Dual Chest Drain Technique In Uniportal Major Lung Resections. Presentation Of Our Experience.
MICHAEL KLIMATSIDAS1, Aneel Zaheer1, Je Song Shin1, Helen Monaghan, Sr.2, Tony Vassalos, MD2.
1Golden Jubille National Hospital, Glasgow, United Kingdom, 2424 MILITARY HOSPITAL GREECE, THESSALONIKI, Greece.
OBJECTIVE: Video-Assisted Thoracic Surgery (VATS) for Major Lung Resections is the Gold standard of care in Enhanced Recovery after Surgery (ERAS). The Uniportal VATS Lung resections is a promising technique where the chest drain is inserted through the same port incision. We wanted to see is the use of 2 much smaller chest drains than usual would make a difference in terms of pain and recovery.
METHODS: We have modified the standard technique od a chest drain between 24 and 28 French through the same port incision. We have calculated that 2 smaller curved chest drains of 18 F can provide adequate air flow if needed. We have registered this study with our Audit Service and we have analysed the results of 25 consecutive cases in terms of pain, mobilisation, duration od postoperative air leak, the amount of painkillers and day of discharge.
RESULTS: We have seen that the patients with the dual chest drain (DD) experienced less pain than the single chest drain (SD). There was no difference in the use of the painkillers.There was a trend of earlier discharge but this can not be statistically attributed only to this technique as this might be the evolution of the learning curve in the surgical technique.
CONCLUSIONS: This modification showed that the use of 2 chest drains even through the same port can have numerous of benefits. The fluid drainage felt to be better, with less pain and even in the 2 cases that these chest drains were kept for more than 3 weeks there were no signs of discomfort or local inflammation that can be seen with bigger drains when they are kept that long. The fact that the diameter of the chest drain is less than the average intercostal space is definitely beneficial. More studies are needed to reach statistical significance.
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