Single chest tube superior to double chest tube after decortication in trauma or TB patients

It is already known that draining the chest cavity with two tubes is commonly practised among thoracic surgeons.

Researchers from the Department of Surgery, Tikur Anbessa Specialized Hospital (Addis Ababa University), Ethiopia, investigated the superiority of single-tube or double-tube insertion following decortication (March 2021 - May 2022).

The study summary is as follows:

• There were 62 patients aged 18-70 years, and a mean age of 44 years was included in the study having a male-to-female ratio of 2.9:1.
• There were two groups: A and B.
• Two tubes were inserted in Group A, while single tube 32F was inserted in Group B.
• Researchers used SPSS V.27, student’s t-test and Pearson chi-square test for statistics.
• TB and trauma were the dominant underlying pathologies constituting 45.2% vs 35.5%.
• The right side was involved more constituting 62.3%.
• Drain output in Group A and B was 1465ml ± 1887.9751 and 1018ml ± 802.5662, respectively, with significant p values.
• The duration of drains in Group A and B was 7.5498 ± 11.3137 days and 3.8730 ± 1.4142 days, respectively.
• Group A and B had a degree of pain of 2.6458 ± 4.2426 and 2.000 ± 2.1213, respectively.
• The length of hospital stay was 21.5818 ± 11.9791 days vs 13.6091 ± 6.2048 days in Group A and B, respectively.
• The air leak in Group A and B was 90.3% vs 74.2%, respectively.
• Group A had 9.7 % subcutaneous emphysema, while Group B had 12.9%.
• No fluid recollection and no patients required a reinsertion tube.

The researchers wrote, “The single tube placement after decortication effectively reduces drain output. The time of drain is comparatively shorter time with a reduced hospital stay. There was no association of pain. No effect on other endpoints."

Further reading:

Hart, Jonathan Minagogo BSc, MD, MLCPS1; Mohammed, Anwar Hussien MD2; Tesfaye, Samuel MD3; Nadamo, Siyasebew Mamo MD4; Feyissa, Mekonnen Senbu MD5; Fekadu, Desalegn Wadaja MD5; Tadesse, Isreal Bacha MD1; Gebeyehu, Hiwot Tebeje MD1. Effectiveness of Single Chest Tube vs Double Chest Tube Application Post Decortication: Prospective Randomized Controlled Study. Journal of the American College of Surgeons ():e000661, February 20, 2023. | DOI: 10.1097/XCS.0000000000000661