This study is a single centre, prospective clinical trial evaluating the safety and feasibility of implementing a same day chest tube removal protocol in patients undergoing Video Assisted Thoracic Surgery (VATS) anatomical pulmonary surgery.
18 yrs or older
scheduled to undergo elective VATS segmental or lobar resection of the lung
Pulmonary function tests demonstrating forced expiratory volume in 1 second Forced Expiratory Volume (FEV1) <50% predicted, FEV1 <1.5L and/or diffusion lung capacity of carbon monoxide Lung Diffusion Test (DLCO) <50% predicted
Patient receives an intraoperative pleurodesis
Conversion to open thoracotomy or mini thoracotomy intraoperatively.
Underlying cognitive disorder resulting in inability to complete activities of daily living.
Crossover
early chest tube removal
Procedure/SurgeryChest tube removal
Rate of successful same day chest tube removal
These patients have chest tube removed if they meet study criteria
EuroQol 5 Dimension 5 Level (EQ5D5L) score
Difference in EQ5D5L scores between standard care and early chest tube removal on POD1 and POD30.
Mean Morphine Equivalents (MME) Post-Operative Day 1 (POD1)
Mean Morphine Equivalents used on post operative day 1
Pleural reintervention
Rate of pleural reintervention (defined as requiring reinsertion of a chest tube or return to the operating room)
Complications
The rates of grade 1 to 5 complications as per the Thoracic Surgery Quality Improvement Canada (TSQIC) will be recorded for up to 30 days after surgery in the divisional thoracic REDCap database.
Chest Tube duration
Duration the patient had chest tubes in situ will be measured by collecting the date and time of arrival to Post anesthesia Care Unit (PACU) and the date and time the chest tube was removed.
Unplanned return
Unplanned returns to clinic or emergency room within the first 30 days after surgery
Length Of Stay
Duration of hospital length of stay
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