Cardiovascular Surgery and Interventions 2024, Vol 11, Num 2 Page(s):
Investigation of effects of different drain materials on postoperative pleural complications and pain in off-pump surgery

Ferhat Borulu1, Kaptanıderya Tayfur1, Yusuf Velioğlu2

1Department of Cardiovascular Surgery, Ordu University Faculty of Medicine, Ordu, Türkiye
2Department of Cardiovascular Surgery, Bursa City Hospital, Bursa, Türkiye

Keywords: Beating heart, chest tube, Jackson-Pratt drain, pain
Objectives: This study aimed to investigate whether the need for thoracic tubes placed in the intercostal space, which cause severe pain in the postoperative period and significant problems in pulmonary rehabilitation, could be eliminated by Jackson-Pratt drains placed in the mediastinum in patients who undergo off-pump surgery.

Patients and methods: A prospective analysis of 129 patients (100 males, 29 females; mean age: 62.9±8.5 range, 44 to 82) who underwent routine off-pump isolated coronary artery bypass grafting surgery between January 2018 and December 2018 was performed. The number of patients who had subxiphoid mediastinal drainage and one mediastinal Jackson-Pratt drainage was 64 (Group 1), and the number of patients who had subxiphoid mediastinal drainage and intercostal chest drainage was 65 (Group 2). Postoperative pain scores, analgesic needs of patients, and radiological effusion and pneumothorax assessments were recorded, and pleural complications requiring invasive intervention were compared.

Results: There was no difference between the groups in terms of age, sex, and comorbidities. There was a significant superiority in Group 2 in terms of pain scoring in the first hour after extubation and the need for analgesia in all follow-up periods (p<0.001). In two (3.12%) patients in Group 1 and in two (3.07%) patients in Group 2, pleural effusion requiring intervention was detected. There was no significant difference between the two groups in terms of effusion pneumothorax, in terms of blood transfusion, and other postoperative complications. Postoperative whole blood replacement was higher in Group 2 (p=0.002).

Conclusion: In off-pump heart surgery patient groups that do not have a high risk of bleeding, follow-up can be done without inserting an intercostal chest tube as a result of good bleeding control.

DOI : 10.5606/e-cvsi.2024.1597