title: Pleural drainage after transthoracic esophagectomy: experience with a vacuum system.
abstract: Conventional pleural cavity drainage after esophagectomy involves one to two large-bore drainage tubes connected to underwater bottles. The purpose of this study is to evaluate the use of a small mobile vacuum drainage system. Out of 173 patients who underwent transthoracic esophagectomy, 167 (97%) had the vacuum drain successfully placed at the end of the operation. Of those, use of the vacuum drain was uneventful for 131 until its removal (78%). Air leaks necessitating connection to underwater drainage occurred in 34 patients (20%), but in 26 of them this was only temporary. Overall success was therefore achieved in 157 patients (94%). Median in-situ placement of the vacuum drain was 4 days, and 85% of patients had their drains removed by the seventh postoperative day. The presence of lung adhesions significantly increased the need for underwater drainage. Postoperative outcomes were no different from a historical cohort with conventional underwater drainage. No drain-related complications were reported. The vacuum drain is an alternative to the conventional, large-bore, chest tube system after transthoracic esophagectomy.
authors.affiliation: Division of Esophageal Surgery, Department of Surgery, University of Hong Kong Medical Center, Queen Mary Hospital, Hong Kong.
authors.forename: Simon
authors.initials: S
authors.lastname: Law
authors.forename: Jir-Ping
authors.initials: JP
authors.lastname: Boey
authors.forename: Ka-Fai
authors.initials: KF
authors.lastname: Kwok
authors.forename: Kam-Ho
authors.initials: KH
authors.lastname: Wong
authors.forename: Kent-Man
authors.initials: KM
authors.lastname: Chu
authors.forename: John
authors.initials: J
authors.lastname: Wong
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004322:Drainage / Q000295:instrumentation* / Q000379:methods; D004867:Equipment Design; D004869:Equipment Safety; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010996:Pleural Effusion / Q000209:etiology / Q000628:therapy*; D011182:Postoperative Care; D011183:Postoperative Complications / Q000517:prevention & control; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D013908:Thoracotomy / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome