Risk factors influencing the pleural drainage volume after transthoracic oesophagectomy

OBJECTIVES The objective of this study was to clarify the factors influencing pleural drainage volume after transthoracic oesophagectomy and to determine criteria for the selection of patients who would benefit from the early removal of chest drains. METHODS Clinicopathological characteristics of 15...

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Published in:European journal of cardio-thoracic surgery 2013-06, Vol.43 (6), p.1116-1120
Main Authors: Kosugi, Shin-ichi, Kanda, Tatsuo, Yajima, Kazuhito, Ishikawa, Takashi, Sakamoto, Kaoru
Format: Article
Language:English
Subjects:
Aged
Case-Control Studies
Drainage - methods
Esophageal Neoplasms - surgery
Esophagectomy - adverse effects
Female
Humans
Logistic Models
Male
Middle Aged
Odds Ratio
Pleural Effusion - etiology
Pleural Effusion - pathology
Pleural Effusion - surgery
Postoperative Complications - etiology
Postoperative Complications - pathology
Risk Factors
Treatment Outcome
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Summary:OBJECTIVES The objective of this study was to clarify the factors influencing pleural drainage volume after transthoracic oesophagectomy and to determine criteria for the selection of patients who would benefit from the early removal of chest drains. METHODS Clinicopathological characteristics of 155 patients who underwent transthoracic oesophagectomy were prospectively collected, and the daily drainage volume of each patient was retrospectively reviewed. Potential risk factors were compared between the high-output group (n = 39) and low-output group (n = 116), which were dichotomized using the 75th percentile of total pleural drainage volume of the total study population. Multivariate logistic regression analyses were used to identify independent risk factors. RESULTS The median duration of drainage was 10 days, with a median total drainage volume of 2258 ml. Of 27 potential risk factors influencing the drainage volume, creatinine clearance (P = 0.04), operative approach (P = 0.03) and thoracic duct removal (P = 0.01) were significantly associated with the total pleural drainage volume. The removal of the thoracic duct (P = 0.02; odds ratio, 4.02; 95% confidence interval 1.20-13.41) and lower creatinine clearance (P = 0.04; odds ratio, 1.02; 95% confidence interval 1.00-1.04) was independent risk factors for increased pleural drainage volume after transthoracic oesophagectomy. CONCLUSIONS The early removal of chest drains may be possible in patients without these risk factors.
ISSN:1010-7940
1873-734X
DOI:10.1093/ejcts/ezs556