Randomized Controlled Trial of Thresholds for Drain Removal After Anatomic Lung Resection.

Gioutsos, Konstantinos; Ehrenreich, Lasse; Azenha, Luis Filipe; Quapp, Christopher Siegbert; Kocher, Gregor Jan; Lutz, Jon Andri; Peischl, Stephan; Dorn, Patrick (2024). Randomized Controlled Trial of Thresholds for Drain Removal After Anatomic Lung Resection. The annals of thoracic surgery, 117(6), pp. 1103-1109. Elsevier 10.1016/j.athoracsur.2023.09.011

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BACKGROUND

The criteria for chest drain removal following lung resections remain vague and rely on personal experience instead of evidence. Since pleural fluid resorption is proportional to body weight, a weight-related approach seems reasonable. We examined the feasibility of a weight-adjusted fluid output threshold concerning postoperative respiratory complications and the occurrence of symptomatic pleural effusion after chest drain removal. Our secondary objectives were the length of hospital stay and the pain levels before and after chest drain removal.

METHODS

Single-center randomized controlled trial including 337 patients planned for open or thoracoscopic anatomical lung resections. Patients were randomized postoperatively into two groups. The chest drain was removed in the study group according to a fluid output threshold calculated by the 5 mL x body weight (in kg) / 24 hours formula. In the control group, our previous traditional fluid threshold of 200 mL/ 24 hours was applied.

RESULTS

No differences were evident regarding the occurrence of pleural effusion, dyspnea at discharge and 30 days postoperatively. In the logistic regression analysis, the surgical modality was a risk factor for other complications, and age was the only variable influencing postoperative dyspnea. Time to chest drain removal was identical in both groups, and time to discharge was shorter following open surgery in the test group.

CONCLUSIONS

No increased postoperative complications occurred with this weight-based formula, and a trend toward earlier discharge after open surgery was observed in the test group.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Thoracic Surgery
08 Faculty of Science > Department of Biology > Bioinformatics and Computational Biology

UniBE Contributor:

Gioutsos, Konstantinos, Azenha Figueiredo, Luís Filipe, Quapp, Christopher Siegbert, Kocher, Gregor, Lutz, Jon Andri, Peischl, Stephan, Dorn, Patrick

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1552-6259

Publisher:

Elsevier

Language:

English

Submitter:

Pubmed Import

Date Deposited:

25 Sep 2023 14:14

Last Modified:

25 May 2024 00:11

Publisher DOI:

10.1016/j.athoracsur.2023.09.011

PubMed ID:

37734641

BORIS DOI:

10.48350/186504

URI:

https://boris.unibe.ch/id/eprint/186504

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