Postoperative Drainage with 16 French Urinary Catheter for Video-assisted Thoracoscopic Surgery Lobectomy: A Prospective Cohort Study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHOUHong-xia ¹ , YANGMei ¹ , LIAOHu ¹ , LAIYu-tian ¹ , JIYan-li ¹ , QIUFang ¹ , LIWei-min ² ,  CHEGuo-wei

1. Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, P.R.China;
2. Department of Respiratory Medicine of West China Hospital, Sichuan University, Chengdu 610041, P.R.China;

Corresponding?author：

CHEGuo-wei, Email: guowei_che@yahoo.com

Keywords：

16F urinary catheter; Video-assisted thoracoscopic surgery (VATS) lobectomy; Fast track rehabilitation

DOI：

10.7507/1007-4848.20160078

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Objective To explore the advantages of postoperative chest drainage with 16F urinary catheter for video- assisted thoracoscopic surgery (VATS) lobectomy. Methods Data of 102 patients (October to December 2015) who under- went VATS lobectomy of lung disease with insertion of catheter (16 F urinary catheter or 28 F chest tube) were analyzed. The patients were divided into two groups including a 16F group (49 patients, with 16 F urinary catheter) and a 18F group (53 patients, with 18F chest drainage tube).The following post-operative data were evaluated: primary healing of tube inci- sion, chest X ray abnormalities (pneumothorax, pleural effusion, subcutaneous emphysema, and hematoma), drainage time, re-insert the drainage tube, and wound healing at the site of insertion. Results Both groups were similar in age, gender, co-morbidity and pathological evaluation of resected specimens. After adjustment, no statistically significant difference was found between the two groups in pulmonary complications (30.6% vs. 28.3%, P=0.102), subcutaneous emphysema (60.0% vs. 6.7%, P=0.011), required intervention (2.0% vs. 5.7%, P=0.048). The average total drainage volume in the 16F group (587.3±323.7 ml) was less than that of the 28 F group (824.1±444.3 ml, P=0.000). The rate of primary healing at the site of insertion in the 16 F group (100.0%) was higher than that in the 28F group (58.5%, P=0.014). A significant difference was found in the drainage time and post-operative length of stay between the two groups (54.2±28.6 h vs. 95.6±65.5 h，4.2±1.4 d vs. 6.5±3.0 d). Conclusion Since 16F urinary catheter has advantage in fast track rehabilitation and low risk of pulmonary complications, the use of 16F urinary catheter is appropriate after VATS pulmonary lobectomy.

Citation： ZHOUHong-xia, YANGMei, LIAOHu, LAIYu-tian, JIYan-li, QIUFang, LIWei-min, CHEGuo-wei. Postoperative Drainage with 16 French Urinary Catheter for Video-assisted Thoracoscopic Surgery Lobectomy: A Prospective Cohort Study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(4): 334-340. doi: 10.7507/1007-4848.20160078 Copy

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2.	Kim SS, Khalpey Z, Daugherty SL, et al. Factors in the selection and management of chest tubes after pulmonary lobectomy: results of a national survey of thoracic surgeons. Ann Thorac Surg, 2016, 101(3): 1082-1088.
3.	Shi H, Mei L, Che G. The current concepts of closed chest drainage in lobectomy of lung cancer. Zhongguo Fei Ai Za Zhi, 2010,13(11): 999-1003.
4.	Rahman NM, Pepperell J, Rehal S, et al. Effect of opioids vs nsaids and larger vs smaller chest tube size on pain control and pleurodesis efficacy among patients with malignant pleural effusion: the time randomized clinical trial. JAMA, 2015, 314(24): 2641-2653.
5.	Kamiyoshihara M, Nagashima T, Ibe T, et al. A proposal for management after lung resection, using a flexible silastic drain. Asian Cardiovasc Thorac Ann, 2010, 18(5): 435-442.
6.	Utter GH. The rate of pleural fluid drainage as a criterion for the timing of chest tuberemoval: theoretical and practical considerations. Ann Thorac Surg, 2013, 96(6): 2262-2267.
7.	Liu L, Che G, Pu Q,et al. A new concept of endoscopic lung cancer resection: Single-direction thoracoscopic lobectomy. Surg Oncol, 2010, 19(2): e71-e77.
8.	Zhi XY, Yu JM, Shi YK. Chinese guidelines on the diagnosis and treatment of primary lung cancer (2015 version). Cancer, 2015, 121(Suppl 17): 3165-3181.
9.	韓兆杰, 宋志芳, 蘇建華, 等.單胸腔引流管在肺癌術后快速康復中的應用. 中國胸心血管外科臨床雜志, 2014, 21(1): 17-20.
10.	楊梅,樊駿,周紅霞,等. 胸腔鏡肺癌肺葉切除術后16F較28F胸腔引流管應用的臨床優勢. 中國肺癌雜志, 2015, 18(8): 512-517.
11.	鮑珊, 蘇建華, 廖虎, 等. 合并慢性阻塞性肺病和手術方式對肺癌患者術后快速康復及治療費用的影響. 中國胸心血管外科臨床雜志, 2014, 21(1): 7-20.
12.	沈春輝, 梅龍勇, 喻鵬銘, 等. 術前肺康復對肺癌合并中-重度慢性阻塞性肺疾病患者運動耐力影響. 中國胸心血管外科臨床雜志, 2011, 18(6): 514-517.
13.	邱舫, 楊梅, 王維, 等. 肺葉切除術后患者無尿管留置的前瞻性隊列研究. 中國胸心血管外科臨床雜志, 2015, 22(7): 634-637.
14.	宋志芳, 韓兆杰, 林琳, 等. SF-36 量表評價胸外科住院患者生活質量的信度和效度. 中國胸心血管外科臨床雜志, 2014, 21(2): 164-167.
15.	杜恒, 廖虎, 宋志芳, 等. 胸腔鏡手術在中國地市級醫院胸外科應用現狀的問卷調查. 中國胸心血管外科臨床雜志, 2013, 20(3): 347-351.
16.	周渝斌, 劉倫旭, 喻鵬銘, 等. 胸腔鏡肺葉切除術后心肺功能的快速康復. 中國胸心血管外科臨床雜志, 2013, 20(2): 168-171.
17.	車國衛, 梅龍勇, 梅建東, 等. 單操作孔電視胸腔鏡手術治療肺部疾病158例臨床分析. 中國胸心血管外科臨床雜志, 2012, 19( 2): 116-119.
18.	Tanaka M, Sagawa M, Usuda K,et al.Postoperative drainage with one chest tube is appropriate for pulmonary lobectomy: a randomized trial. Tohoku J Exp Med, 2014, 232(1): 55-61.
19.	Zardo P, Busk H, Kutschka I. Chest tube management: state of the art. Curr Opin Anaesthesiol, 2015, 28(1): 45-49.
20.	Bjerregaard LS, Jensen K, Petersen RH, et al. Early chest tube removal after video-assisted thoracic surgery lobectomy with serous fluid production up to 500 ml/day. Eur J Cardiothorac Surg, 2014, 45(2): 241-246.
21.	Nadlonek NA, Acker SN, Deterding RR, et al. Intraoperative chest tube removal following thoracoscopic lung biopsy results in improved outcomes. J Pediatr Surg, 2014, 49(11): 1573-1576.
22.	Lijkendijk M, Licht PB, Neckelmann K, et al. Electronic versus traditional chest tube drainage following lobectomy: a randomized trial. Eur J Cardiothorac Surg, 2015, 48(6): 893-898.
23.	Dumans-Nizard V, Guezennec J, Parquin F, et al. Feasibility and results of a fast-track protocol in thoracic surgery. Minerva Anestesiol, 2016, 82(1): 15-21.
24.	McGuire AL, Gilbert S. Calculation of individual expected pleural drainage from total body lymph flow: a guide for fast-tracking removal of chest drains. Eur J Cardiothorac Surg, 2015, 47(1): 199.
25.	Cerfolio RJ, Bryant AS, Skylizard L, et al. Optimal technique for the removal of chest tubes after pulmonary resection. J Thorac Cardiovasc Surg, 2013, 145(6): 1535-1539.
26.	Martin K, Emil S, Zavalkoff S, et al. Transitioning from stiff chest tubes to soft pleural catheters: prospective assessment of a practice change. Eur J Pediatr Surg, 2013, 23(5): 389-393.

1. Shah RD, D’Amico TA. Modern impact of video assisted thoracic surgery. J Thorac Dis, 2014, 6(Suppl 6): S631-S636.
2. Kim SS, Khalpey Z, Daugherty SL, et al. Factors in the selection and management of chest tubes after pulmonary lobectomy: results of a national survey of thoracic surgeons. Ann Thorac Surg, 2016, 101(3): 1082-1088.
3. Shi H, Mei L, Che G. The current concepts of closed chest drainage in lobectomy of lung cancer. Zhongguo Fei Ai Za Zhi, 2010,13(11): 999-1003.
4. Rahman NM, Pepperell J, Rehal S, et al. Effect of opioids vs nsaids and larger vs smaller chest tube size on pain control and pleurodesis efficacy among patients with malignant pleural effusion: the time randomized clinical trial. JAMA, 2015, 314(24): 2641-2653.
5. Kamiyoshihara M, Nagashima T, Ibe T, et al. A proposal for management after lung resection, using a flexible silastic drain. Asian Cardiovasc Thorac Ann, 2010, 18(5): 435-442.
6. Utter GH. The rate of pleural fluid drainage as a criterion for the timing of chest tuberemoval: theoretical and practical considerations. Ann Thorac Surg, 2013, 96(6): 2262-2267.
7. Liu L, Che G, Pu Q,et al. A new concept of endoscopic lung cancer resection: Single-direction thoracoscopic lobectomy. Surg Oncol, 2010, 19(2): e71-e77.
8. Zhi XY, Yu JM, Shi YK. Chinese guidelines on the diagnosis and treatment of primary lung cancer (2015 version). Cancer, 2015, 121(Suppl 17): 3165-3181.
9. 韓兆杰, 宋志芳, 蘇建華, 等.單胸腔引流管在肺癌術后快速康復中的應用. 中國胸心血管外科臨床雜志, 2014, 21(1): 17-20.
10. 楊梅,樊駿,周紅霞,等. 胸腔鏡肺癌肺葉切除術后16F較28F胸腔引流管應用的臨床優勢. 中國肺癌雜志, 2015, 18(8): 512-517.
11. 鮑珊, 蘇建華, 廖虎, 等. 合并慢性阻塞性肺病和手術方式對肺癌患者術后快速康復及治療費用的影響. 中國胸心血管外科臨床雜志, 2014, 21(1): 7-20.
12. 沈春輝, 梅龍勇, 喻鵬銘, 等. 術前肺康復對肺癌合并中-重度慢性阻塞性肺疾病患者運動耐力影響. 中國胸心血管外科臨床雜志, 2011, 18(6): 514-517.
13. 邱舫, 楊梅, 王維, 等. 肺葉切除術后患者無尿管留置的前瞻性隊列研究. 中國胸心血管外科臨床雜志, 2015, 22(7): 634-637.
14. 宋志芳, 韓兆杰, 林琳, 等. SF-36 量表評價胸外科住院患者生活質量的信度和效度. 中國胸心血管外科臨床雜志, 2014, 21(2): 164-167.
15. 杜恒, 廖虎, 宋志芳, 等. 胸腔鏡手術在中國地市級醫院胸外科應用現狀的問卷調查. 中國胸心血管外科臨床雜志, 2013, 20(3): 347-351.
16. 周渝斌, 劉倫旭, 喻鵬銘, 等. 胸腔鏡肺葉切除術后心肺功能的快速康復. 中國胸心血管外科臨床雜志, 2013, 20(2): 168-171.
17. 車國衛, 梅龍勇, 梅建東, 等. 單操作孔電視胸腔鏡手術治療肺部疾病158例臨床分析. 中國胸心血管外科臨床雜志, 2012, 19( 2): 116-119.
18. Tanaka M, Sagawa M, Usuda K,et al.Postoperative drainage with one chest tube is appropriate for pulmonary lobectomy: a randomized trial. Tohoku J Exp Med, 2014, 232(1): 55-61.
19. Zardo P, Busk H, Kutschka I. Chest tube management: state of the art. Curr Opin Anaesthesiol, 2015, 28(1): 45-49.
20. Bjerregaard LS, Jensen K, Petersen RH, et al. Early chest tube removal after video-assisted thoracic surgery lobectomy with serous fluid production up to 500 ml/day. Eur J Cardiothorac Surg, 2014, 45(2): 241-246.
21. Nadlonek NA, Acker SN, Deterding RR, et al. Intraoperative chest tube removal following thoracoscopic lung biopsy results in improved outcomes. J Pediatr Surg, 2014, 49(11): 1573-1576.
22. Lijkendijk M, Licht PB, Neckelmann K, et al. Electronic versus traditional chest tube drainage following lobectomy: a randomized trial. Eur J Cardiothorac Surg, 2015, 48(6): 893-898.
23. Dumans-Nizard V, Guezennec J, Parquin F, et al. Feasibility and results of a fast-track protocol in thoracic surgery. Minerva Anestesiol, 2016, 82(1): 15-21.
24. McGuire AL, Gilbert S. Calculation of individual expected pleural drainage from total body lymph flow: a guide for fast-tracking removal of chest drains. Eur J Cardiothorac Surg, 2015, 47(1): 199.
25. Cerfolio RJ, Bryant AS, Skylizard L, et al. Optimal technique for the removal of chest tubes after pulmonary resection. J Thorac Cardiovasc Surg, 2013, 145(6): 1535-1539.
26. Martin K, Emil S, Zavalkoff S, et al. Transitioning from stiff chest tubes to soft pleural catheters: prospective assessment of a practice change. Eur J Pediatr Surg, 2013, 23(5): 389-393.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Postoperative Drainage with 16 French Urinary Catheter for Video-assisted Thoracoscopic Surgery Lobectomy: A Prospective Cohort Study

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