Chest drains after open paediatric lung resections: not always required

Area of Science:

• Pediatric Surgery
• Thoracic Surgery
• Critical Care Medicine

Background:

• Chest drains cause pain and anxiety in pediatric patients.
• Evidence supports omitting drains after thoracoscopic lung resection in children.
• Safety of omitting drains after open lung resection in children is unevaluated.

Purpose of the Study:

• Evaluate the safety of selective chest drain placement in children undergoing open lung resection.
• Describe institutional experience with selective chest drain omission.
• Report complication profile of selective chest drain placement.

Main Methods:

• Retrospective review of open lung resections in children (<16 years) from June 2009 to June 2022.
• Analysis of clinical, radiological, and operative outcomes.
• Comparison between children with and without intraoperative chest drains.

Main Results:

• 35 children underwent open lung resection; 8 (23%) had no drain, 29 (77%) had drains.
• Children without drains had significantly shorter hospital stays (2.5 vs. 5.0 days).
• No significant differences in complication rates, reintervention, residual pneumothorax, or effusion between groups.

Conclusions:

• Chest drains are not always necessary after pediatric open lung resection.
• Selective omission of chest drains is safe, with no increased complications or reinterventions.
• Omitting chest drains is associated with shorter hospital stays.