Abstract
BackgroundPrevious randomized controlled trials have compared the efficacy and safety of single chest drain (SCD) and double chest drains (DCD) in the patients undergone pulmonary lobectomy, yet the results remain inconsistent. Therefore, we aimed to conduct this present systematic review and meta-analysis to evaluate the role of SCD and DCD in the patients undergone pulmonary lobectomy.MethodsPubMed, Medline, EMBASE, Cochrane library, Web of Science, China National Knowledge Infrastructure, Wanfang, Weipu, and China Biomedical Literature databases were searched up to February 28, 2020, to identify the potential RCTs on SCD and DCD in the patients undergone pulmonary lobectomy. The main outcomes including verbal pain score, the duration of drainage (days), the length of hospital stay (days), and the incidence of air leak and re-drainage were collected and analyzed. All the data were processed and analyzed with software RevMan 5.3. We calculated and analyzed the odds ratios (OR) for dichotomous outcomes and the mean difference (MD) for continuous outcomes.ResultsA total of 11 RCTs with 1214 patients were included, in which 589 patients received SCD treatment and 625 patients DCD treatment. The verbal pain score (MD = − 0.54, 95%CI (− 0.87, − 0.21)), the duration of drainage (MD = − 0.65, 95%CI (− 1.04, − 0.26)), and the length of hospital stay (MD = − 0.55, 95%CI (− 0.80, − 0.29)) in SCD group were significantly less than that of DCD group. There were no significant differences on the incidence of air leak (OR = 1.35, 95%CI (0.86, 2.11)) and re-drainage (OR = 0.88, 95%CI (0.41, 1.90)) among the two groups.ConclusionsSCD is a safe option, and it has the advantages of less postoperative pain, shortened duration of drain, and reduced length of hospital stay when compared with DCD in the patients undergone pulmonary lobectomy.
Highlights
Previous randomized controlled trials have compared the efficacy and safety of single chest drain (SCD) and double chest drains (DCD) in the patients undergone pulmonary lobectomy, yet the results remain inconsistent
We have conducted a meta-analysis of included randomized controlled trials (RCTs) comparing the effects and safety of SCD and DCD after pulmonary lobectomy, and we have found that the pain level in SCD is much less than that of DCD, and the duration of drainage and hospital stay are much shorter than DCD, and SCD and DCD do not act different role in the incidence of air leak and re-drainage
In conclusion, the results of this present meta-analysis have found that SCD is much better than DCD in reducing the postoperative pain level, shortening the duration of drains, and decreasing the length of hospital stay
Summary
Previous randomized controlled trials have compared the efficacy and safety of single chest drain (SCD) and double chest drains (DCD) in the patients undergone pulmonary lobectomy, yet the results remain inconsistent. We aimed to conduct this present systematic review and meta-analysis to evaluate the role of SCD and DCD in the patients undergone pulmonary lobectomy. Lung cancer is one of the most common malignant tumors with high mortality [1]. Surgery is the main treatment for lung cancer, and closed chest tubes are placed generally for drainage. The purpose of placing closed chest drains after lobectomy is mainly to drain the blood and gas from the chest cavity and prevent regurgitation, to restore the normal negative pressure in the chest cavity, thereby promoting the lung expansion and prevent infections in the chest cavity [3]. The management of chest drains after pulmonary lobectomy is crucial to the prognosis of patients
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