Original articleGeneral thoracicAlternate Suction Reduces Prolonged Air Leak After Pulmonary Lobectomy: A Randomized Comparison Versus Water Seal
Section snippets
Patients and Methods
One hundred and ninety-four patients underwent pulmonary lobectomy or bilobectomy for nonsmall-cell carcinoma (NSCLC) at our institution from April 2003 through December 2004 and were enrolled in the study after informed consent. The local ethical committee of the hospital approved this study.
Patients underwent chest wall resection, and bronchoplastic procedures were excluded from the analysis. Resectability was evaluated by means of computed tomography (CT) scan, bronchoscopy, and when
Results
Table 1 shows that the two groups were evenly matched for preoperative and operative variables. Two patients in the water seal group and 4 patients in the alternate suction group received preoperative systemic steroids.
As shown in Table 2, the alternate suction group had a reduced presence of PAL (p = 0.02), less days required for chest tubes removal (p = 0.002) and shorter length of postoperative hospital stay (p = 0.004). In group 2, only 8 patients had an air leak lasting more than 4 days
Comment
The objective of the present study was to compare a combined modality of chest tube management (water seal during the day and suction overnight) to water seal alone in a randomized group of patients submitted to lobectomy.
This study was prompted by the results of our previous analysis [4] that showed that water seal was not superior to continuous suction in reducing air leak after lobectomy. Nevertheless, in that study, we showed that water seal was safe and well tolerated by the patients, as
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