Serdar BEDİRHANOĞLU, Ezhar ERSÖZ
Anatolian Current Medical Journal - 2026;8(6):1107-1114
Aims: The aim was to evaluate the effects of posterior mediastinal drain (PMD) use on the early postoperative recovery process following cardiac surgery. Methods: A total 105 patients (84 CABG, 11 MVR, 10 AVR) were included. Patients were grouped by PMD presence (PMD (+), n=70; PMD (-), n=35) and drain type (no drain, silicone straight drain, PVC hemovac drain). Patients' demographic characteristics, operative findings, and early postoperative outcomes (pericardial effusion volume, intensive care unit (ICU) stay, and hospital length of stay) were systematically recorded. Perioperative changes in hematocrit, platelet, creatinine (Cr), and BUN were analyzed. Results: A significant increase in postoperative pericardial fluid volume was observed in the group without PMD (0.88+/-0.30 cm vs. 0.36+/-0.13 cm, p<0.001). The length of hospital stay was longer in the group without (7.0+/-1.0 days vs. 7.0+/-1.25 days, p=0.016). Although preoperative renal function was similar, postoperative Cr (0.97+/-0.38 vs. 0.93+/-0.25 mg/dl, p=0.044) and BUN (47.30+/-14.00 vs. 38.52+/-10.60 mg/dl, p<0.001) were higher in patients without PMD. DeltaCr and DeltaBUN were also significantly greater in the PMD-negative group (both p<0.001). No significant differences in pericardial effusion were observed between drain types (p=0.832). Spearman correlation analysis showed a positive association between postoperative pericardial effusion and BUN (rho=0.619, p<0.001) as well as hospital length of stay (rho=0.220, p=0.024). Conclusion: Posterior mediastinal drainage reduces early postoperative pericardial effusion, limits renal function deterioration, and shortens hospital stay after cardiac surgery. Drain presence, rather than type, appears to be the key factor in reducing postoperative morbidity. Routine use of PMD, particularly in high-risk patients, may improve clinical outcomes.
