• Erdal Okur, Volkan Baysungur, Cagatay Tezel, Gokcen Sevilgen, Gokhan Ergene, Mertol Gokce, and Semih Halezeroglu.
• Sureyyapasa Chest Diseases and Thoracic Surgery Teaching and Research Hospital, Istanbul, Turkey.
• Eur J Cardiothorac Surg. 2009 Jan 1;35(1):32-5; discussion 35-6.

ObjectiveDraining of the chest cavity with two chest tubes after pulmonary lobectomy is a common practice. This study aimed to investigate whether using two tubes after a pulmonary lobectomy is more effective than using a single tube.MethodThis prospective randomised study included 100 consecutive patients who underwent lobectomy or bilobectomy for any pathological condition between May 2006 and November 2007. In the 50 patients in the 'single-tube group', only one 32F chest tube was inserted, and in the 50 patients in the 'double-tube group', two 32F chest tubes were inserted. Pre-, intra- and postoperative variables in both the groups were compared.ResultsThe pre- and intraoperative characteristics of the patients were similar in both groups. The mean amount of drainage from chest tubes was 600+/-43.2cc in the single-tube group and 896+/-56.2cc in the double-tube group (p<0.001). The mean values of postoperative pain assessed on the visual analogue scale (VAS) in the early (second day) period were 4.28+/-0.21 in the single-tube group and 5.10+/-0.23 in the double-tube group (p=0.014). The VAS scores in the late (second week) period were 1.48+/-0.13 in the single-tube group and 2.00+/-0.17 in the double-tube group (p=0.01). All other related parameters were similar in both groups.ConclusionsInsertion of two chest tubes is not more effective than the insertion of a single chest tube after pulmonary lobectomy. Moreover, using a single tube is in fact more effective than using two tubes in that it causes less postoperative pain and less pleural fluid loss.

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