scholarly journals Suction Versus Nonsuction Drainage After Uniportal Video-Assisted Thoracoscopic Surgery: A Propensity Score-Matched Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Jian Zhou ◽  
Chuan Li ◽  
Quan Zheng ◽  
Chenglin Guo ◽  
Mengyuan Lyu ◽  
...  
Keyword(s):  
Propensity Score ◽  
Chest Tube ◽  
Thoracoscopic Surgery ◽  
Air Leak ◽  
Chest Drainage ◽  
Video Assisted ◽  
Matched Study ◽  
Water Seal ◽  
Persistent Air Leak ◽  
Video Assisted Thoracoscopic Surgery

BackgroundUniportal video-assisted thoracoscopic surgery (UniVATS) was utilized with a rapid growth. The evidence is sparse, however, on whether to add external suction to water-seal drainage for chest drainage after UniVATS. This retrospective propensity score-matched study aimed to identify the necessity of adding external suction to chest drainage after UniVATS.MethodsPatients with lung cancer who underwent UniVATS were included from our prospectively maintained database. Patients were divided into two cohorts based on the addition of external suction to postoperative water-seal drainage or not. Propensity score-matched analysis was performed to identify the impact of suction on chest tube duration, incidence of persistent air leak, hospital stay, and hospitalization cost. Multivariable model with interaction terms was constructed to identify impact of covariables on effect of suction.ResultsThe two cohorts matched well on baseline characteristics (nonsuction: 173; suction: 96). Compared with nonsuction group, suction group showed longer median chest tube duration (3 vs. 2 days, p = 0.003), higher incidences of persistent air leak (9.4% vs. 1.2%, p = 0.003), persistent drainage (16.8% vs. 5.8%, p = 0.007), and reduced drainage volume within first 3 postoperative days (386.90 vs. 504.78 ml, p = 0.011). Resection extent was identified to mediate the relationship between suction and chest tube drainage.ConclusionsThese findings discouraged adding external suction to water-seal drainage after UniVATS regarding longer chest tube duration and more persistent air leak. Patients undergoing lobectomy would benefit more from water-seal drainage without external suction compared with those doing sublobectomy.

scholarly journals Socioeconomic Impact of Recurrent Primary Spontaneous Pneumothorax: Should Video-Assisted Thoracoscopic Surgery Be Considered at First Episode of Primary Spontaneous Pneumothorax?

Healthcare ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1236
Author(s):  
Stephen Fung ◽  
Andrea Alexander ◽  
Hany Ashmawy ◽  
Levent Dizdar ◽  
Sami Safi ◽  
...  
Keyword(s):  
Healthcare System ◽  
Chest Tube ◽  
Spontaneous Pneumothorax ◽  
Thoracoscopic Surgery ◽  
Primary Spontaneous Pneumothorax ◽  
Socioeconomic Impact ◽  
First Episode ◽  
Air Leak ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery

Background: Current guidelines recommend video-assisted thoracoscopic surgery (VATS) for recurrent primary spontaneous pneumothorax (PSP) and for cases with persistent air leak after chest tube treatment. The socioeconomic impact of recurrent PSP on the healthcare system is insufficiently reported. Methods: Ninety-six patients treated for PSP between 01/2010 and 01/2020 were included. Forty-eight patients underwent primary VATS, while the second group received chest tube (CT) treatment only. Length of hospital stay (LOS), duration of chest tube, prolonged air leak, postoperative complications, recurrences and treatment costs were analyzed. Results: Prolonged air leaks were evident in 12.5% and 22.9% patients of the VATS and CT group, respectively. Ten (20.8%) patients in the CT group underwent VATS for persistent air leakage. During follow-up, the VATS group recurred at 8.3% compared to 52.1% in the CT group. The total cost of treatment per patient, including treatment cost due to recurrence, was EUR 1.501 in the VATS group and EUR 2.233 in the CT group. Conclusions: Primary treatment of PSP by CT is associated with an increased socioeconomic burden for patients and the healthcare system due to high recurrence rates. This burden may be reduced if VATS is considered at the first episode of PSP.

scholarly journals Making the transition from video-assisted thoracoscopic surgery to chest tube with fibrinolytics for empyema in children: Any change in outcomes?

2016 ◽  
Vol 59 (3) ◽  
pp. 167-171 ◽  
Author(s):  
Michael H. Livingston ◽  
Sara Colozza ◽  
Kelly N. Vogt ◽  
Neil Merritt ◽  
Andreana Bütter
Keyword(s):  
Chest Tube ◽  
Thoracoscopic Surgery ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery

Comparison of Subxiphoid and Intercostal Uniportal Thoracoscopic Thymectomy for Nonmyasthenic Early-Stage Thymoma: A Retrospective Single-Center Propensity-Score Matching Analysis

2020 ◽  
Author(s):  
Zhengcheng Liu ◽  
Rusong Yang
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Early Stage ◽  
Thoracoscopic Surgery ◽  
Disease Stage ◽  
Perioperative Outcomes ◽  
Control Group ◽  
Video Assisted ◽  
Drainage Time ◽  
Video Assisted Thoracoscopic Surgery

Abstract Objective The aim of this study was to compare early outcome between intercostal uniportal video-assisted thoracoscopic surgery (IU-VATS) versus subxiphoid uniportal video-assisted thoracoscopic surgery (SU-VATS) in thymectomy for non-myasthenic early-stage thymoma. Method Retrospective analysis of 76 cases completed in our hospital from May 2018 to September 2019 with subxiphoid uniportal thoracoscopic thymectomy; a single incision of ∼3 cm was made ∼1 cm under the xiphoid process. The control group included 213 patients who received intercostal uniportal thoracoscopic thymectomy from August 2015, and propensity score matching was conducted. All patients who were clinically diagnosed with thymic tumor before surgery were treated with thymectomy. Perioperative outcomes between SU-VATS (n = 76) and IU-VATS, n = 76 were compared. Result After propensity score matching, there were no statistically significant differences between the two groups in terms of age, gender, disease stage, maximal tumor size, or other baseline demographic and clinical variables. All operation was successfully completed; there were no significant differences in the operative time (88 vs. 81 minutes, p = 0.63), intraoperative blood loss (55 vs. 46 mL, p = 0.47), postoperative drainage time (2.2 vs. 2.5 days, p = 0.72), and postoperative hospital stay (3.2 vs. 3.4 days, p = 0.78) between the two groups. The visual analog scale (VAS) on postoperative days 1, 3, 7, and 30 was less in the SU-VATS group than that in the IU-VATS group. The VAS on days 60 and 180 did not differ significantly between the two groups. Conclusion Thymectomy using SU-VATS is a feasible procedure; it might reduce early postoperative pain and lead to faster recovery.

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