Respiratory investigation · 2025
Efficacy of chest tube clamping prior to removal in patients with pneumothorax.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Shimoda Masafumi, Tanaka Yoshiaki, Morimoto Kozo, Yanagawa Ryo, Yoshimori Kozo, Kudoh Shoji
Аннотация
BACKGROUND: Pneumothorax often requires chest drain insertion, and a clamping test is sometimes performed before removal to minimize lung re-collapse. However, evidence supporting its utility remains limited. This study evaluated the utility of the clamping procedure and identified risk factors associated with lung re-collapse.
METHODS: We retrospectively analyzed 440 patients with pneumothorax treated at Fukujuji Hospital from January 2016 to April 2025. The primary outcome was the frequency of lung re-collapse during the clamping test. To identify associated risk factors, patients who experienced re-collapse during the test (re-collapse group) were compared with those who completed the test successfully (success group). Patients who did not undergo clamping (nonclamping group) were also reviewed.
RESULTS: Among 440 patients, 355 underwent clamping, including 41 (11.5 %) in the re-collapse group. Incomplete lung expansion (61.0 % vs. 29.9 %, p < 0.001), the presence of lung fluctuations (82.9 % vs. 43.0 %, p < 0.001) before clamping, and a history of smoking (85.4 % vs. 65.1 %, p = 0.008) were significantly more common in the re-collapse group than in the success group. The relapse rates were 45.2 % among patients with all risk factors, 12.7 % among those with two risk factors, 3.5 % among those with one risk factor, and 2.6 % among those with none. Similar trends were observed in analyses including the nonclamping group.
CONCLUSION: The clamping test helped avoid chest tube reinsertion in 11.5 % of the patients. Incomplete lung expansion, fluctuations prior to clamping, and a history of smoking were identified as risk factors for re-collapse, suggesting their potential utility in guiding the need for clamping.
METHODS: We retrospectively analyzed 440 patients with pneumothorax treated at Fukujuji Hospital from January 2016 to April 2025. The primary outcome was the frequency of lung re-collapse during the clamping test. To identify associated risk factors, patients who experienced re-collapse during the test (re-collapse group) were compared with those who completed the test successfully (success group). Patients who did not undergo clamping (nonclamping group) were also reviewed.
RESULTS: Among 440 patients, 355 underwent clamping, including 41 (11.5 %) in the re-collapse group. Incomplete lung expansion (61.0 % vs. 29.9 %, p < 0.001), the presence of lung fluctuations (82.9 % vs. 43.0 %, p < 0.001) before clamping, and a history of smoking (85.4 % vs. 65.1 %, p = 0.008) were significantly more common in the re-collapse group than in the success group. The relapse rates were 45.2 % among patients with all risk factors, 12.7 % among those with two risk factors, 3.5 % among those with one risk factor, and 2.6 % among those with none. Similar trends were observed in analyses including the nonclamping group.
CONCLUSION: The clamping test helped avoid chest tube reinsertion in 11.5 % of the patients. Incomplete lung expansion, fluctuations prior to clamping, and a history of smoking were identified as risk factors for re-collapse, suggesting their potential utility in guiding the need for clamping.