Comparison of the single or double chest tube applications after pulmonary lobectomies

• Published in: European journal of cardio-thoracic surgery Vol. 35; no. 1; pp. 32 - 36
• Main Authors: Okur, Erdal, Baysungur, Volkan, Tezel, Cagatay, Sevilgen, Gokcen, Ergene, Gokhan, Gokce, Mertol, Halezeroglu, Semih
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Science B.V 01.01.2009; Oxford University Press
• Subjects: Adult; Aged; Biological and medical sciences; Cardiology. Vascular system; Chest tubes; Chest Tubes - adverse effects; Drainage - adverse effects; Drainage - instrumentation; Drainage - methods; Female; Humans; Lung Diseases - surgery; Male; Medical sciences; Middle Aged; Pain measurement; Pain Measurement - methods; Pain, Postoperative - prevention & control; Pneumology; Pneumonectomy - methods; Postoperative Care - adverse effects; Postoperative Care - instrumentation; Postoperative Care - methods; Postoperative pain; Prospective Studies; Pulmonary surgical procedures; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Postoperative pain; Pulmonary surgical procedures; Pain measurement; Chest tubes; Measurement; Postoperative; Tube; Lung; Thorax; Double; Pain; Treatment; Surgery; Procedure; Circulatory system; Cardiology; Application; Lobectomy; Comparative study; Pneumology
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1016/j.ejcts.2008.09.009

Objective: Draining of the chest cavity with two chest tubes after pulmonary lobectomy is a common practice. This study aimed to investigate whether using two tubes after a pulmonary lobectomy is more effective than using a single tube. Method: This prospective randomised study included 100 consecutive patients who underwent lobectomy or bilobectomy for any pathological condition between May 2006 and November 2007. In the 50 patients in the ‘single-tube group’, only one 32 F chest tube was inserted, and in the 50 patients in the ‘double-tube group’, two 32 F chest tubes were inserted. Pre-, intra- and postoperative variables in both the groups were compared. Results: The pre- and intraoperative characteristics of the patients were similar in both groups. The mean amount of drainage from chest tubes was 600 ± 43.2 cc in the single-tube group and 896 ± 56.2 cc in the double-tube group (p ≪ 0.001). The mean values of postoperative pain assessed on the visual analogue scale (VAS) in the early (second day) period were 4.28 ± 0.21 in the single-tube group and 5.10 ± 0.23 in the double-tube group (p = 0.014). The VAS scores in the late (second week) period were 1.48 ± 0.13 in the single-tube group and 2.00 ± 0.17 in the double-tube group (p = 0.01). All other related parameters were similar in both groups. Conclusions: Insertion of two chest tubes is not more effective than the insertion of a single chest tube after pulmonary lobectomy. Moreover, using a single tube is in fact more effective than using two tubes in that it causes less postoperative pain and less pleural fluid loss.