title: Intraoperative chest tube removal following thoracoscopic lung biopsy results in improved outcomes.
abstract: BACKGROUND
  Traditionally, chest tubes are left following video assisted thoracoscopic surgery (VATS) to treat a potential air leak or significant drainage. Recognizing the potential complications, our aim was to determine if intraoperative chest tube removal in children undergoing VATS lung biopsy is safe and if outcomes differ from when a chest tube is left in place.
  
  
  METHODS
  We identified all children who underwent VATS lung biopsies from 2009 to 2013 and performed a retrospective review of the medical records. Pulmonary resection patients were excluded as were those with an air leak present in the operating room.
  
  
  RESULTS
  A total of 90 VATS lung biopsies were performed. 41 children had a postoperative chest tube left in place (Group A), and 49 children had it removed intraoperatively (Group B). Mean age was 9 ± 6.4 years. One child in Group A and 2 children in Group B required replacement of a chest tube (p=NS). Group B patients had a lower postoperative pain score on day one, fewer postoperative chest X-rays, and a shorter length of postoperative stay.
  
  
  CONCLUSIONS
  These data suggest that intraoperative chest tube removal is safe and may be associated with improved outcomes following lung biopsy in children.
authors.affiliation: Department of Pediatric Surgery, Children's Hospital Colorado, Aurora, CO 80045, USA.
authors.forename: Nicole A
authors.initials: NA
authors.lastname: Nadlonek
authors.affiliation: Department of Pediatric Surgery, Children's Hospital Colorado, Aurora, CO 80045, USA. Electronic address: Shannon.acker@ucdenver.edu.
authors.forename: Shannon N
authors.initials: SN
authors.lastname: Acker
authors.affiliation: Deparment of Pediatric Pulmonology, Children's Hospital Colorado, Aurora, CO 80045, USA.
authors.forename: Robin R
authors.initials: RR
authors.lastname: Deterding
authors.affiliation: Department of Pediatric Surgery, Children's Hospital Colorado, Aurora, CO 80045, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Partrick
mesh_terms: D000293:Adolescent; D001706:Biopsy; D015505:Chest Tubes; D002648:Child; D002675:Child, Preschool; D020878:Device Removal; D004322:Drainage / Q000379:methods; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008168:Lung / Q000473:pathology; D008297:Male; D010149:Postoperative Pain / Q000453:epidemiology; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*
keywords: Chest tube; Lung biopsy; Pediatrics; Video-assisted thoracoscopic surgery (VATS)