title: Factors in the Selection and Management of Chest Tubes After Pulmonary Lobectomy: Results of a National Survey of Thoracic Surgeons.
abstract: BACKGROUND
  This study determined patterns of chest tube (CT) selection and management after open lobectomy and minimally invasive lobectomy by thoracic surgeons.
  
  
  METHODS
  Surveys were sent electronically to 5,175 thoracic surgeons, and 475 were completed. Responses, blinded so individuals could not be identified, were analyzed and compared according to surgeon characteristics (academic/private practice, years in practice, lobectomy volume, and geographic region). All indicated differences were statistically significant (p < 0.05 by χ(2) tests).
  
  
  RESULTS
  CT selection: Most surgeons prefer rigid tubes, and the size most commonly used was 28F. Most place 2 CTs after open lobectomy and 1 CT after minimally invasive lobectomy. Academic surgeons are more likely than private surgeons to use 1 tube after open lobectomy, but both prefer 1 tube after minimally invasive lobectomy. Younger surgeons and high-volume surgeons are more likely to use 1 CT than senior surgeons and low-volume surgeons after both open lobectomy and minimally invasive lobectomy. CT management: Academic and younger surgeons remove the CT sooner after open lobectomy. Younger and high-volume surgeons remove the CT with greater drainage amounts. All groups remove CTs sooner after minimally invasive lobectomy than after open lobectomy. Approximately half of surgeons get a daily chest roentgenogram. Younger and low-volume surgeons are most likely to discharge patients with Heimlich valves, although overall use was in less than 5% (49 of 475) of respondents. Most surgeons believe clinical experience rather than training or the literature determined their CT strategy.
  
  
  CONCLUSIONS
  This survey determined the difference in CT management among various groups of surgeons. Clinical experience was the most important factor in determining their CT strategy.
authors.affiliation: Division of Cardiothoracic Surgery, University of Arizona, Tucson, Arizona. Electronic address: skim@surgery.arizona.edu.
authors.forename: Samuel S
authors.initials: SS
authors.lastname: Kim
authors.affiliation: Division of Cardiothoracic Surgery, University of Arizona, Tucson, Arizona.
authors.forename: Zain
authors.initials: Z
authors.lastname: Khalpey
authors.affiliation: Division of Cardiothoracic Surgery, University of Arizona, Tucson, Arizona.
authors.forename: Sherry L
authors.initials: SL
authors.lastname: Daugherty
authors.affiliation: Information Technology, University of Arizona, Tucson, Arizona.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Torabi
authors.affiliation: Division of Cardiothoracic Surgery, University of Arizona, Tucson, Arizona.
authors.forename: Alex G
authors.initials: AG
authors.lastname: Little
mesh_terms: D001291:Attitude of Health Personnel; D015505:Chest Tubes; D003430:Cross-Sectional Studies; D020878:Device Removal; D019468:Disease Management; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D018579:Patient Selection; D011013:Pneumonectomy / Q000295:instrumentation* / Q000379:methods; D011379:Prognosis; D066231:Surgeons / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D013903:Thoracic Surgery / Q000592:standards / Q000639:trends; D020775:Thoracic Surgery, Video-Assisted / Q000295:instrumentation* / Q000379:methods; D013908:Thoracotomy / Q000295:instrumentation* / Q000379:methods; D013997:Time Factors; D016896:Treatment Outcome