胸腔鏡下縦隔腫瘍手術後の胸腔ドレーンは不要である

Chest Tube is Unnecessary after Video-assisted Thoracoscopic Mediastinal Tumor Resection

胸腔鏡下縦隔腫瘍手術では開胸手術と比較して疼痛や在院日数が少ないと報告されている1）．しかしながら，胸腔ドレーンを留置すると術後疼痛が増悪して早期離床を妨げられ，生活の質（QOL）は低下するうえ，創部感染のリスクが上がり，管理面でも医療コストや手間が増加する2～5）．

Of the 64 patients who underwent surgery for mediastinal tumors at our department from April 2019 to December 2022, 59 patients （92.2％） underwent video-assisted thoracic surgery （VATS）. Among the patients who underwent open surgery, 5 patients underwent median sternotomy and 1 patient underwent posterolateral thoracotomy. We usually perform 3-port VATS for mediastinal tumors. After surgery, patients are allowed to drink water after awakening from anesthesia, and they can have dinner on the day. If no lung resection is performed, we use a Nélaton catheter to remove air from the thoracic cavity and do not place a chest tube, and none had a chest tube insertion after surgery. As a result, postoperative pain was minimal, early ambulation was possible, and hospital stay was shortened.