Early Chest Tube Removal After Thoracoscopic Esophagectomy with High Output

The optimal volume threshold for removal of chest tubes after thoracic surgery has not been determined. The purpose of the study was to assess the new volume threshold for chest tube removal after thoracoscopic esophagectomy (TSE).

A retrospective study was conducted with a prospective database. All patients underwent TSE. Eligible patients were divided into two groups: Group A had their chest tubes removed at a drainage volume of 150 mL/day or less, whereas Group B had their chest tubes removed at a drainage volume of 300 mL/day or less. Chest drainage time, volume of drainage on postoperative day (POD) 1 and 2, postoperative hospital stay, postoperative complications, and the incidence of invasive re-intervention were evaluated.

In total, 70 patients were included, with 32 patients in Group A and 38 patients in Group B. The mean chest drainage time in Group B was significantly shorter than that in Group A (2.6 ± 0.8 versus 4.0 ± 1.0 days, P < .001). There were no statistically significant differences in volume of drainage on POD 1 and 2, postoperative hospital stay, and postoperative complications between Group A and Group B (P > .05). A total of 4 patients in Group A and 3 patients in Group B developed postoperative pleural effusions requiring thoracentesis (P > .05). No patient was re-admitted because of pleural effusion during the 30-day follow-up period.

This study showed that a 300 mL/day volume threshold for chest tube removal after TSE was capable of reducing the postoperative chest drainage time without compromising patient safety.