Thorac Cardiovasc Surg 2020; 68(05): 446-449
DOI: 10.1055/s-0039-1693027
Original Thoracic
Georg Thieme Verlag KG Stuttgart · New York

Omitting Chest Tube Drainage after Subxiphoid Thoracoscopic Thymectomy

Hao Xu
1   Department of Thoracic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, People's Republic of China
,
Congying Guo
1   Department of Thoracic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, People's Republic of China
,
Yi Li
1   Department of Thoracic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, People's Republic of China
,
Lei Yang
1   Department of Thoracic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, People's Republic of China
,
Linyou Zhang
1   Department of Thoracic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, People's Republic of China
› Author Affiliations
Further Information

Publication History

17 December 2018

29 May 2019

Publication Date:
22 July 2019 (online)

Abstract

Background This study investigated the feasibility and safety of omitting chest tube drainage after subxiphoid thoracoscopic thymectomy.

Methods From July 2018 through October 2018, 20 patients underwent subxiphoid thoracoscopic thymectomy without chest tube drainage. The clinical characteristics and perioperative outcomes of these patients are presented.

Results All patients (10 males, 10 females; average age: 53.25 ± 12.50 years old) completed the operation. Chest tube drainage was omitted in a total of 20 patients. The operative time was 89.45 ± 49.80 minutes. No adverse events were observed. The bed-side ultrasound examination of the pleural cavity on the day of surgery showed a thimbleful of effusion and did not require thoracentesis. A postoperative chest roentgenogram on the next morning showed full expansion without pneumothorax in all patients. None of the patients required reintervention with chest drainage through the time of discharge.

Conclusion The omission of chest tube drainage may be an alternative procedure for selected patients undergoing thoracoscopic thymectomy. The omission of chest tubes in thymectomy is safe, but further investigation is required.

 
  • References

  • 1 Ueda K, Hayashi M, Tanaka T, Hamano K. Omitting chest tube drainage after thoracoscopic major lung resection. Eur J Cardiothorac Surg 2013; 44 (02) 225-229 , discussion 229
  • 2 Refai M, Brunelli A, Salati M, Xiumè F, Pompili C, Sabbatini A. The impact of chest tube removal on pain and pulmonary function after pulmonary resection. Eur J Cardiothorac Surg 2012; 41 (04) 820-822 , discussion 823
  • 3 Holbek BL, Hansen HJ, Kehlet H, Petersen RH. Thoracoscopic pulmonary wedge resection without post-operative chest drain: an observational study. Gen Thorac Cardiovasc Surg 2016; 64 (10) 612-617
  • 4 Watanabe A, Watanabe T, Ohsawa H. , et al. Avoiding chest tube placement after video-assisted thoracoscopic wedge resection of the lung. Eur J Cardiothorac Surg 2004; 25 (05) 872-876
  • 5 Luckraz H, Rammohan KS, Phillips M. , et al. Is an intercostal chest drain necessary after video-assisted thoracoscopic (VATS) lung biopsy?. Ann Thorac Surg 2007; 84 (01) 237-239
  • 6 Aitken RC. Measurement of feelings using visual analogue scales. Proc R Soc Med 1969; 62 (10) 989-993
  • 7 Zhang JT, Tang YC, Lin JT. , et al. Prophylactic air-extraction strategy after thoracoscopic wedge resection. Thorac Cancer 2018; 9 (11) 1406-1412
  • 8 Cui F, Liu J, Li S. , et al. Tubeless video-assisted thoracoscopic surgery (VATS) under non-intubated, intravenous anesthesia with spontaneous ventilation and no placement of chest tube postoperatively. J Thorac Dis 2016; 8 (08) 2226-2232
  • 9 Liu CY, Hsu PK, Chien HC, Hsieh CC, Ting CK, Tsou MY. Tubeless single-port thoracoscopic sublobar resection: indication and safety. J Thorac Dis 2018; 10 (06) 3729-3737
  • 10 Yang SM, Wang ML, Hung MH, Hsu HH, Cheng YJ, Chen JS. Tubeless uniportal thoracoscopic wedge resection for peripheral lung nodules. Ann Thorac Surg 2017; 103 (02) 462-468
  • 11 Kehlet H, Jensen TS, Woolf CJ. Persistent postsurgical pain: risk factors and prevention. Lancet 2006; 367 (9522): 1618-1625
  • 12 Suda T, Sugimura H, Tochii D, Kihara M, Hattori Y. Single-port thymectomy through an infrasternal approach. Ann Thorac Surg 2012; 93 (01) 334-336
  • 13 Suda T. Subxiphoid uniportal video-assisted thoracoscopic surgery procedure. Thorac Surg Clin 2017; 27 (04) 381-386
  • 14 Zhong Y, Zhou Y, Jiang L. , et al. Modified transsubxiphoid thoracoscopic extended thymectomy in patients with myasthenia gravis. Thorac Cardiovasc Surg 2017; 65 (03) 250-254
  • 15 Venuta F, Diso D, Anile M, Rendina EA, Onorati I. Chest tubes: generalities. Thorac Surg Clin 2017; 27 (01) 1-5