Postoperative pulmonary complications and thoracocentesis associated with early versus late chest tube removal after thoracic esophagectomy with three-field dissection: a propensity score matching analysis.

Abstract:

PURPOSE:To evaluate the safety of early chest tube removal after thoracic esophagectomy with three-field dissection. METHODS:This prospective cohort study evaluated patients who underwent thoracic esophagectomy with three-field dissection during 2013-2015. Patients were divided into two groups according to whether they underwent early or late chest tube removal. Propensity score matching in a 1:1 ratio was applied. We compared the incidences of postoperative pulmonary complications and thoracocentesis in the two groups. RESULTS:After propensity score matching, 89 patients in each group were analyzed. There was no significant difference between the groups in the incidences of pulmonary complications or thoracocentesis. Significantly more patients achieved first mobilization within 15 h postoperatively in the early removal group (89.8%) than in the late removal group (52%, p < 0.01). Multivariate analysis revealed that early chest tube removal was not a risk factor for pulmonary complications or thoracocentesis. Independent risk factors for pulmonary complications were a history of pulmonary disease (odds ratio: 0.81 [0.63-0.98]; p = 0.02) and neoadjuvant chemotherapy (odds ratio: 0.67 [0.32-0.96]; p = 0.04). CONCLUSION:Early chest tube removal is as safe and feasible as late chest tube removal after thoracic esophagectomy with three-field dissection.

journal_name

Surg Today

journal_title

Surgery today

authors

Sato T,Fujita T,Okada N,Fujiwara H,Kojima T,Hayashi R,Daiko H

doi

10.1007/s00595-018-1694-z

subject

Has Abstract

pub_date

2018-11-01 00:00:00

pages

1020-1030

issue

11

eissn

0941-1291

issn

1436-2813

pii

10.1007/s00595-018-1694-z

journal_volume

48

pub_type

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