• Joost W M Bertholet, Joris J A Joosten, Mariël E Keemers-Gels, Frits J H van den Wildenberg, and Wouter B Barendregt.
• Division of Lung Surgery, Department of General Surgery, Canisius-Wilhemina Hospital, PO Box 9015, 6500 GS Nijmegen, The Netherlands. jwmbertholet@gmail.com
• Interact Cardiovasc Thorac Surg. 2011 Jan 1; 12 (1): 28-31.

AbstractMuch controversy exists regarding the management of chest tubes following pulmonary lobectomy. The objective of this study was to analyse the effect of a new chest tube management protocol on clinical features, such as postoperative air leak, drain characteristics, 30-day postoperative complications and length of hospital stay. We retrospectively analysed 133 patients who underwent pulmonary lobectomy, from January 2005 to December 2008. A new chest tube protocol was introduced on 1 January 2007 and included placement of a single chest tube and early conversion to water seal. The chest tube was removed when air leak had resolved and (non-chylous) fluid drainage was <400 ml/day. The results of patients in the old (n=68) and the new protocol (n=65) were compared. In the new protocol group the median duration of air leak and duration of chest tube drainage declined significantly. Also the length of hospital stay decreased significantly to a median of eight days. The number of reinterventions and 30-day morbidity and mortality rates did not differ significantly. Our data suggest that placement of a single chest tube and early conversion to water seal decreases the duration of air leak and chest tube drainage and length of hospital stay.

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