A comparison of chest tubes versus bulb-suction drains in pediatric thoracic surgery

Chest tubes are commonly used to evacuate the pleural space of air and fluid after thoracic surgery. The safety and efficacy of postoperative traditional chest tubes (CTs) versus soft bulb-suction drains (BDs) in the management of pediatric patients undergoing thoracic procedures were investigated.

An institutional review board-approved, retrospective review was performed on all patients who required noncardiac, nontraumatic thoracic operations from January 2000 to December 2005. Patient data included BD or CT drainage, age at operation, indication for surgery, open or thoracoscopic approach, days of postoperative drainage, the development of a postremoval pneumothorax, and complications. Statistical comparisons were made using t test and chi2 test.

During the study period, 186 patients with complete records underwent a thoracic operation. One hundred twenty (65%) received a CT, whereas 66 (35%) received a BD. Patients who received CT averaged 5.6 days of drainage compared with 4.4 days in the group that received BD. Postremoval pneumothorax developed in 5 (4%) patients with CT compared with 4 (6%) patients with BD. Two patients in the CT group required reinsertion of another CT. None of the BD patients required further intervention.

For thoracoscopic and open thoracic operations, BDs are as safe and efficacious as traditional CT.