Evaluation of a newly developed thoracic drain in lobectomies for NSCLC

Background:

The concept of using two drains has been left behind by many surgeons during the rise of minimal-invasive techniques. However, a possible inadequate drainage of just one standard drain often leads to unauthorized drain-manipulation. Consequently a new co-axial drain is now available characterized by an inner lumen with 4 fluted profiles around to collect fluid and air through the whole length.

Method:

We performed a single center study analyzing all patients undergoing a lobectomy for oncological reasons. VATS versus open approach, amount of drained liquid, number and duration of drains were observed. Decision for the type of drain used was in the hands of the surgeon.

Results:

79 procedures, 35 open and 44 VATS lobectomies were analyzed. In 69,6% co axial drains were used. In 2 cases out of 55 more than one co-axial drain was used and in 10 out of 24 cases more than one standard drain.

There was no significant difference of the type of drain used compared to the stage of the tumor. Drain duration and fluid production was similar in both groups of drains. Drain duration was slightly longer in open (mean = 7797 min) compared to VATS procedure (mean = 5555 min) (p < 0.01). Fluid production was as well was higher in the open surgery group (mean = 2065 ml vs. 1348 ml) (p < 0.01). There was a trend to shorter in-hospital stay in the co-axial drain group.

No malfunction was seen in both drain types. It was not possible to quantify for the amount of clots inside the drains. Nevertheless a subclinical clotting was often seen in the standard drain despite daily milking. Such clots rarely occurred in the co-axial group.

Conclusion:

The new co-axial drains clearly showed non-inferiority, were easy to handle; usage felt quite comfortable and save.