A novel drainage strategy using chest tube plus pleural catheter in uniportal upper lobectomy: A randomized controlled trial
Abstract Background In this study we explored whether one pleural catheter plus single chest tube drainage could achieve a noninferior drainage effect when compared with the traditional two chest tubes in uniportal video‐assisted thoracoscopic surgery (VATS) for an upper pulmonary lobectomy. Methods...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-02-01
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| Series: | Thoracic Cancer |
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| Online Access: | https://doi.org/10.1111/1759-7714.14759 |
| _version_ | 1797936834259451904 |
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| author | Fu Yang Xing Wang Honglei Xu Beatrice Aramini Yuming Zhu Gening Jiang Jiang Fan |
| author_facet | Fu Yang Xing Wang Honglei Xu Beatrice Aramini Yuming Zhu Gening Jiang Jiang Fan |
| author_sort | Fu Yang |
| collection | DOAJ |
| description | Abstract Background In this study we explored whether one pleural catheter plus single chest tube drainage could achieve a noninferior drainage effect when compared with the traditional two chest tubes in uniportal video‐assisted thoracoscopic surgery (VATS) for an upper pulmonary lobectomy. Methods Patients that underwent an upper pulmonary lobectomy from January to November 2020 were enrolled in this single‐center, randomized, open‐label, noninferiority trial. Prior to closure, patients were randomized to an intervention group who received an improved drainage strategy involving one pleural catheter with one chest tube (24 Fr), while traditional double chest tube drainage was applied for the control group. Results A total of 390 patients entered the study, although 190 were excluded for changing nonuniportal surgical approaches or opting for nonlobectomy resections. Finally, 200 patients were randomized (100 in the intervention group and 100 in the control group). The baseline demographic and clinical characteristics were comparable between the groups. The incidence of pneumothorax in the intervention and control groups was similar on postoperative Day 1 (noninferiority, 10% vs. 13%, p = 0.658). In addition, there were no significant differences in secondary outcomes such as incidence of pneumothorax by Day 30, postoperative chest tube/pleural catheter removal time, amount of drainage on Day 1, total amount of drainage after operation, or postoperative hospitalization. A significantly lower pain score was observed in the intervention group (3.33 ± 0.68 vs. 3.68 ± 0.94, p = 0.003). Conclusions The new strategy is noninferior to double chest tube drainage after an upper pulmonary lobectomy offers superior pain control, and is recommended for an upper lobectomy by uniportal VATS. |
| first_indexed | 2024-04-10T18:36:26Z |
| format | Article |
| id | doaj.art-842ac0b1fca34b54b04b8d0261ffc734 |
| institution | Directory Open Access Journal |
| issn | 1759-7706 1759-7714 |
| language | English |
| last_indexed | 2024-04-10T18:36:26Z |
| publishDate | 2023-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Thoracic Cancer |
| spelling | doaj.art-842ac0b1fca34b54b04b8d0261ffc7342023-02-02T01:18:42ZengWileyThoracic Cancer1759-77061759-77142023-02-0114439940610.1111/1759-7714.14759A novel drainage strategy using chest tube plus pleural catheter in uniportal upper lobectomy: A randomized controlled trialFu Yang0Xing Wang1Honglei Xu2Beatrice Aramini3Yuming Zhu4Gening Jiang5Jiang Fan6Department of Thoracic Surgery Shanghai Jiao Tong University First People's Hospital Shanghai ChinaDepartment of Thoracic Surgery Shanghai Jiao Tong University First People's Hospital Shanghai ChinaDepartment of Thoracic Surgery Shanghai Tongji University Affiliated Shanghai Pulmonary Hospital Shanghai ChinaDivision of Thoracic Surgery G.B. Morgagni‐L. Pierantoni Hospital, University of Bologna Forli ItalyDepartment of Thoracic Surgery Shanghai Tongji University Affiliated Shanghai Pulmonary Hospital Shanghai ChinaDepartment of Thoracic Surgery Shanghai Tongji University Affiliated Shanghai Pulmonary Hospital Shanghai ChinaDepartment of Thoracic Surgery Shanghai Jiao Tong University First People's Hospital Shanghai ChinaAbstract Background In this study we explored whether one pleural catheter plus single chest tube drainage could achieve a noninferior drainage effect when compared with the traditional two chest tubes in uniportal video‐assisted thoracoscopic surgery (VATS) for an upper pulmonary lobectomy. Methods Patients that underwent an upper pulmonary lobectomy from January to November 2020 were enrolled in this single‐center, randomized, open‐label, noninferiority trial. Prior to closure, patients were randomized to an intervention group who received an improved drainage strategy involving one pleural catheter with one chest tube (24 Fr), while traditional double chest tube drainage was applied for the control group. Results A total of 390 patients entered the study, although 190 were excluded for changing nonuniportal surgical approaches or opting for nonlobectomy resections. Finally, 200 patients were randomized (100 in the intervention group and 100 in the control group). The baseline demographic and clinical characteristics were comparable between the groups. The incidence of pneumothorax in the intervention and control groups was similar on postoperative Day 1 (noninferiority, 10% vs. 13%, p = 0.658). In addition, there were no significant differences in secondary outcomes such as incidence of pneumothorax by Day 30, postoperative chest tube/pleural catheter removal time, amount of drainage on Day 1, total amount of drainage after operation, or postoperative hospitalization. A significantly lower pain score was observed in the intervention group (3.33 ± 0.68 vs. 3.68 ± 0.94, p = 0.003). Conclusions The new strategy is noninferior to double chest tube drainage after an upper pulmonary lobectomy offers superior pain control, and is recommended for an upper lobectomy by uniportal VATS.https://doi.org/10.1111/1759-7714.14759chest tubepleural catheteruniportal video‐assisted thoracoscopic surgeryupper lobectomy |
| spellingShingle | Fu Yang Xing Wang Honglei Xu Beatrice Aramini Yuming Zhu Gening Jiang Jiang Fan A novel drainage strategy using chest tube plus pleural catheter in uniportal upper lobectomy: A randomized controlled trial Thoracic Cancer chest tube pleural catheter uniportal video‐assisted thoracoscopic surgery upper lobectomy |
| title | A novel drainage strategy using chest tube plus pleural catheter in uniportal upper lobectomy: A randomized controlled trial |
| title_full | A novel drainage strategy using chest tube plus pleural catheter in uniportal upper lobectomy: A randomized controlled trial |
| title_fullStr | A novel drainage strategy using chest tube plus pleural catheter in uniportal upper lobectomy: A randomized controlled trial |
| title_full_unstemmed | A novel drainage strategy using chest tube plus pleural catheter in uniportal upper lobectomy: A randomized controlled trial |
| title_short | A novel drainage strategy using chest tube plus pleural catheter in uniportal upper lobectomy: A randomized controlled trial |
| title_sort | novel drainage strategy using chest tube plus pleural catheter in uniportal upper lobectomy a randomized controlled trial |
| topic | chest tube pleural catheter uniportal video‐assisted thoracoscopic surgery upper lobectomy |
| url | https://doi.org/10.1111/1759-7714.14759 |
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