| Objective: To explore the clinical safety and feasibility of 8.5F ultra-fine chest tube(YB-A-II 2.8/235)after video-assisted thoracoscopic lobectomy/sublobectomy.Methods: Patients who were admited to Department of Thoracic Surgery of the First Affiliated Hospital of Dalian Medical University from October 16,2018 to January 31,2019,was included continuously.The inclusion criteria were as follows: 1.Patients should have no surgery contraindications and can tolerate an operation;2.Patients should also have undergone a Video-assisted thoracoscopic lobectomy/sublobectomy.The exclusion criteria were as follows: 1.Patients with severe pulmonary disease could not tolerate an surgery;2.Patients suffered from leakage during operation;3.Patients needed a mediastinal or esophageal tumor resection;4.Patients had a preoperative diagnosis of empyema.They were divided into two groups(experimental group and control group).In the experimental group,8.5F ultra-fine chest tube was placed into patients' bodies at the end of the operation process together with traditional 28 F largebore silicone tube.In the control group,a single 28 F silicone tube was left with patients.The chest tube was removed after chest X-ray within 48 hours,which shows no leakage,no chylothorax and no hemothorax.That the quantity of intrapleural fluid was ?200ml/24 h was also needed.As well as pain scores when patients were being in status of quiet and coughing for the first three days after surgery,the basic information of the two groups(sex,age,smoking status,diabetes mellitus,hypertension,hepatitis,chronic obstructive pulmonary disease),surgical procedures,duration of 28 F silicone tube,total duration of chest tube,Postoperative hospitalization time,tube-associated complications(clogging,dislocation/shedding)and intrapleural fluid quantity within 48 hours after surgery were collected.The data were analyzed by student-t test and chisquare test with assist of SPSS 22.0 software.Results: A total of 117 patients met the criteria(25 patients were excluded,6 patients underwent thoracotomy or transformed into thoracic thoracotomy,and 19 patients underwent non-lobular/sublobectomy).Sixty-four patients of them were in the experimental group and fifty-three in the control group.Our Data showed age(P=0.603),gender(P=0.136),smoking history(P=0.483),hepatitis(P=0.11),diabetes(P=0.319),hypertension(P=0.241),surgical procedure(P=0.442),postoperative hospitalization time(P=0.260),chest tube obstruction(P=1.000),and intrapleural fluid volume(P=0.895)within 48 hours after surgery were not statistically different in two groups.There was no patients with chronic obstructive pulmonary disease in both groups.Chest tube dislocation or falling was not been seen in our study.There was a statistically difference between two groups in 28 F silicone tube duration(P=0.000)and total duration of chest tube(P=0.021).The duration of 28 F drainage tube in the experimental group was shorter than that in the control group.The proportion of largebore tube's duration in experimental group is significantly larger than those in the control group in both indwelling time?48h(38%: 8%)and indwelling time?72h(72%: 32%).The pain scores at quiet and cough showed no difference on the first postoperative day(P=0.542,P=0.226).The pain scores in the experimental group were lower than the control group in the next two days(P <0.05).Conclusion: Compared with the only 28 F large-bore silicone tube,8.5F ultra-fine drainage tube together with 28 F tube is better.The complications of the drainage tube are similar and the hospitalization duration has no statistical difference between two groups.But ultra-fine chest tube significantly shorten the duration of the 28 F silicone tube and alleviate patients' pain after surgery. |
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