title: Risk factors influencing the pleural drainage volume after transthoracic oesophagectomy.
abstract: OBJECTIVE
  The objective of this study was to clarify the factors influencing pleural drainage volume after transthoracic oesophagectomy and to determine criteria for the selection of patients who would benefit from the early removal of chest drains.
  
  
  METHODS
  Clinicopathological characteristics of 155 patients who underwent transthoracic oesophagectomy were prospectively collected, and the daily drainage volume of each patient was retrospectively reviewed. Potential risk factors were compared between the high-output group (n = 39) and low-output group (n = 116), which were dichotomized using the 75th percentile of total pleural drainage volume of the total study population. Multivariate logistic regression analyses were used to identify independent risk factors.
  
  
  RESULTS
  The median duration of drainage was 10 days, with a median total drainage volume of 2258 ml. Of 27 potential risk factors influencing the drainage volume, creatinine clearance (P = 0.04), operative approach (P = 0.03) and thoracic duct removal (P = 0.01) were significantly associated with the total pleural drainage volume. The removal of the thoracic duct (P = 0.02; odds ratio, 4.02; 95% confidence interval 1.20-13.41) and lower creatinine clearance (P = 0.04; odds ratio, 1.02; 95% confidence interval 1.00-1.04) was independent risk factors for increased pleural drainage volume after transthoracic oesophagectomy.
  
  
  CONCLUSIONS
  The early removal of chest drains may be possible in patients without these risk factors.
authors.affiliation: Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan. shin@med.niigata-u.ac.jp
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Kosugi
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Kanda
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Yajima
authors.forename: Takashi
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Kaoru
authors.initials: K
authors.lastname: Sakamoto
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D004322:Drainage / Q000379:methods; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010996:Pleural Effusion / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology / Q000473:pathology; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Oesophageal cancer; Oesophageal surgery; Pleural effusion; Postoperative care