Successful use of a single chest drain postlobectomy instead of two classical drains: a randomized study.
OBJECTIVE
To compare surgical results and complications in the immediate postoperative course between the use of a single drain and two-drain post-anatomical pulmonary resections.


METHODS
Between January 2004 and September 2005, 143 patients were scheduled for pulmonary lobectomy or bilobectomy for non-small cell lung cancer (NSCLC) in our department. Pneumonectomies, wedge resection, and nonresectable thoracotomies were excluded from the study. Hundred and nineteen patients were enrolled in this study. Clinical and surgical variables were collected prospectively. Lobectomy or bilobectomy and systematic mediastinal node dissection were performed in all cases. The patients were randomly assigned to receive single (group A) or two (group B) drains, independent of any preoperative or intraoperative variables. Group A consisted of 60 patients who had one single drain sited in the mid-position and group B consisted of 59 patients who had two classical drains (apical and basal). There were no surgical, oncological, or physiological differences between the groups (p=NS).


RESULTS
There were no statistically significant differences detected between the groups in relation to postsurgical morbidity or mortality and other issues studied, except in analgesia requirements (group A less than group B, p<0.05). After drain removal there were no significant differences between the groups in terms of subcutaneous emphysema, new drains needed, residual pleural effusion, or residual space (p>0.05).


CONCLUSIONS
In our study, we did not find significant differences between the use of one or two drains after lobectomy or bilobectomy in relation to early postoperative outcome. However, the use of only one drain is more economical and is less painful for patients, without any additional adverse consequences.
Thoracic Surgery Department, Hospital Universitario Virgen de Arrixaca, Autovia Murcia-Cartagena s/n, CP 30120 Murcia, Spain. abelitov@yahoo.es
Abel
A
Gómez-Caro
Maria J
MJ
Roca
Juan
J
Torres
Pedro
P
Cascales
Emilio
E
Terol
Juan
J
Castañer
Antonio
A
Piñero
Pascual
P
Parrilla
D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000601:surgery*; D004322:Drainage / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D007902:Length of Stay; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000517:prevention & control*; D011013:Pneumonectomy; D011182:Postoperative Care / Q000379:methods*