Active or passive chest drainage after oesophagectomy in 101 patients: a prospective randomized study

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Abstract
Background: This study evaluates the efficiency and safety of two methods of chest drainage after uncomplicated oesophagectomy. Methods: A prospective randomized study between active suction drainage and passive chest drainage was carried out in 101 patients who underwent gastric pull-up oesophagectomy. Results: No difference in the prevalence of pneumothorax during treatment was noted between the active (nine of 55) and the passive (four of 46) drainage groups (P=0·20). Nor was there any difference in the size (P=0·46) and duration (P=0·53) of the pneumothorax. There was no significant difference in right (P=0·84) and left (P=0·61) basal atelectases and the amounts of right (P=0·10) and left (P=0·24) pleural effusions. There were significantly more basal atelectases (P<0·001) and pleural effusions (P<0·001) in the non-operated left side compared with the operated right side. Postoperative hospital stay was the same in both groups (median 13 days; P=0·86). The hospital mortality rate was two of 101, and was not affected by the type of drainage. Conclusion: Passive drainage did not reduce hospital stay, but was as safe and effective as the active system in draining the pleural cavity after uncomplicated oesophagectomy.