Method of bilateral pleural drainage by single Blake drain after esophagectomy.

Abstract

Clinicians often encounter left pleural effusion after esophagectomy, which sometimes necessitates thoracentesis. We have introduced a new drainage method, bilateral pleural drainage by single Blake drain (BDSD), which we have been using since April 2013. This study aims to evaluate the performance of the BDSD. The BDSD method employs a 15-F Blake drain inserted from the right thoracic cavity to the left thoracic cavity across the posterior mediastinum. The conventional drain (CD) group consisted of 50 patients with a 19-F Blake drain placed in the right thoracic cavity during the period from April 2012 to March 2013. The BDSD group consisted of 54 patients treated from April 2013 to June 2014. The amount of total drainage in the BDSD group was significantly higher than that in the CD group (P < 0.0001). The rates of left pleural effusion and left lower lobe atelectasis in the BDSD group were significantly lower than those in the CD group (P < 0.0001 and P < 0.0001, respectively). No patients developed a left pleural effusion necessitating thoracentesis drainage in the BDSD group. Compared with the conventional method, BDSD was able to evacuate bilateral pleural effusion more effectively, and the incidences of left pleural effusion and left atelectasis were lower. This method is therefore clinically useful after esophagectomy.