TY - JOUR
T1 - Factors in the selection and management of chest tubes after pulmonary lobectomy
T2 - Results of a national survey of thoracic surgeons
AU - Kim, Samuel S.
AU - Khalpey, Zain
AU - Daugherty, Sherry L.
AU - Torabi, Mohammad
AU - Little, Alex G.
N1 - Publisher Copyright:
© 2016 The Society of Thoracic Surgeons.
PY - 2016/3/1
Y1 - 2016/3/1
N2 - Background This study determined patterns of chest tube (CT) selection and management after open lobectomy and minimally invasive lobectomy by thoracic surgeons. Methods Surveys were sent electronically to 5,175 thoracic surgeons, and 475 were completed. Responses, blinded so individuals could not be identified, were analyzed and compared according to surgeon characteristics (academic/private practice, years in practice, lobectomy volume, and geographic region). All indicated differences were statistically significant (p < 0.05 by χ2 tests). Results CT selection: Most surgeons prefer rigid tubes, and the size most commonly used was 28F. Most place 2 CTs after open lobectomy and 1 CT after minimally invasive lobectomy. Academic surgeons are more likely than private surgeons to use 1 tube after open lobectomy, but both prefer 1 tube after minimally invasive lobectomy. Younger surgeons and high-volume surgeons are more likely to use 1 CT than senior surgeons and low-volume surgeons after both open lobectomy and minimally invasive lobectomy. CT management: Academic and younger surgeons remove the CT sooner after open lobectomy. Younger and high-volume surgeons remove the CT with greater drainage amounts. All groups remove CTs sooner after minimally invasive lobectomy than after open lobectomy. Approximately half of surgeons get a daily chest roentgenogram. Younger and low-volume surgeons are most likely to discharge patients with Heimlich valves, although overall use was in less than 5% (49 of 475) of respondents. Most surgeons believe clinical experience rather than training or the literature determined their CT strategy. Conclusions This survey determined the difference in CT management among various groups of surgeons. Clinical experience was the most important factor in determining their CT strategy.
AB - Background This study determined patterns of chest tube (CT) selection and management after open lobectomy and minimally invasive lobectomy by thoracic surgeons. Methods Surveys were sent electronically to 5,175 thoracic surgeons, and 475 were completed. Responses, blinded so individuals could not be identified, were analyzed and compared according to surgeon characteristics (academic/private practice, years in practice, lobectomy volume, and geographic region). All indicated differences were statistically significant (p < 0.05 by χ2 tests). Results CT selection: Most surgeons prefer rigid tubes, and the size most commonly used was 28F. Most place 2 CTs after open lobectomy and 1 CT after minimally invasive lobectomy. Academic surgeons are more likely than private surgeons to use 1 tube after open lobectomy, but both prefer 1 tube after minimally invasive lobectomy. Younger surgeons and high-volume surgeons are more likely to use 1 CT than senior surgeons and low-volume surgeons after both open lobectomy and minimally invasive lobectomy. CT management: Academic and younger surgeons remove the CT sooner after open lobectomy. Younger and high-volume surgeons remove the CT with greater drainage amounts. All groups remove CTs sooner after minimally invasive lobectomy than after open lobectomy. Approximately half of surgeons get a daily chest roentgenogram. Younger and low-volume surgeons are most likely to discharge patients with Heimlich valves, although overall use was in less than 5% (49 of 475) of respondents. Most surgeons believe clinical experience rather than training or the literature determined their CT strategy. Conclusions This survey determined the difference in CT management among various groups of surgeons. Clinical experience was the most important factor in determining their CT strategy.
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U2 - 10.1016/j.athoracsur.2015.09.079
DO - 10.1016/j.athoracsur.2015.09.079
M3 - Article
C2 - 26680313
AN - SCOPUS:84959571386
SN - 0003-4975
VL - 101
SP - 1082
EP - 1088
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
IS - 3
ER -