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 thoracic surgery. Type of surgery, VATS versus open approach, amount of drained liquid, number and duration of drains were observed.
A combination of drains as well as procedures requiring redo-surgery were excluded.
Results:
116 procedures (46 lobectomies, 25 pneumothoraces, 23 empyemas and 22 wedge resections) were analyzed. Drain-duration (p < 0.01) and fluid production (p = 0.01) showed significant differences between the procedures.
These parameters also differed significantly between open surgery (7589 min, 1504 mL) and VATS (5050 min, 976 mL; p < 0.01; p = 0.04).
Co-axial compared to standard drains were equal in drain duration and fluid production in the whole study population as well as in the lobectomy subgroup.
Co-axial drains were always used as single drains after lobectomy while standard drains were used as single (n = 15) and double drains (n = 7; p < 0.01).
Analysis of open (n = 19) versus VATS lobectomies (n = 26) showed a significant difference in drain duration (8218 min vs. 5457 min; p < 0.028) but not in fluid production. Co-axial and standard drains did not differ significantly in drain duration or fluid production in the lobectomy subgroup.
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.
