P3.16-47 Analysis of The Novel Chest Tube (Coaxial Drain) for Lung Cancer Surgery

Abstract

The chest tube following a thoracic surgery must immediately read a sign of the postoperative abnormal findings and should be safe and effective in draining both air and fluid. The purpose here is to elucidate the efficacy of the novel chest tube (Coaxial Drain) after anatomical pulmonary resection in patients with lung malignant tumor. At first, we analyzed the evacuation of air of various chest tubes (TC: Thoracic Catheter, BD: Blake drain, CD: COAXIAL DRAIN). We measured the maximum pressure and the time required for pressure to reduce under 0.2hPa. Additionally, we verified fluid emission amount and evacuation site of various chest tubes. Next, a clinical trial was performed. This study included patients who underwent anatomical pulmonary resection and mediastinal lymph node dissection for lung malignant tumor between September 2017 and April 2018. One chest tube (２4Fr.TC or ２4Fr.CD) was positioned apically and posteriorly after surgery. We reviewed the postoperative pain, the amount of chest tube drainage and the presence of subcutaneous emphysema. Pain intensity was evaluated by using The Prince Henry Hospital pain scale (PHPS), and satisfaction scores were evaluated by numeric rating scores (NRS). The decompression time of TC was the shortest and its time of CD was shorter than BD (BD>CD>TC). The fluid emission amount increased in proportion to the cross-section area of a drain (CD＞TC＞BD). All cases found no severe pain in this clinical study. There were no significant differences of pain scale between the TC group and the CD group (PHPS; p=0.83, NSR; p=0.78). No significant difference was observed in total drainage and duration of drainage both the groups. Subcutaneous emphysema occurred in 4 of 8 TC patients and 4 of 20 CD patients, indicating no significant difference between the two groups (p=0.172). There were no complications in any patient. All patients recovered and were discharged home. Moreover, all the cases in which Coaxial Drains were used obtained good wound healing at the drain insertion site. When air leakage occurs, air evacuation with the only BD or TC tends to be insufficient, irrespective of suction conditions. Coaxial Drains have both air inner lumen and liquid duct channels for drainage capability. Therefore, we think Coaxial Drains provide proper drainage of both airs and fluid after pulmonary resection.