Clinical experience and complications with limited pleural dissection combined with a novel, simplified technique for thoracic Redon-like drain in vertebral body tethering

Spine Deformity, vol. 12, pp. 165–171

Abstract

PURPOSE: To report on our experience with a simplified, suction-bottle-drain technique of thoracic drain (Redon-like) combined with fully thoracoscopic vertebral body tethering (VBT) and a limited pleural approach, with particular focus on the rate of pulmonary complications. METHODS: A retrospective study was performed on all consecutive patients who underwent VBT for adolescent idiopathic scoliosis. For all subjects, a 10G Redon drain, an active drain system consisting of a perforated tube and a suction bottle, was placed intrathoracically and tunneled under the skin. All drains were removed on the first postoperative day. Perioperative and postoperative data such as type of access, length of surgery, amount of fluid collection in the drain, and length of hospital stay were collected. The type and number of pulmonary complications occurring in the first 3 months after surgery, along with their symptoms and management, were recorded. RESULTS: One Hundred eighty-two patients were included in the analysis. The mean length of surgery was 97 min (75-120). The average fluid collection in the drain was 30 ml (5-50), the mean length of hospital stay was 3 days (2-4). During the observation period, pulmonary complications occurred in five patients (2%). Two patients presented an aseptic right pleural effusion; for two patients, a residual pneumothorax was diagnosed on the X-rays in the recovery room and one patient developed a chylothorax. All patients recovered without sequelae. CONCLUSION: The simplified, Redon-like drain combined with a fully thoracoscopic VBT and limited pleural approach seems a safe and effective alternative to the chest drain. This technique allows to remove the drain on the first postoperative day, thus simplifying the management of the patients and improving their comfort.

Authors 5

1. Aurélien Courvoisier

   Centre National de la Recherche Scientifique · Université Grenoble Alpes · Institut polytechnique de Grenoble · Translational Innovation in Medicine and Complexity

   Affiliation as printed

   Grenoble Alps Scoliosis and Spine Center, Grenoble Alps University Hospital, Bvd de la Chantourne, CEDEX 09, 38043, Grenoble, France

   TIMC, University Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, CHU Grenoble Alpes, 38000, Grenoble, France

2. Marie-Christine Maximin
   Affiliation as printed

   Grenoble Alps Scoliosis and Spine Center, Grenoble Alps University Hospital, Bvd de la Chantourne, CEDEX 09, 38043, Grenoble, France

3. Richard Gouron

   Centre Hospitalier Universitaire Amiens-Picardie · Université de Picardie Jules Verne

   Affiliation as printed

   Service d'Orthopédie Pédiatrique, CHU d'Amiens, Université Picardie Jules Verne, Chemin du Thil-CS 52501, 80025, Amiens Cedex 1, France

4. Jean‐Noël Evain

   Centre National de la Recherche Scientifique · Université Grenoble Alpes · Institut polytechnique de Grenoble · Centre Hospitalier Universitaire de Grenoble · Translational Innovation in Medicine and Complexity

   Affiliation as printed

   Pediatric Anesthesia Department, Grenoble Alps University Hospital, Bvd de la Chantourne, CEDEX 09, 38043, Grenoble, France

   TIMC, University Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, CHU Grenoble Alpes, 38000, Grenoble, France

5. Alice Baroncini corresponding Aachen Department of Orthopaedics

   RWTH Aachen University · Universitätsklinikum Aachen

   Affiliation as printed

   Department of Orthopaedics, RWTH Uniklinik Aachen, Pauwelsstraße 30, 52074, Aachen, Germany. Alice.baroncini@gmail.com

   Department of Orthopaedics, RWTH Uniklinik Aachen, Pauwelsstraße 30, 52074, Aachen, Germany