scholarly journals Clinical Efficacy of Intraoperative Cell Saver Autologous Blood Salvage in Emergency Thoracoscopic Surgery for Massive Hemothorax.

2020 ◽  
Author(s):  
Hideki Itano ◽  
Takayuki Takeda ◽  
Hidehito Nakahara ◽  
Toshinori Kobayashi ◽  
Junsuke Hinami
Keyword(s):  
Blood Transfusion ◽  
Chest Tube ◽  
Thoracoscopic Surgery ◽  
Autologous Blood ◽  
The Other ◽  
Chest Tube Drainage ◽  
Cell Saver ◽  
Tube Drainage ◽  
Blood Salvage ◽  
Massive Hemothorax

Abstract Objectives: The objectives of this study were to investigate the efficacy of intraoperative Cell Saver autologous blood salvage in emergency thoracoscopic surgery for massive hemothorax.methods: Nine consecutive cases, including 8 idiopathic hemopneumothoraxes and 1 late-onset traumatic hemothorax, for which emergency surgery was performed at Uji Tokushu-kai Hospital between 2009 and 2016, were retrospectively reviewed. Results: The median total blood loss was 2200 cc (range, 840–4170 cc). Intraoperative Cell Saver autotransfusion with a median volume of 820 cc was performed in the last 7 patients. The first 2 patients who did not receive an autotransfusion required substantially more allogeneic blood transfusion (10 and 14U, respectively), while the other 7 autotransfusion patients required much smaller amounts of allogeneic transfusion (4 U in 3 and 0 U in 4). Four autotransfusion patients who did not undergo preoperative chest tube drainage and/or who had drainage of < 150cc received a greater amount of intraoperative autotransfusion (mean, 1162 ± 414 cc) than the other 3 patients who had a chest tube drainage of ≥ 150 cc (mean, 666.7 ± 150 cc; P = 0.0574). Torn and bleeding arteries were thoracoscopically clipped in 7 patients. One patient with right lung collapse over 2.5 days developed severe acute respiratory distress syndrome intraoperatively, but fully recovered. Conclusions: Utilizing intraoperative autologous blood salvage with the sparing of preoperative chest tube drainage to the maximum possible extent is an efficient strategy to reduce both overall blood loss and allogeneic blood transfusion in emergency thoracoscopic surgery for massive hemothorax.

Salvage for Unsuccessful Aspiration of Primary Pneumothorax: Thoracoscopic Surgery or Chest Tube Drainage?

2008 ◽  
Vol 85 (6) ◽  
pp. 1908-1913 ◽  
Author(s):  
Jin-Shing Chen ◽  
Hsao-Hsun Hsu ◽  
Kung-Tsao Tsai ◽  
Ang Yuan ◽  
Wen-Jone Chen ◽  
...  
Keyword(s):  
Chest Tube ◽  
Thoracoscopic Surgery ◽  
Chest Tube Drainage ◽  
Tube Drainage

scholarly journals Chest tube drainage versus video-assisted thoracoscopic surgery for a first episode of primary spontaneous pneumothorax: a systematic review and meta-analysis

2019 ◽  
Vol 56 (5) ◽  
pp. 819-829
Author(s):  
Jean H T Daemen ◽  
Pieter W J Lozekoot ◽  
Jos G Maessen ◽  
Michiel H M Gronenschild ◽  
Gerben P Bootsma ◽  
...  
Keyword(s):  
Chest Tube ◽  
Spontaneous Pneumothorax ◽  
Thoracoscopic Surgery ◽  
Meta Analysis ◽  
Primary Spontaneous Pneumothorax ◽  
Chest Tube Drainage ◽  
Recurrence Rates ◽  
Tube Drainage ◽  
Ipsilateral Recurrence ◽  
Length Of Hospitalization

Summary Primary spontaneous pneumothorax affects up to 28 patients per 100 000 population yearly and is commonly resolved by chest tube drainage. However, drainage is also known to be associated with ipsilateral recurrence rates ranging from 25% to 43%. Preventive video-assisted thoracoscopic surgery (VATS) may be an effective alternative to diminish these recurrence rates and its associated morbidity. The aim of this study was to compare the efficacy of chest tube drainage and VATS as first line treatments of an initial episode of primary spontaneous pneumothorax. The MEDLINE, EMBASE, CENTRAL and Clinicaltrials.gov databases were searched through 16 September 2018. Data regarding the ipsilateral recurrence rate and the length of hospitalization were extracted and submitted to meta-analysis using the random-effects model and the I2 test for heterogeneity. Two randomized controlled trials and 2 observational studies were included, enrolling a total of 479 patients. Pairwise analysis demonstrated significantly reduced ipsilateral recurrence rates [odds ratio 0.15, 95% confidence interval (CI) 0.07–0.33; P < 0.00001] and length of hospitalization (standardized mean difference −2.19, 95% CI −4.34 to −0.04; P = 0.046) in favour of VATS. However, a significant level of heterogeneity was detected for the length of hospitalization (I2 = 97%; P < 0.00001). Subgroup analysis that stratified study design found no statistical differences regarding recurrence rate. In conclusion, VATS can be an effective and attractive alternative to standard chest tube drainage, with reduced ipsilateral recurrence rates and length of hospitalization. However, given the low quality of the majority of included studies, more well-designed randomized controlled trials are necessary to strengthen the current evidence.

scholarly journals Implication of pigtail catheter vs chest tube drainage

2018 ◽  
Vol 5 (9) ◽  
pp. 3686
Author(s):  
Alaa Elsayed ◽  
Rayan Alkhalifa ◽  
Muhannad Alodayni ◽  
Rakan Alanazi ◽  
Lara Alkhelaiwy ◽  
...  
Keyword(s):  
Thoracic Surgery ◽  
Chest Tube ◽  
The Other ◽  
Chest Tube Drainage ◽  
Complication Rates ◽  
Pigtail Catheter ◽  
Chest Tubes ◽  
Tube Drainage ◽  
Other Hand ◽  
Lower Complication

Pigtail catheters and chest tubes have long been used for drainage of pleural collections for many years. In thoracic surgery, each technique is preferred in certain conditions. Pigtail catheters have the advantages of being smaller in size, more flexible, less traumatic, easier in insertion, and are associated with lower complication rates. They are particularly effective in draining non-viscid and non-coagulable fluids. The main disadvantages are their ineffectiveness in draining thick fluids, their higher liability to clogging, kinking, and obstruction. Chest tubes, on the other hand, have larger diameters allowing faster and more efficacious drainage of thick fluids and hemothorax. However, they are more painful, more distorting to tissues, and have higher complications rates. The aim of this article is to provide a review on both systems, and to compare the reported safety, efficacy, and complications of each.

A comparison of intra-operative cell-saving strategies upon immediate post-operative outcomes after CPB-assisted cardiac procedures

Perfusion ◽  
2008 ◽  
Vol 23 (3) ◽  
pp. 157-164 ◽  
Author(s):  
JE Marcoux ◽  
M Rosin ◽  
E McNair ◽  
G Smith ◽  
HJ Lim ◽  
...  
Keyword(s):  
Chest Tube ◽  
Negative Impact ◽  
Adverse Outcomes ◽  
Chest Tube Drainage ◽  
Transfusion Rate ◽  
Cell Saver ◽  
Tube Drainage ◽  
Ventilation Time ◽  
Cardiotomy Suction ◽  
A Cell

Cardiotomy suction has been associated with adverse outcomes under routine conditions in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). We hypothesized that the routine use of a cell saver (CS) in place of the cardiotomy sucker would have no negative impact on transfusion rate (TR), chest tube drainage (CTD), ventilation time (VT) or intensive care unit length of stay (ICULOS) while avoiding the detrimental effects of cardiotomy suction. Retrospective data were collected from 69 patients where a cell saver was not used (NCS). Prospective data were collected from 219 patients who were followed after the implementation of an intra-operative cell saver. No significant increase in transfusion rate, chest tube drainage or ventilation time was found between the NCS group and the CS group. However, post-operative hemoglobin concentrations were significantly higher in the CS group (0.0001) and the CS group spent significantly less time in the ICU (p=0.018).

Chest tube drainage placement may not be a necessity in paediatric thoracoscopic surgery: a retrospective study

2021 ◽  
pp. 1-5
Author(s):  
Gang Zhang ◽  
Dandan Liu ◽  
Ruiming Kuang ◽  
Chun Cai ◽  
Xiao Li ◽  
...  
Keyword(s):  
Chest Tube ◽  
Thoracoscopic Surgery ◽  
Perioperative Complications ◽  
Chest Tube Drainage ◽  
Tube Placement ◽  
Tube Drainage ◽  
Video Assisted ◽  
Increased Risk ◽  
Psychological Acceptance ◽  
Video Assisted Thoracoscopic Surgery

Abstract Objective: Chest tube drainage placement, a standard procedure in video-assisted thoracoscopic surgery, was reported to cause perioperative complications like pain and increased risk of infection. The present study was designed to evaluate the necessity of chest tube drainage inpaediatric thoracoscopic surgery. Methods: Thirty children admitted to our hospital from April 2018 to April 2020 were included in the current study and were grouped as the tube group (children receiving video-assisted thoracoscopic surgery with chest tube drainage) and the non-tube group (children receiving video-assisted thoracoscopic surgery without chest tube drainage). Laboratory hemogram index, length of hospitalisation, post-operative performance of involved children, and psychological acceptance of indicated therapy by guardians of the involved children were investigated. Results: Laboratory examination revealed that the mean corpuscular haemoglobin concentration in the non-tube group was significantly higher than that in the tube group on post-operative day 1 (p < 0.05). Children in the non-tube group had a shorter length of hospitalisation (7–9 days) than that of patients from the tube group. Additionally, the frequency of crying of children was decreased and psychological acceptance by patients’ guardians was improved in the non-tube group when compared with the tube group. Conclusion: This study showed that chest tube drainage placement may not be necessary in several cases of paediatric video-assisted thoracoscopic surgery. Rapid recovery with decreased perioperative complications in children operated by video-assisted thoracoscopic surgery without tube placement could also reduce the burden of the family and society both economically and psychologically.

Factors Affecting Postoperative Lung Expansion in Patients with Pyogenic Empyema

2018 ◽  
Vol 66 (08) ◽  
pp. 697-700 ◽  
Author(s):  
Hyo Ahn ◽  
Yeong Kim ◽  
Hoseok I. ◽  
Seunghwan Song ◽  
Jung Eom ◽  
...  
Keyword(s):  
Chest Tube ◽  
Thoracoscopic Surgery ◽  
Pearson Correlation ◽  
Chest Tube Drainage ◽  
Tube Placement ◽  
Visceral Pleura ◽  
Factors Affecting ◽  
Tube Drainage ◽  
Hospitalization Time ◽  
Lung Expansion

Background In patients with parapneumonic empyema, decortication is usually preferred to ensure functional lung re-expansion. However, there could be patients exhibiting incomplete postoperative lung expansion and inadequate drainage despite decortication. Therefore, we evaluated factors affecting postoperative lung expansion in patients undergoing decortication. Methods A total of 221 patients with pyogenic empyema who underwent video-assisted thoracoscopic surgery (VATS) between January and October 2016 in our hospital were reviewed in terms of surgical success. The following factors were evaluated: age; the time between identification of a localized effusion and surgical referral; chest tube drainage durations; any underlying morbidity preoperative blood culture data; and the thickness of the visceral pleura. Results Several factors that significantly prolonged the postoperative time to lung expansion were evident in patients with diabetes mellitus (DM) and bacteremia; postoperative chest tube drainage was significantly longer in those with DM (p = 0.009) and bacteremia (p = 0.01); and postoperative hospitalization time was significantly longer in patients with bacteremia (p = 0.01). The thickness of the visceral pleura was strongly correlated with postoperative chest tube drainage duration and postoperative hospitalization time (Pearson correlation coefficient, r = 0.245, p = 0.00). Conclusions In patients with DM, bacteremia, or thickened pleura, the time to lung expansion after operation was longer. Therefore, stricter pre- and post-operative control of blood-sugar levels and adequate antibiotics are required to facilitate postoperative lung re-expansion. In patients with thickened pleurae, prolonged chest tube placement is unavoidable.

Clinico-bacteriological Profile and Outcome of Empyema Thoracis in Children at a Tertiary Care Hospital of Central Nepal

2020 ◽  
Vol 16 (3) ◽  
Author(s):  
Atanu Pan ◽  
Debarshi Jana
Keyword(s):  
Ct Scan ◽  
Broad Spectrum ◽  
Chest Tube ◽  
Chest Tube Drainage ◽  
Diagnostic Tools ◽  
High Morbidity ◽  
Care Hospital ◽  
Empyema Thoracis ◽  
First Line ◽  
Tube Drainage

Background: Empyema thoracis (ET) is a serious infection of the pleural space. Despite the availability of broad spectrum antibacterial, improved vaccination coverage and better diagnostic tools, Empyema Thoracis remains associated with high morbidity worldwide. Delay   in   early   diagnosis,   failure   to institute   appropriate   antimicrobial   therapy,   multidrug resistant   organisms,   malnutrition,   comorbidities,   poor health  seeking  behaviour  and  high treatment  cost  burden contribute  to  increased  morbidity  in  children. The available  treatment  options  include  intravenous broad-spectrum antibiotics  either  alone  or  in  combination  with surgical  procedure  (thoracocentesis,  chest  tube  drainage, fibrinolytic  therapy,  decortications  with  video  assistedthoracoscopic surgery (VATS) and open drainage. Methods: Fifty Children between 1 month to 16 years admitted in the Pediatrics Ward, PICU of College of Medical Sciences, Bharatpur,Nepal. Data analysis was done by SPSS 24.0. Results: Present study found that according to blood culture, 3(6.0%) patients had enterococcus, 40(80.0%) patients had no growth, 2(4.0%) patients had pseudomonas, 4(8.0%) patients had staphylococcus and 1(2.0%) patients had streptococcus. We found that 20(40.0%) patients had done CT scan thorax, 30(60.0%) patients had not done CT scan thorax and 32(64.0%) patients had Amoxiclav first line antibiotic and 18(36.0%) patients had Ceftriaxone first line antibiotic. Conclusions: Suitable antibiotics and prompt chest tube drainage is an effective method of treatment of childhood empyema, especially in resource-poor settings. Majority of the patients progress on this conservative management and have good recovery on follow up.  

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