title: Variation of the postoperative fluid drainage according to the type of lobectomy.
abstract: OBJECTIVE
  The pleural membrane of the lower pleural cavity has a greater ability to recycle fluid than the pleural membrane of the upper pleural cavity. During lobectomy, the visceral pleura is removed with the lobe, whereas the parietal pleura is traumatized during manipulation. This study investigates variations of the drainage according to the type of lobectomy and its relation to effusion-related complications.
  
  
  METHODS
  Data of upper and lower lobectomy patients were compared with those of wedge resection patients. All patients were suctioned until totally dry before closure, and one chest tube was left in the hemithorax. The amount of fluid drained per day, the duration of drainage, the length of hospital stay and the morbidity were noted. Student's paired t-test and Mann-Whitney U-test were used for comparison; P < 0.05 was defined as statistically significant.
  
  
  RESULTS
  Patients after lower lobectomy had more fluid drained when compared with patients after upper lobectomy or wedge resection on the first (636 ± 90, 268 ± 75 and 225 ± 62 ml, respectively; P = 0.002) and second postoperative day (464 ± 94, 237 ± 90 and 220 ± 62 ml, respectively; P = 0.046). The drainage tube was removed earlier in patients with upper lobectomy procedures than in patients with lower lobectomy procedures (4.6 ± 0.9 vs 8.1 ± 1.4 days; P = 0.014). Effusion-related complications developed in lower lobectomies with a higher output from the second postoperative day.
  
  
  CONCLUSIONS
  A larger amount of fluid is drained after removal of the lower lobes, possibly because the important fluid-recycling ability of the lower parts of the cavity is malfunctioning. Early drainage tube removal after lower lobectomy may be reconsidered when taking into account the possibility of effusion-related complications.
authors.affiliation: Department of Thoracic and Vascular Surgery, Evangelismos Hospital, Athens, Greece. kouritas@otenet.gr
authors.forename: Vasileios K
authors.initials: VK
authors.lastname: Kouritas
authors.forename: Charalambos
authors.initials: C
authors.lastname: Zissis
authors.forename: Ion
authors.initials: I
authors.lastname: Bellenis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015505:Chest Tubes; D004322:Drainage / Q000009:adverse effects / Q000295:instrumentation; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000209:etiology / Q000628:therapy*; D011013:Pneumonectomy / Q000009:adverse effects / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome