Original ArticlesEarly chest tube removal after video-assisted thoracoscopic wedge resection of the lung
Section snippets
Methods
From December 1995 to July 1997, 59 patients underwent VATS wedge resection for indeterminate pulmonary nodules or interstitial lung disease. No further resection was used for these patients. A diagnosis of benign or malignant disease was determined with an intraoperative frozen section. Metastatic lesions or limited cardiopulmonary reserve precluded anatomic resection in those patients with malignant disease. Among the last 33 patients, we prospectively evaluated ER for chest tube management
Results
Ninety-four percent (31 of 33) of patients considered for ER met criteria for early tube removal (an intent to treat). An air leak and excessive chest tube drainage prohibited early removal in 2 patients. Both of these patients who were considered for ER had undergone VATS wedge resection of pulmonary parenchymal nodules.
Chest tube duration among the patients undergoing TM of their chest tubes averaged 3.3 days. Chest tubes were maintained an average of 1.8 days on suction and 1.3 days of water
Comment
A surgical procedure is often indicated for the diagnosis of an indeterminate pulmonary nodule and to assist in directing medical therapy for patients with interstitial lung disease. Video-assisted thoracoscopic surgery has become an important tool in this setting 9, 10. Although the cost-effectiveness of VATS has been debated 11, 12, the safety and efficacy have been established 3, 8, 10. Until the development of the thoracoscopic wedge resection technique, most diagnostic lung biopsies were
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