Free of choice on anterior and posterior chest tube position after lung cancer resection

Author:

Pu Qiang1234,Zhou Jian1234,Zheng Quan13,Hao Jianqi13,Wu Dongsheng3,Zhang Ruoxi3,Wang Hang3,Wang Tengyong13,Liu Lunxu123ORCID

Affiliation:

1. Department of Thoracic Surgery, West China Hospital, Sichuan University , Chengdu, China

2. Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Sichuan University , Chengdu, China

3. West China School of Medicine, Sichuan University , Chengdu, China

4. Institute of Thoracic Oncology, West China Hospital, Sichuan University , Chengdu, China

Abstract

Abstract OBJECTIVES The optimal location to insert a chest tube for postoperative drainage has not been identified. We performed a retrospective equivalence study to identify whether the efficiency is similar regarding anterior or posterior position of chest tube in thoracic cavity after video-assisted thoracoscopic surgery for non-small-cell lung cancer. METHODS A retrospective review of 4263 patients undergoing non-small-cell lung cancer resection from October 2009 to August 2019 in the Western China Lung Cancer Database was conducted. Propensity score matching was performed to balance baseline characteristics between anterior and posterior groups. Chest tube duration, drainage volume, postoperative complications and hospitalization cost were compared. Equivalence margin was defined as (−1, 1) in 95% confidence interval of the mean difference of chest tube duration. RESULTS After propensity score matching, we investigated 2912 patients with anterior or posterior (1456 vs 1456) chest tube location following lung cancer resection. The mean time to chest tube removal was 3.39 days in the anterior group and 3.38 days in the posterior group (P = 0.52), while the mean difference and 95% confidence interval were 0.02 (-0.17, 0.20). The mean postoperative hospital stays in 2 groups were 5.47 vs 5.24 days (anterior vs posterior, P = 0.02). No significant differences were identified regarding the drainage volume during the first 3 postoperative days, postoperative complications and hospitalization cost. CONCLUSIONS The comparison of clinical outcomes between anterior and posterior location of chest tube met the criteria for equivalence. For lung cancer patients undergoing video-assisted thoracoscopic surgery resection, it was free choice on anterior or posterior single-tube insertion.

Funder

1.3.5 Project for Disciplines of Excellence, West China Hospital, Sichuan University

1.3.5 Project for Disciplines of Excellence-Clinical Research Incubation Project, West China Hospital, Sichuan University

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine,Pulmonary and Respiratory Medicine,Surgery

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