Comparison of the single or double chest tube applications after lobectomy: A systematic review and meta-analysis_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIU Xiaoqing , ZHAO Fei , DAI Jigang , ZHOU Dong ,  CHEN Wei

Department of Thoracic Surgery, The Second Hospital Affiliated to Army Medical University, Chongqing, 400037, P.R.China;

Corresponding?author：

CHEN Wei, Email: 153249204@qq.com

Keywords：

Lung cancer; lobectomy; single tube; double tube; closed thoracic drainage; systematic review and meta-analysis

DOI：

10.7507/1007-4848.201805028

Video：

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Objective To compare the efficacy of the single tube (ST) and double tube (DT) for closed thoracic drainage after lobectomy. Methods The PubMed, Medline, EMbase, Web of Science, CNKI, Wanfang Database, VIP database and CBMdisc from inception to March 30, 2018 were searched by computer to identify randomized controlled trial (RCT) about ST and DT drainage after lobectomy. Based on inclusion and exclusion criteria the literature was screened. Meta-analysis was performed using RevMan 5.3 software. Results Twelve RCTs were enrolled in this meta-analysis, including 1 442 patients. Compared with the patients using DT after lobectomy, the patients using ST had significantly less postoperative pain (MD=–0.64, 95%CI –0.71 to –0.56, P<0.000 01) and shorter duration of drainage (MD=–0.62, 95%CI –0.78 to –0.46, P<0.000 01) and hospital stay (MD=–0.55, 95%CI –0.80 to –0.29, P<0.000 1). Besides, there was no significant difference in postoperative complications (RR=1.11, 95%CI 0.83 to 1.49, P=0.49), air leaks (RD=0.03, 95%CI –0.02 to 0.08, P=0.19) and the redrainage rate (RR=0.89, 95%CI 0.51 to 1.54, P=0.67). Conclusion ST drainage after lobectomy is effective, which reduces postoperative pain and duration of hospital stay and drainage, and moreover, does not increase the postoperative complications and redrainage rate.

Citation： LIU Xiaoqing, ZHAO Fei, DAI Jigang, ZHOU Dong, CHEN Wei. Comparison of the single or double chest tube applications after lobectomy: A systematic review and meta-analysis. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2019, 26(6): 583-589. doi: 10.7507/1007-4848.201805028 Copy

1.	潘宴青, 邵豐, 孔令源, 等. 單胸管引流在非小細胞肺癌微創手術患者中的應用效果. 中國臨床研究, 2017, 30(9): 1231-1233.
2.	吉紅波. 肺葉切除術和局限性切除術對老年Ⅰ期非小細胞肺癌患者的預后影響. 實用癌癥雜志, 2018, 33(2): 268-272.
3.	曾娟琴, 周燕紅, 高露, 等. 實施集束化護理對降低胸腔閉式引流并發癥的效果觀察. 護理研究, 2017, 31(7): 861-863.
4.	Khan IH, Vaughan R. A national survey of thoracic surgical practice in the UK. Int J Clin Pract, 1999, 53(4): 252-256.
5.	丁淳, 金躍輝, 周海燕, 等. 胸腔閉式引流瓶的研究進展. 中華胸部外科電子雜志, 2017, 4(4): 266-268.
6.	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(5): 872-876.
7.	Okur E, Baysungur V, Tezel C, et al. Comparison of the single or double chest tube applications after pulmonary lobectomies. Eur J Cardiothorac Surg, 2009, 35(1): 32-35.
8.	戴維, 馮飛躍, 王大力. 肺葉切除術后單、雙胸腔引流管的臨床應用. 臨床肺科雜志, 2013, 18(2): 327-329.
9.	Alex J, Ansari J, Bahalkar P, et al. Comparison of the immediate postoperative outcome of using the conventional two drains versus a single drain after lobectomy. Ann Thorac Surg, 2003, 76(4): 1046-1049.
10.	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.
11.	Gómez-Caro A, Roca MJ, Torres J, et al. Successful use of a single chest drain postlobectomy instead of two classical drains: a randomized study. Eur J Cardiothorac Surg, 2006, 29(4): 562-566.
12.	王宇軒, 夏海峰, 黃海濤, 等. 全胸腔鏡下上肺葉切除術后放置單管引流療效分析. 浙江臨床醫學, 2016, 18(12): 2254-2255.
13.	周洪霞, 余娜. 肺葉切除術后兩種胸腔閉式引流方法的效果比較. 中華現代護理雜志, 2011, 17(32): 3881-3882.
14.	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): 7-10.
15.	白傳明, 張楠, 郭楠, 等. 肺葉切除手術側胸壁置入雙引流管效果分析. 中國誤診學雜志, 2011, 11(3): 542.
16.	Pawelczyk K, Marciniak M, Kacprzak G, et al. One or two drains after lobectomy? A comparison of both methods in the immediate postoperative period. Thorac Cardiovasc Surg, 2007, 55(5): 313-316.
17.	李星, 張璐, 仲寧. 單胸腔引流管在肺癌上葉切除術后的應用. 臨床肺科雜志, 2016, 21(12): 2172-2173.
18.	胡波, 周中新, 袁延亮, 等. 改進單根胸腔引流管引流在上葉肺癌根治術后的應用. 徐州醫學院學報, 2014, 34(12): 900-902.
19.	時輝, 梅龍勇, 車國衛. 肺癌術后胸腔閉式引流術應用的新觀念. 中國肺癌雜志, 2010, 13(11): 999-1003.

1. 潘宴青, 邵豐, 孔令源, 等. 單胸管引流在非小細胞肺癌微創手術患者中的應用效果. 中國臨床研究, 2017, 30(9): 1231-1233.
2. 吉紅波. 肺葉切除術和局限性切除術對老年Ⅰ期非小細胞肺癌患者的預后影響. 實用癌癥雜志, 2018, 33(2): 268-272.
3. 曾娟琴, 周燕紅, 高露, 等. 實施集束化護理對降低胸腔閉式引流并發癥的效果觀察. 護理研究, 2017, 31(7): 861-863.
4. Khan IH, Vaughan R. A national survey of thoracic surgical practice in the UK. Int J Clin Pract, 1999, 53(4): 252-256.
5. 丁淳, 金躍輝, 周海燕, 等. 胸腔閉式引流瓶的研究進展. 中華胸部外科電子雜志, 2017, 4(4): 266-268.
6. 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(5): 872-876.
7. Okur E, Baysungur V, Tezel C, et al. Comparison of the single or double chest tube applications after pulmonary lobectomies. Eur J Cardiothorac Surg, 2009, 35(1): 32-35.
8. 戴維, 馮飛躍, 王大力. 肺葉切除術后單、雙胸腔引流管的臨床應用. 臨床肺科雜志, 2013, 18(2): 327-329.
9. Alex J, Ansari J, Bahalkar P, et al. Comparison of the immediate postoperative outcome of using the conventional two drains versus a single drain after lobectomy. Ann Thorac Surg, 2003, 76(4): 1046-1049.
10. 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.
11. Gómez-Caro A, Roca MJ, Torres J, et al. Successful use of a single chest drain postlobectomy instead of two classical drains: a randomized study. Eur J Cardiothorac Surg, 2006, 29(4): 562-566.
12. 王宇軒, 夏海峰, 黃海濤, 等. 全胸腔鏡下上肺葉切除術后放置單管引流療效分析. 浙江臨床醫學, 2016, 18(12): 2254-2255.
13. 周洪霞, 余娜. 肺葉切除術后兩種胸腔閉式引流方法的效果比較. 中華現代護理雜志, 2011, 17(32): 3881-3882.
14. 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): 7-10.
15. 白傳明, 張楠, 郭楠, 等. 肺葉切除手術側胸壁置入雙引流管效果分析. 中國誤診學雜志, 2011, 11(3): 542.
16. Pawelczyk K, Marciniak M, Kacprzak G, et al. One or two drains after lobectomy? A comparison of both methods in the immediate postoperative period. Thorac Cardiovasc Surg, 2007, 55(5): 313-316.
17. 李星, 張璐, 仲寧. 單胸腔引流管在肺癌上葉切除術后的應用. 臨床肺科雜志, 2016, 21(12): 2172-2173.
18. 胡波, 周中新, 袁延亮, 等. 改進單根胸腔引流管引流在上葉肺癌根治術后的應用. 徐州醫學院學報, 2014, 34(12): 900-902.
19. 時輝, 梅龍勇, 車國衛. 肺癌術后胸腔閉式引流術應用的新觀念. 中國肺癌雜志, 2010, 13(11): 999-1003.

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