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Live Event Content
BOB Ped Surg 2023 - Jamie Schnuck, PAPS - Presentation
With Dr. Jamie Schnuck
Chapter 1 of 4 · Fundamentals
Background
Introduction and Background on Chest Tube Practice
Expert statements on this page
No expert statements were drawn from this page.
Host summaries · secondary, not cited in answers
Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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What the experts said
Pleural drainage is nearly universally practiced in pediatric patients following lung resection
Chest tube placement is often associated with increased pain, anxiety, subjecting patients to additional chest X-rays and may prolong hospitalizations
130 procedures at one academic children's hospital met inclusion criteria for the study
In lobectomy patients (n=59), nearly 75% did not have an air leak noted post-operatively
Median chest tube duration in lobectomy patients was two days regardless of air leak presence
In diagnostic wedge resection patients (n=19), nearly 90% did not have an air leak noted post-operatively
Median chest tube duration in diagnostic wedge resection patients was one day
In diagnostic wedge resection patients with documented air leak, the leak lasted only one day and chest tubes were removed on post-op day two
In excisional wedge resection patients (n=52), 80% did not have an air leak noted post-operatively
Median chest tube duration in excisional wedge resection patients was one day
In excisional wedge resection patients with air leak (n=10), median chest tube duration was two days
Overall, 43% of patients had their chest tube removed on post-op day one
22% of patients had their chest tube removed on post-op day two
A quarter of patients had their chest tube left in place for a documented air leak
35% of patients had their chest tube removed on post-op day three or later
Chest tube duration following lung resection in children is typically brief with removal within one to two days post-operatively
Avoidance of chest tube placement may reduce post-operative pain and hospital length of stay
In adult literature, elimination of routine chest tubes is part of enhanced recovery after surgery (ERAS) pathways in select patients