Objective To analyze the effect of different drainage modes on the postoperative thoracic drainage after video-assisted thoracoscopic surgery for radical resection of lower lung carcinoma.Methods A total of 183 patients with non-small cell lung cancer who received biportal thoracoscopic anatomical lower lobectomy combined with mediastinal lymph node dissection in the First Affiliated Hospital of Xi'an Jiaotong University from August 2017 to August 2019 were enrolled, including 113 males and 70 females, aged 31-77 (56.5±6.4) years. The patients were randomly divided into three groups, including an anterior axillary line group, a mid-axillary line group and a modified anterior axillary line group. Clinical efficacy of the three groups was compared.Results No significant difference among these three groups in terms of gender, age, surgical site, pathological type, pathological staging, postoperative chest wall subcutaneous emphysema, postoperative pain score, and postoperative hospital stay was found (P>0.05). There were significant differences among the patients in terms of postoperative pleural effusion, re-insertion of chest tube or aspiration, total liquid quantity of thoracic drainage, drainage time and chest wall incision stitches time (P<0.05). The anterior axillary line group had higher risk of postoperative pleural effusion than the other groups (P<0.05). The occurrence of postoperative pleural effusion and rate of reposition of chest tube or aspiration were significantly reduced in the modified anterior axillary line group (P<0.05).Conclusion Chest drainage tube with large diameter (24F) in the 5th intercostal space of the anterior axillary line combined with another micro-tube (8.5F) in the 7th or 8th intercostal space of the inferior scapular angle line can shorten drainage time to reduce postoperative pain, reduce the occurrence of postoperative pleural effusion, and shorten the time of surgical incision stitches.
Citation：
LI Haijun, WU Qifei, ZHANG Guangjian, FU Junke. Effect of different drainage modes on postoperative thoracic drainage after video-assisted thoracoscopic surgery for radical resection of lower lung carcinoma. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(12): 1441-1445. doi: 10.7507/1007-4848.202002003
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Gonzalez D, Paradela M, Garcia J, et al. Single-port video-assisted thoracoscopic lobectomy. Interact Cardiovasc Thorac Surg, 2011, 12(3): 514-515.
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Bourdages-Pageau E, Vieira A, Lacasse Y, et al. Outcomes of uniportal vs. multiportal video-assisted thoracoscopic lobectomy. Semin Thorac Cardiovasc Surg, 2020, 32(1): 145-151.
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Zhou D, Deng XF, Liu QX, et al. Single chest tube drainage is superior to double chest tube drainage after lobectomy: a meta-analysis. J Cardiothorac Surg, 2016, 11(1): 88.
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Nakanishi R, Fujino Y, Kato M, et al. Early chest tube removal after thoracoscopic lobectomy with the aid of an additional thin tube: a prospective multi-institutional study. Gen Thorac Cardiovasc Surg, 2018, 66(12): 723-730.
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马丹, 杨梅, 樊骏, 等. 胸腔镜肺叶切除术后引流管管径对患者舒适度影响的前瞻性队列研究. 中国胸心血管外科临床杂志, 2015, 22(10): 928-931.
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潘良彬, 冯宇, 陈科, 等. 胸腔镜肺癌根治术引流管位置对引流效果的影响. 江苏医药, 2019, 45(3): 233-235.
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Gao S, Zhang Z, Aragón J, et al. The Society for Translational Medicine: clinical practice guidelines for the postoperative management of chest tube for patients undergoing lobectomy. J Thorac Dis, 2017, 9(9): 3255-3264.
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王新连, 俞峥, 顾家榕, 等. 超细胸腔引流管在电视胸腔镜肺叶切除术中的应用效果分析. 实用临床医药杂志, 2018, 22(11): 106-108.
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焦嘉, 杜铭. 中心静脉导管在单孔胸腔镜肺叶切除术后快速康复中应用的随机对照研究. 中国胸心血管外科临床杂志, 2019, 26(4): 358-363.
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Yang Z, Hu T, Shen H, et al. Application of small-bore pigtail catheter to improve pleural drainage after single-incision thoracoscopic lobectomy for lung cancer. ANZ J Surg, 2020, 90(1-2): 139-143.
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王磊, 洪志鹏. 胸腔引流管结合微管在电视胸腔镜单肺叶切除术后快速康复的临床应用. 中华肺部疾病杂志 (电子版), 2018, 11(1): 63-66.
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- 1. Gonzalez D, Paradela M, Garcia J, et al. Single-port video-assisted thoracoscopic lobectomy. Interact Cardiovasc Thorac Surg, 2011, 12(3): 514-515.
- 2. Bourdages-Pageau E, Vieira A, Lacasse Y, et al. Outcomes of uniportal vs. multiportal video-assisted thoracoscopic lobectomy. Semin Thorac Cardiovasc Surg, 2020, 32(1): 145-151.
- 3. Zhou D, Deng XF, Liu QX, et al. Single chest tube drainage is superior to double chest tube drainage after lobectomy: a meta-analysis. J Cardiothorac Surg, 2016, 11(1): 88.
- 4. Nakanishi R, Fujino Y, Kato M, et al. Early chest tube removal after thoracoscopic lobectomy with the aid of an additional thin tube: a prospective multi-institutional study. Gen Thorac Cardiovasc Surg, 2018, 66(12): 723-730.
- 5. 马丹, 杨梅, 樊骏, 等. 胸腔镜肺叶切除术后引流管管径对患者舒适度影响的前瞻性队列研究. 中国胸心血管外科临床杂志, 2015, 22(10): 928-931.
- 6. 孙燕, 顾安萍, 主编. 癌症三阶段止痛指导原则. 第2版. 北京: 北京医科大学出版社, 2002.15-17.
- 7. 潘良彬, 冯宇, 陈科, 等. 胸腔镜肺癌根治术引流管位置对引流效果的影响. 江苏医药, 2019, 45(3): 233-235.
- 8. Gao S, Zhang Z, Aragón J, et al. The Society for Translational Medicine: clinical practice guidelines for the postoperative management of chest tube for patients undergoing lobectomy. J Thorac Dis, 2017, 9(9): 3255-3264.
- 9. 王新连, 俞峥, 顾家榕, 等. 超细胸腔引流管在电视胸腔镜肺叶切除术中的应用效果分析. 实用临床医药杂志, 2018, 22(11): 106-108.
- 10. 焦嘉, 杜铭. 中心静脉导管在单孔胸腔镜肺叶切除术后快速康复中应用的随机对照研究. 中国胸心血管外科临床杂志, 2019, 26(4): 358-363.
- 11. Yang Z, Hu T, Shen H, et al. Application of small-bore pigtail catheter to improve pleural drainage after single-incision thoracoscopic lobectomy for lung cancer. ANZ J Surg, 2020, 90(1-2): 139-143.
- 12. 王磊, 洪志鹏. 胸腔引流管结合微管在电视胸腔镜单肺叶切除术后快速康复的临床应用. 中华肺部疾病杂志 (电子版), 2018, 11(1): 63-66.
