title: Implementation and Effectiveness of Early Chest Tube Removal during an Enhanced Recovery Programme after Oesophago-gastrectomy.
abstract: BACKGROUND
  Oesophageal resection were notoriously complicated and produces a cohort of patients prone to postoperative complications and here we would like to focus on the implementation and effectiveness of early chest tube removal in ERAS after oesophago-gastrectomy considering the various aspect like pleural effusion and reducing the length of hospital stay which ultimately lead to reducing the economic burden on patient.
  
  
  METHODS
  An ERAS programme was devised and implemented with the support of a dedicated in-hospital task-force. The patients underwent esophago-gastrectomy were randomly divided into two groups: the ERAS group and the control group (non-ERAS). The ERAS group was treated with early removal of the chest tube after surgery, and the control group was treated with traditional way and outcomes were compared between them.
  
  
  RESULTS
  The length of hospital stay and the cost of hospitalization in the ERAS group were significantly lower than those in the control group（p<0.05. However, there was no statistical significant difference in the incidences of pleural effusion between the two groups（p＞0.05).
  
  
  CONCLUSIONS
  The introduction of early chest tube removal as an ERAS programme after oesophago-gastrectomy would not increase the risk of pleural effusion and would not increase the total length of stay and cost of hospitalisation without jeopardising patient safety or clinical outcomes.
authors.affiliation: Yangtze University, Jingzhou, Hubei 434000, China.
authors.forename: R
authors.initials: R
authors.lastname: Bhandari
authors.affiliation: The Clinical Medical College of Yangtze University, Jingzhou, Hubei 434000, China.
authors.forename: Y Y
authors.initials: YY
authors.lastname: Hao
mesh_terms: D060666:Airway Extubation / Q000379:methods; D016022:Case-Control Studies; D015505:Chest Tubes; D002681:China; D020878:Device Removal; D004322:Drainage; D004938:Esophageal Neoplasms / Q000601:surgery; D016629:Esophagectomy / Q000191:economics / Q000379:methods; D005260:Female; D005743:Gastrectomy / Q000191:economics / Q000379:methods; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome
keywords: chest tubes; ERAS; Oesophago-gastrectomy.