Zheng Shuo, Shi Qinlang, Ma Qinya, Fu Qiang, Qiao Kun
The Second Affiliated Hospital, Southern University of Science and Technology, Shenzhen, China.
Department of Thoracic Surgery, The Third People's Hospital of Shenzhen, Shenzhen, China.
Transl Cancer Res. 2022 Sep;11(9):3260-3266. doi: 10.21037/tcr-22-1910.
Early removal of the chest tube has advantages of reducing postoperative pain and speed recovery. This study aimed to confirm its safety and feasibility of early removal of a pigtail catheter used as a chest drain in patients undergoing anatomical surgery.
This retrospective cohort study included 126 patients who removed pigtail catheter ≤24 h after surgery, and 56 patients >24 h who underwent uniportal video-assisted thoracic surgery (u-VATS) between January 2020 and April 2022. All patients had stage I lung cancer and underwent anatomical surgery (lobectomy or segmentectomy). The clinical characteristics, perioperative data, and postoperative complications of both groups were analyzed and compared.
The >24 h group had more patients with a higher body mass index (BMI) (P<0.001), a lower forced expiratory volume in the first second (FEV1) (P<0.001), Chronic obstructive pulmonary disease (COPD) (P<0.001), and current smokers (P=0.006) than the ≤24 h group. There were no significant differences in terms of age, sex, type of resection, operation time, and bleeding loss between the two groups (P>0.05). The pain of patients in the ≤24 h group was significantly less than that in the >24 h group only on the third postoperative day (P=0.035). There were no significant differences in the postoperative visual analogue scale (VAS) at postoperative day 0, day 1, day 7, and 1 month between the two groups (P>0.05). With the exception of a higher occurrence of subcutaneous emphysema in the >24 h group (71.7% 100%, P=0.001), there were no statistically significant differences in the postoperative complications (e.g., pneumonia, atrial fibrillation, atelectasis, pleural effusion, and wound infection) between the 2 groups (P>0.05). During the 30-day follow-up period, none of the patients required tube reinsertion for pneumothorax. A total of 8 patients in the ≤24 h group and 4 in the >24 h group required tube reinsertion (6.7% 7.1%, P>0.99) due to pleural effusion.
In stage I lung cancer patients who underwent u-VATS anatomic surgery, the pigtail catheter used as a thoracic drainage tube removed with 24 h after was safe and feasible.
早期拔除胸管具有减轻术后疼痛和加速康复的优点。本研究旨在证实早期拔除用于解剖性手术患者的猪尾导管作为胸腔引流管的安全性和可行性。
这项回顾性队列研究纳入了2020年1月至2022年4月期间接受单孔电视辅助胸腔镜手术（u-VATS）且术后≤24小时拔除猪尾导管的126例患者，以及术后>24小时拔除的56例患者。所有患者均为I期肺癌并接受了解剖性手术（肺叶切除术或肺段切除术）。分析并比较了两组患者的临床特征、围手术期数据和术后并发症。
24小时组患者的体重指数（BMI）较高（P<0.001）、第一秒用力呼气量（FEV1）较低（P<0.001）、慢性阻塞性肺疾病（COPD）患病率较高（P<0.001）以及当前吸烟者比例较高（P=0.006），均高于≤24小时组。两组在年龄、性别、切除类型、手术时间和失血量方面无显著差异（P>0.05）。仅在术后第三天，≤24小时组患者的疼痛明显低于>24小时组（P=0.035）。两组在术后第0天、第1天、第7天和1个月时的术后视觉模拟评分（VAS）无显著差异（P>0.05）。除了>24小时组皮下气肿发生率较高（71.7%对100%，P=0.001）外，两组术后并发症（如肺炎、心房颤动、肺不张、胸腔积液和伤口感染）无统计学显著差异（P>0.05）。在30天随访期内，无患者因气胸需要重新置管。≤24小时组共有8例患者，>24小时组有4例患者因胸腔积液需要重新置管（6.7%对7.1%，P>0.99）。
在接受u-VATS解剖性手术的I期肺癌患者中，术后24小时内拔除作为胸腔引流管的猪尾导管是安全可行的。
