Comparison of chest drainage tube types (24Fr silastic vs. thoracic catheter) after lung resection

Background: Silastic drains (SDs) are widely used for postoperative chest drainage. We performed a direct comparison of SDs and conventional single-lumen thoracic catheters (TCs) with similar sizes.Methods: We performed a historically controlled retrospective study. SDs (24 Fr in size) were used for postoperative drainage from September 2017 to May 2018, and TCs (24 or 28Fr) were used from June 2018 to March 2019. Drainage tubes were maintained with a water seal alone. A comparison was performed of the volume and the speed of fluid until 48 hrs after surgery, the undrained area on chest X-ray, expansion of subcutaneous emphysema, and the duration of drainage.Results: One hundred fifty-eight patients with SDs and one hundred fifty-five patients with TCs were included. The patient characteristics were equivalent between the groups. The median length of drainage was two days for both groups. The fluid drainage speed was similar between the groups. While the incidence of expansion of subcutaneous emphysema was equivalent for both groups, reinsertion of drainage tubes was more frequent in the SD group due to insufficient air drainage.Conclusions: SDs and TCs have almost equivalent drainage performances. For patients with a risk of massive air leakage, SDs should be avoided.