Complications related directly to drains were reported by 3 studies (n = 59).Īvailable evidence on the impact of thoracic drainage after oesophagectomy is limited, but has the potential to negatively affect outcomes. Drain removal criteria by daily drainage volumes of up to 300 mL did not impact subsequent effusion rates (2 studies, n = 130). Narrow calibre Blake drains may effectively drain both air and fluid (2 studies, n = 163).

Amylase levels may aid diagnosis of anastomotic leak (9 studies, n = 888). Studies that examined the number of drains showed pain reduction with a single drain compared to multiple drains (3 studies, n = 103), and transhiatal placement compared to intercostal (6 studies, n = 425).

Methodological quality was assessed with Newcastle-Ottawa and Jadad scores.Īmong 434 potentially relevant studies, 27 studies met the inclusion criteria and these included 2564 patients. Studies were collated into domains based on variations in number, position, type, removal criteria, diagnostic use and complications of drains. Studies reporting outcomes for different types or uses of thoracic drainage, or outcomes related to drains after trans-thoracic oesophagectomy were included. This review aimed to assess the evidence for, and how best to use chest drains after oesophageal surgery.Ī systematic literature search was performed in Medline, Embase and Cochrane collaboration databases. After oesophagectomy, however, drains are still routinely placed. Modern enhanced recovery protocols discourage drain use due to negative impacts on patient comfort, mobility, and recovery, and lack of proven clinical benefit.

University of st. thomas calibre press