Chest Tube Management following Lung Resection in Pediatric Patients: A Retrospective Analysis
Jamie K Schnuck1, Patrick J Javid2, Kimberly J Riehle2
1Department of General Surgery, University of Washington, Seattle, WA, USA.
Insights
Pediatric lung resections rarely require prolonged chest tube (CT) drainage. Most children have no air leak and CT removal within two days, suggesting obligatory drainage may not be necessary.
Area of Science:
- Pediatric Surgery
- Thoracic Surgery
- Pulmonary Medicine
Background:
- Pleural drainage via chest tubes (CT) is standard after pediatric lung resection.
- Its necessity in pediatric patients remains debated, contrasting with adult literature findings.
Purpose of the Study:
- To characterize chest tube (CT) practices in pediatric lung resections.
- To evaluate the utility and necessity of chest tube (CT) drainage in this population.
Main Methods:
- Retrospective chart review of pediatric patients (<21 years) undergoing lobectomy or wedge resection (2013-2022).
- Data collected included demographics and post-operative chest tube (CT) management.
- Study design: Level IV Retrospective Study.
Main Results:
- 130 procedures analyzed: 59 lobectomies, 19 diagnostic wedges, 52 excisional wedges.
- High rates of no air leak observed: 74.6% (lobectomy), 89.5% (diagnostic wedge), 80.8% (excisional wedge).
- Median chest tube (CT) duration was short: 2 days (lobectomy), 1 day (wedges). 43.1% removed on POD 1, 21.5% on POD 2.
Conclusions:
- Chest tube (CT) duration after pediatric lung resection is typically brief.
- Most pediatric patients undergoing lung resection experience no air leak and have CTs removed within 2 days.
- Routine, obligatory chest tube (CT) drainage may be unnecessary for select pediatric patients post-lung resection.
Background:
Pleural drainage following lung resection is almost universally practiced in pediatric surgery, but its necessity has been questioned in adult literature. We performed a cross-sectional study of pediatric patients undergoing lung resection to characterize chest tube (CT) practices and clarify their utility.
Method:
Retrospective chart review of patients <21 years of age undergoing pulmonary lobectomy or wedge resection at an academic children's hospital from 2013 to 2022. Variables regarding demographics and post-operative CT management were recorded.
Results:
130 procedures meet inclusion criteria: 59 lobectomies (group 1), 19 diagnostic wedges (group 2), and 52 excisional wedges (group 3). 74.6% of group 1 patients had no air leak, and median CT duration was 2 days. In group 2, 89.5% had no air leak and median CT duration was 1 day. In Group 3, 80.8% had no air leak and median CT duration was 1 day. Overall, 43.1% patients had their CT removed on post-operative day 1 and 21.5% on post-operative day 2.
Conclusion:
CT duration following lung resection in pediatric patients is typically brief, with most patients having no air leak and CT removal within 2 days of surgery. Obligatory CT drainage may not be necessary in select patients undergoing lung resection.
Level Of Evidence:
Level IV.
Type Of Study:
Retrospective Study.
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