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Randomized Controlled Trial of Thresholds for Drain Removal After Anatomic Lung Resection
Konstantinos Gioutsos1, Lasse Ehrenreich1, Luis Filipe Azenha1
1Department of Thoracic Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
The Annals of Thoracic Surgery
|September 21, 2023
Summary
A new weight-based formula for chest drain removal after lung surgery is safe and effective. This approach did not increase postoperative complications and showed a trend toward earlier discharge in open surgery patients.
Area of Science:
- Thoracic Surgery
- Pulmonary Medicine
- Evidence-Based Medicine
Background:
- Chest drain removal criteria post-lung resection are often subjective.
- Pleural fluid resorption correlates with body weight, suggesting a weight-based approach.
Purpose of the Study:
- To assess a weight-adjusted fluid output threshold for chest drain removal.
- To evaluate its impact on postoperative respiratory complications and pleural effusion.
- To analyze secondary outcomes including hospital stay and pain levels.
Main Methods:
- Single-center randomized controlled trial with 337 patients undergoing lung resection.
- Study group: drain removal based on 5 mL × body weight (kg)/24h formula.
- Control group: traditional 200 mL/24h fluid threshold.
Main Results:
- No significant differences in pleural effusion or dyspnea at discharge or 30 days.
- Surgical modality was a risk factor for complications; age influenced dyspnea.
- Drain removal time was similar; discharge was shorter after open surgery in the study group.
Conclusions:
- The weight-based formula for chest drain removal is not associated with increased postoperative complications.
- A trend towards earlier discharge was observed in the study group undergoing open surgery.
