title: Feasibility and safety of postoperative management without chest tube placement after thoracoscopic wedge resection of the lung.
abstract: OBJECTIVE
  The aim of the present study was to assess the feasibility and safety of several improved criteria to avoid chest tube placement after thoracoscopic wedge resection of the lung.
  
  
  METHODS
  From 2000 to 2009, 333 patients who underwent thoracoscopic wedge resections of the lung were reviewed. The patients were classified into two groups: (1) the no chest tube group (NCT), consisting of 132 patients in whom chest tubes were not placed because no air leakage or bleeding during intraoperative alternative sealing test was confirmed, and (2) the chest tube placement (CTP) group, consisting of 201 patients in whom chest tubes were placed because the criteria for the nonplacement of a chest tube were not met. The clinical data and postoperative morbidity were assessed between the two groups.
  
  
  RESULTS
  The number of specimens (1.3 vs 1.5) and the endostapler cartridges used (2.5 vs 3.3), and the duration of the postoperative hospital stay (4.6 vs 6.7 days) in the NCT group were significantly lower than in the CTP group. One patient from the NCT group required chest tube insertion due to the development of late pneumothorax. However, no significant differences were found between the two groups.
  
  
  CONCLUSIONS
  Our improved criteria are therefore considered to positively contribute to a safe and definite clinical decision regarding postoperative patient management.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Sapporo Medical University School of Medicine, South 1 West 16, Chuo-ku, Sapporo, 060-8543, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Nakashima
authors.forename: Atsushi
authors.initials: A
authors.lastname: Watanabe
authors.forename: Taijirou
authors.initials: T
authors.lastname: Mishina
authors.forename: Takuro
authors.initials: T
authors.lastname: Obama
authors.forename: Tohru
authors.initials: T
authors.lastname: Mawatari
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Higami
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015505:Chest Tubes / Q000009:adverse effects*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000295:instrumentation / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control; D011184:Postoperative Period; D012189:Retrospective Studies; D017792:Surgical Stapling; D020775:Thoracic Surgery, Video-Assisted; D013907:Thoracostomy / Q000009:adverse effects* / Q000295:instrumentation*; D016896:Treatment Outcome; D055815:Young Adult