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OBJECTIVE: To investigate the safety and feasibility of early removal of chest tubes after video-assisted thoracoscopic lobectomy for lung cancer.
METHODS: The prospective study included sixty consecutive patients who underwent VATS lobectomy plus mediastinal lymph nodes dissection for lung cancer between October 2013 and September 2014 in a single center. Thirty patients were randomized divided into early removal management group (chest tubes removal when the drainage volume is less than 300ml/d), while the other thirty patients were in the traditional management group (chest tubes removal at the drainage volume less than 100ml/d). The time of tubes removal, drainage volume, hospital stay and postoperative complications were recorded. All patients were followed up at fifteen days by telephone and thirty days by chest X-ray after operation.
RESULTS: There was no difference between two groups in terms of age, sex, smoking, FEV1, lobes of dissection, pathology and TNM stage. Patients who underwent early removal management had a shorter time of chest tubes removal and postoperative hospital stay compared to the traditional management group ((2.10±0.99) d vs. (3.83±1.41) d, t=5.485, P=0.000; (7.97±1.54) d vs. (9.20±2.01) d, t=2.669, P=0.010). No statistically significant differences were observed between the drainage volume and postoperative complications. No complication occurred when the patients were followed up thirty days after operation.
CONCLUSIONS: Early removal of the chest tubes after VATS lobectomy when the drainage volume is less than 300ml/d is safe and feasible. This leads to shorter length of hospital stays without added risk of early postoperative complications.