Comparison of post-operative and pulmonary morbidity due to subxiphoid and midaxillary chest drainage tubes after coronary artery bypass grafting

Abstract

AIM: pain and pulmonary morbidity in patients who underwent coronary artery bypass grafting (CABG) using left internal thoracic artery (LITA) grafting.

MATERIAL AND METHOD: The study was prospective and included 40 patients who underwent elective isolated CABG with pedicled LITA grafts. Patients were divided into two groups according to the method used to place chest drainage tubes. Group 1 (n=20) had the left chest drain tube inserted through the sixth intercostal space along the anterior axillary line (mid-axillary approach), and Group 2 (n=20) had the left chest drain tube inserted through the midline inferior to the xiphoid process (subxiphoid approach). We evaluated the groups in terms of postoperative pain, pulmonary morbidity, amount of chest tube drainage, need for analgesic agents, and length of hospital stay.

RESULTS: In group 1, the pain was significantly higher during mobilization and drain removal (p<0.05) but was similar at rest. In Group 1 and Group 2, pulmonary morbidity rates were statistically similar for pleural effusion (2 vs. 5; p=0.40), atelectasis (2 vs. 5; p=0.40), and pneumothorax after drain removal (1 vs. 0; p=1.00). Two of the patients with pleural effusion in Group 2 underwent thoracentesis. There was no difference between the two groups regarding the amount of chest tube drainage, cumulative doses of an analgesic agent, and length of hospital stay (p>0.05).

CONCLUSION: According to these results, both procedures can be used safely for chest drainage tube placement after CABG.