• 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.
• Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan. Electronic address: ktakamo@juntendo.ac.jp.
• J. Thorac. Cardiovasc. Surg. 2024 Aug 1; 168 (2): 401410.e1401-410.e1.

ObjectivesThis study aimed to evaluate the safety and feasibility of early chest tube removal after anatomic pulmonary resection, regardless of the drainage volume.MethodsWe conducted a multicenter, randomized, controlled, noninferiority trial. Patients with greater than 300 mL drainage volume during postoperative day 1 were randomly assigned to group A (tube removed on postoperative day 2) and group B (tube retained until drainage volume ≤300 mL/24 hours). The primary end point 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 group A (N = 88) or group B (N = 87). One patient in group B who experienced chylothorax was excluded from the study. Respiratory-related adverse events were observed in 10 patients (11.4%) in group A and 12 patients (14.0%) in group B (P = .008). The frequencies of thoracentesis or chest tube reinsertion were not significantly different (8.0% and 9.3% in groups A and B, respectively, P = .752). Additionally, the duration of chest tube placement was significantly shorter in group A than in group B (median, 2 vs 3 days; P < .001). No significant difference between groups A and B was found in postoperative hospital stay (median, 6 vs 7 days, P = .231).ConclusionsEarly chest tube removal, regardless of drainage volume, was safe and feasible in patients who underwent anatomic pulmonary resection.Copyright © 2023 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

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