目的 對比引流管固定器與傳統固定方法在膽道術后患者“ T ”管固定中的效果。 方法 2012年2月－5月，將102例膽道術后留置“ T ”管的患者，按住院號隨機分為試驗組（52例）和對照組（50例），試驗組在傳統固定方法的基礎上加用引流管固定器固定“ T ”管，對照組采用傳統的方法固定“ T ”管，觀察比較兩種固定方法的效果。 結果 試驗組“ T ”管固定良好，無松動和脫落情況發生，僅5例患者存在“ T ”管周圍有疼痛刺激，兩組比較差異有統計學意義（P＜0.05）。 結論 采用引流管固定器固定“ T ”管能防止“ T ”管的松動和脫落，減輕患者“ T ”管周圍的疼痛，且便于醫護人員的觀察和操作，值得臨床推廣使用。
ObjectiveTo explore the effect of mediastinal drainage tube placed after the esophageal cancer resection with intrathoracic anastomosis on postoperative complications such as anastomotic fistula. MethodsLiterature on the application of mediastinal drainage tubes in esophageal cancer surgery published in databases such as PubMed, EMbase, CNKI, China Biomedical Literature Database, VIP, and Wanfang were searched using English or Chinese, from the establishment of the databases to December 31, 2023. The Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of the included retrospective studies, the Cochrane Handbook bias risk tool was used to assess the bias risk of randomized controlled trials (RCT), and Review Manager 5.4 software was used for meta-analysis. ResultsA total of 19 retrospective studies and 8 RCT involving 6320 patients were included, with 3257 patients in the observation group (mediastinal drainage tube+closed thoracic drainage tube) and 3063 patients in the control group (closed thoracic drainage tube or single mediastinal drainage tube). The NOS score of the included literature was≥6 points, and one RCT had a low risk of bias and the other RCT had a moderate risk of bias . Meta-analysis results showed that compared with the control group, the observation group had fewer postoperative lung complications [OR=0.44, 95%CI (0.36, 0.53), P<0.001], fewer postoperative cardiac complications [OR=0.40, 95%CI (0.33, 0.49), P<0.001], earlier average diagnosis time of anastomotic fistula [MD=?3.33, 95%CI (?3.95, ?2.71), P<0.001], lower inflammation indicators [body temperature: MD=?1.15, 95%CI (?1.36, ?0.93), P<0.001; white cell count: MD=?5.62, 95%CI (?7.29, ?3.96), P<0.001], and shorter postoperative hospital stay [MD=?15.13, 95%CI (?18.69, ?11.56), P<0.001]. However, there was no statistically significant difference in the incidence of postoperative anastomotic fistula between the two groups [OR=0.85, 95%CI (0.70, 1.05), P=0.13]. ConclusionPlacing a mediastinal drainage tube cannot reduce the incidence of anastomotic fistula, but it can effectively reduce the incidence of postoperative respiratory and circulatory system complications in patients and improve patients’ prognosis. It can early detect teh anastomotic fistula and fully drain digestive fluid to promote rapid healing of the fistula, alleviate the infection symptoms of postoperative anastomotic fistula, and shorten the hospital stay.
Objective To evaluate the effect of mediastinal drainage tube placed in the left thoracic cavity after partial resection of the mediastinum pleura in robot-assisted McKeown esophagectomy for esophageal carcinoma, and to compare it with the traditional method of mediastinal drainage tube placed in mediastinum. MethodsWe retrospectively analyzed clinical data of 96 patients who underwent robot-assisted McKeown esophagectomy for esophageal carcinoma by the surgeons in the same medical group in our department between July 2018 and March 2021. There were 78 males and 18 females, aged 52-79 years. Left mediastinum pleura around the carcinoma during operation was resected in all patients. Patients were divided into two groups according to the method of mediastinal drainage tube placement: a control group (placed in mediastinum) and an observation group (placed through the mediastinal pleura into the left thoracic cavity with several side ports distributed in the mediastinum). The incidence of left thoracentesis or catheterization after surgery, anastomotic fistula and anastomotic healing time, other complications such as pneumonia and postoperative pain score were also compared between the two groups. Results There was no statistical difference in baseline data or surgical parameters between the two groups. The percentage of patients in the observation group who needed re-thoracentesis or re-catheterization postoperatively due to massive pleural effusion in the left thoracic cavity was significantly lower than that in the control group (5.6% vs. 21.4%, P=0.020). The incidence of anastomotic leakage (3.7% vs. 7.1%, P=0.651) and the healing time of anastomosis (18.56±4.27 d vs. 24.33±5.48 d, P=0.304) were not statistically different between the two groups, and there was no statistical difference in other complications such as pulmonary infection. Moreover, the postoperative pain score was also similar between the two groups. Conclusion For patients whose mediastinal pleura is removed partially during robot-assisted McKeown esophagectomy for esophageal carcinoma, placing the drainage tube through the mediastinal pleura into the left thoracic cavity can reduce the risk of left-side thoracentesis or catheterization, which may promote the postoperative recovery of patients.
ObjectiveTo compare postoperative efficacy of thoracoscopic partial pneumonectomy with or without thoracic drainage tube postoperatively.MethodsThe PubMed, Wanfang database, CNKI and Web of Science from January 2000 to August 2020 were searched by computer to collect randomized controlled studies (RCT), cohort studies and case-control studies on the efficacy of chest drainage tube placement versus no placement after thoracoscopic partial pneumonectomy. Two reviewers independently screened articles and extracted data to evaluate the risk of literature bias. Meta-analysis was performed with RevMan software.ResultsA total of 15 articles were included, including 1 RCT and 14 cohort studies. A total of 1 524 patients were enrolled, including 819 patients in the test group (no postoperative chest drainage tube group) and 705 patients in the control group (postoperative chest drainage tube group). Compared with the control group, the length of hospital stay in the test group was shorter (MD=–1.3, 95%CI –1.23 to –0.17, P<0.000 01) and the incidence of postoperative pneumothorax was higher (RD=0.06, 95%CI 0.01 to 0.10, P=0.01). There was no significant difference between the two groups in operation time (MD=–2.37, 95%CI –7.04 to 2.30, P=0.32), the incidence of postoperative complications (RR=2.43, 95%CI 0.79 to 1.80, P=0.39), the reintervention rate of postoperative complications (RD=0.02, 95%CI=–0.00 to 0.04, P=0.05), postoperative subcutaneous emphysema (RD=0.02, 95%CI –0.01 to 0.06, P=0.20) and the incidence of postoperative pleural effusion (RD=0.04, 95%CI –0.00 to 0.09, P=0.10) .ConclusionCompared with the patients with chest drainage tube placement after thoracoscopic partial pneumonectomy (the control group), the test group can shorten the hospital stay. Although the incidence of postoperative pneumothorax is higher than that of the control group, the operation time, incidence of postoperative subcutaneous emphysema and in-hospital complications, and reintervention rate of in-hospital complications are not statistically significant between the two groups. Therefore no chest drainage tube may be placed after partial pneumonectomy.
ObjectiveTo compare and evaluate the effect and quality of T-tube drainage and bulit-in-tube drainage plus primary suture after laparoscopic cholecystectomy (LC). MethodsA clinical trial was taken in 79 cases with T-tube drainage (control group) and 62 cases with built-in-tube drainage (observation group). The treatment success rate, incidence of complications, bilirubin recovered time, length of stay, recuperation time, and treatment cost were measured and compared between the two groups. ResultsThere were no statistically significant differences between the two groups in treatment success rate, incidences of complications, and bilirubin recovered time of patients （Pgt;0.05）, while length of stay, recuperation time, and treatment cost of patients in observation group were significantly less than those in control group （Plt;0.05）. ConclusionsBuilt-in-tube drainage plus primary suture after LC and common bile duct exploration could achieve the same therapeutic effect as the traditional T-tube drainage with less length of stay, recuperation time, and treatment cost.
