• J. Thorac. Cardiovasc. Surg. · Oct 2023

    Randomized Controlled Trial Multicenter Study

    Early chest tube removal, regardless of drainage volume after anatomical pulmonary resection: a multicenter randomized controlled trial.

    • Kazuya Takamochi, Tomohiro Haruki, Shiaki Oh, Makoto Endo, Kazuhito Funai, Yoshitaka Kitamura, Masahiro Tsuboi, Takuma Tsukioka, Hiroyuki Suzuki, Hiroyuki Ito, Norihito Okumura, Tsuyoshi Ueno, Norihito Ikeda, Hisashi Iwata, Morihito Okada, Tomohiro Ichikawa, Tatsuro Okamoto, Shuko Nojiri, Kenji Suzuki, and Advanced Clinical Trial Chest Surgery Group (ACTG).
    • Department of General Thoracic Surgery, Juntendo University School of Medicine. Electronic address: ktakamo@juntendo.ac.jp.
    • J. Thorac. Cardiovasc. Surg. 2023 Oct 28.

    ObjectivesThis study aimed to evaluate the safety and feasibility of early chest tube removal after anatomical pulmonary resection, regardless of the drainage volume.MethodsWe conducted a multicenter, randomized, controlled, non-inferiority trial. Patients with a >300 mL drainage volume during postoperative day (POD) 1 were randomly assigned to groups A (tube removed on POD 2) and B (tube retained till drainage volume ≤300 mL/24 h). The primary endpoint was the frequency of respiratory-related adverse events (grade 2 or higher based on the Clavien-Dindo classification) within 30 days postoperatively.ResultsBetween April 2019 and October 2021, 175 patients were assigned to either group A (N = 88) or B (N = 87). One patient in group B who experienced chylothorax was excluded from the study. Respiratory-related adverse events were observed in 10 (11.4%) and 12 (14.0%) patients in groups A and B, respectively (P = 0.008). The frequencies of thoracentesis and/or chest tube re-insertion were not significantly different (8.0% and 9.3% in groups A and B, respectively, P = 0.752). Additionally, the duration of chest tube placement was significantly shorter in group A than in group B (median, 2 vs. 3 days; P < 0.001). No significant difference between groups A and B was found in postoperative hospital stay (median, 6 vs. 7 days, P = 0.231).ConclusionsEarly chest tube removal, regardless of drainage volume, was safe and feasible in patients who underwent anatomical pulmonary resection.Copyright © 2023. Published by Elsevier Inc.

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