Efficacy of a 14Fr Blake Drain for Pleural Drainage Following Video-Assisted Thoracic Surgery

비디오 흉강경 수술에 적용된 14Fr Blake Drain의 효능 분석

  • Choi, Jinwook (Department of Thoracic and Cardiovascular Surgery, Ajou Universitiy Hosipital, Ajou University College of Medicine) ;
  • Choi, Ho (Department of Thoracic and Cardiovascular Surgery, Ajou Universitiy Hosipital, Ajou University College of Medicine) ;
  • Lee, Sungsoo (Department of Thoracic and Cardiovascular Surgery, Ajou Universitiy Hosipital, Ajou University College of Medicine) ;
  • Moon, Jonghwan (Department of Thoracic and Cardiovascular Surgery, Ajou Universitiy Hosipital, Ajou University College of Medicine) ;
  • Kim, Jongseok (Department of Thoracic and Cardiovascular Surgery, Ajou Universitiy Hosipital, Ajou University College of Medicine) ;
  • Chung, Sangho (Department of Thoracic and Cardiovascular Surgery, Ajou Universitiy Hosipital, Ajou University College of Medicine) ;
  • An, Hyoungwook (Department of Thoracic and Cardiovascular Surgery, Ajou Universitiy Hosipital, Ajou University College of Medicine)
  • 최진욱 (아주대학교 의과대학 아주대학교병원 흉부외과학교실) ;
  • 최호 (아주대학교 의과대학 아주대학교병원 흉부외과학교실) ;
  • 이성수 (아주대학교 의과대학 아주대학교병원 흉부외과학교실) ;
  • 문종환 (아주대학교 의과대학 아주대학교병원 흉부외과학교실) ;
  • 김종석 (아주대학교 의과대학 아주대학교병원 흉부외과학교실) ;
  • 정상호 (아주대학교 의과대학 아주대학교병원 흉부외과학교실) ;
  • 안형욱 (아주대학교 의과대학 아주대학교병원 흉부외과학교실)
  • Received : 2008.07.29
  • Accepted : 2008.09.16
  • Published : 2009.02.05

Abstract

Background: Pleural drainage following video-assisted thoracic surgery has traditionally been achieved with largebore, semi-rigid chest tubes. Recent trends in thoracic surgery have been toward less invasive approaches for a variety of diseases. The purpose of this study was to evaluate the safety and efficacy of drainage by means of small, soft, and flexible 14Fr Blake drains. Material and Method: Between December 2007 and March 2008, 14Fr silastic Blake drains were used for drainage of the pleural cavity in 37 patients who underwent a variety of video-assisted thoracic surgical procedures at our institution. Result: The average postoperative length of hospital stay was 3.26 days (range, 2~12 days), Blake drains were left in the pleural space for an average of 3.15 days (range, 1~7 days), and the average amount of drainage was 43.8 ml/day. The maximal amount of blood removed daily by a Brake drain was as much as 290 mL. There were no drain-related complications. Blake drains seemed to cause less pain while in place, and particularly at the time of removal. Conclusion: The use of a Blake drain following minor thoracic surgery appeared to be safe and effective in drainage of fluid or air in the pleural space, and were associated with minimal discomfort.

배경: 전통적으로 흉부외과 수술 후 흉강 배액을 위하여 사용하는 흉관은 굵은 원통형이고 측면에 구멍이 뚫린 반강체이다. 최근 흉부외과 영역에서 보다 덜 침습적인 수술이 증가하고 있어 기존의 흉관 대신 국내에서 자가 제작한 작고 부드러운 14Fr Blake drain을 적용하였다. 흉부외과 수술에 기존의 흉관 대신 사용한 Blake drain의 안정성과 효능을 판단하고자 한다. 대상 및 방법: 2007년 12월부터 2008년 3월까지 비디오 흉강경 수술을 받은 37명의 환자를 대상으로 14Fr 실라스틱 Blake drain을 적용하여 유용성을 분석하였다. 결과: 수술 후 재원기간은 평균 3.26일이었으며 흉관 거치기간은 평균 3.15일이었고 수술 후 배액양은 평균 43.8 mL/day였다. 하루 최고 배액양은 290 mL였으며 배액과 관련된 합병증은 관찰되지 않았다. 저자들의 관찰 결과 흉통은 일반적인 흉관보다 적은 것으로 판단되었다. 특히 흉관 제거 시 발생하는 통증이 적었다. 결론 : 흉부외과 영역에 적용된 작은 Blake drain은 흉수 및 공기 배액에 매우 안전하고 효과적이었으며 환자들의 통증을 최소화할 수 있을 것으로 사료된다.

Keywords

References

  1. Lilienthal H. Pulminary resection for bronchiectasis. Ann Surg 1922;75:257-70 https://doi.org/10.1097/00000658-192203000-00001
  2. card P, Chautard J, Zhang X, et al. A single 24F Blake drain after wedge resection or lobectomy: a study on 100 consecutive cases. Eur J Cardiothorac Surg 2006;30:649-51 https://doi.org/10.1016/j.ejcts.2006.06.032
  3. Kerjriwal NK, Newman MA. Use of a single silastic chest drain following thoracotomy: initial evaluation. ANZ J Surg 2005;75:710-2 https://doi.org/10.1111/j.1445-2197.2005.03479.x
  4. Lancey RA, Gaca C, Vander Salm TJ. The use of smaller, more flexible chest drains following open heart surgery. An initial evaluation. Chest 2001;119:19-24 https://doi.org/10.1378/chest.119.1.19
  5. Terzi A, Feil B, Bonadiman C, et al. The use of flexible spiral drains after non-cardiac thoracic surgery. A clinical study. Eur J Cardiothorac Surg 2005;27:134-7 https://doi.org/10.1016/j.ejcts.2004.10.016
  6. Clark G, Licker M, Bertin D, et al. Small size new silastic drains: life-threatening hypovolemic shock after thoracic surgery associated with a non-functioning chest tube. Eur J Cardiothorac Surg 2007;31:566-81 https://doi.org/10.1016/j.ejcts.2006.12.010