Analysis of advantages and disadvantages of indwelling fine drainage tube after thoracoscopic surgery in internal medicine

Objective To investigate the indications, safety, and advantages and disadvantages of indwelling ultra-fine drainage tube after thoracoscopic surgery. Methods A retrospective analysis of 165 cases of inpatients with pleural disease, treated by thoracoscopic surgery, from January 2008 to May 2017 in the Department of Respiratory Medicine, Beijing Tiantan Hospital.Among them, 143 patients received central venous catheter drainage after thoracoscopic surgery, and 22 patients underwent conventional drainage tube drainage after thoracoscopic surgery.According to the volume of gas and fluid needed to be drained after thoracoscopic surgery, different drainage tubes and different drainage devices were imbedded, which could be divided into four groups: indwelling central venous catheter connected to the drainage bag; indwelling central venous catheter not connected to the drainage bag; indwelling central venous catheter connected to the water-sealed bottle; thoracoscopic incision was indwelled with a thick tube connected to the water-sealed bottle.The comparison between the thick tube group and the thin tube group are made from the following aspects: drainage time, total drainage volume, postoperative pain complaint rate, postoperative analgesic drug use rate, drainage port infection rate, the healing time of drainageopening, and postoperative complications incidence, reinsertion rate.Summarize the indications, advantages and value of indwelling superfine drainage tube after thoracoscopic surgery. Results There showed no significant difference in drainage time and re-insertion rate between indwelling conventional drainage tube and indwelling ultra-fine drainage tube.The drainage pain rate, analgesic drug use rate and drainage mouth infection rate were significantly increased in patients with crude drainage tube.The healing time was long and the complication rate was high. Conclusions Drainage pain rate, analgesic drug use rate, and drainage port infection rate are significantly reduced in patients with fine drainage tube.Drainage port healing time is short.Different drainage devices could be connected to according to the specific conditions of patient′s postoperative drainage volume of gas and fluid.If the patient′s condition permits, catheter drainage is preferred.For patients with purulent pleural effusion, or empyema, a thick tube connected to the water-sealed bottle is better after thoracoscopic surgery and continue drainage with pressure.For elderly patients with chronic obstructive pulmonary disease and pulmonary infection and patients with spontaneous pneumothorax, a thick tube connected to the water-sealed bottle and continue drainage with pressure is better. Key words: Medical thoracoscopy; Thoracic drainage; Drainage tube