的数量、术后住院时间、患者术后皮下气肿的数量、患者残余胸膜腔积气的数量、疼痛评分、需要胸腔穿刺的患者数量以及费用。
纳入了五项随机对照试验，共502例患者。荟萃分析结果如下：引流量（风险比[RR]= -0.15；95%置信区间[CI]= -3.17，-0.12，P = 0.03）、胸管引流持续时间（RR = -0.43；95% CI = -0.57，-0.19，P = 0.02）、疼痛评分（P < 0.05）存在统计学显著差异。与接受双根胸管组的患者相比，两组在患者术后新置引流管的数量方面无统计学显著差异。
与双根胸管相比，单根胸管显著减少了引流量、胸管引流持续时间、疼痛评分、需要胸腔穿刺的患者数量以及费用。尽管有令人信服的证据证实本文所述结果，但仍需大样本、多中心、随机对照试验予以证实。
