eISSN: 1897-4252
ISSN: 1731-5530
Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery
Current issue Archive About the journal Supplements Abstracting and indexing Contact Instructions for authors
SCImago Journal & Country Rank

vol. 10

The implementation of a digital chest drainage system significantly reduces complication rates after lobectomy – a randomized clinical trial

Tomasz Marjański, Adam Sternau, Witold Rzyman

Kardiochirurgia i Torakochirurgia Polska 2013; 10 (2): 133–138
Online publish date: 2013/07/09
View full text
Get citation
JabRef, Mendeley
Papers, Reference Manager, RefWorks, Zotero
Aim of the study: The aim of the study was to evaluate the impact of implementing a digital chest drainage device with regulated suction during postoperative care following a pulmonary lobectomy.

Material and methods: Sixty-four patients who underwent a lobectomy at the Department of Thoracic Surgery of the Medical University of Gdańsk between June 2011 and January 2012 were included in this study. The patients were randomly divided into two groups. During the postoperative period, the patients in the study group received thoracic drainage using digital chest drainage or a conventional glass bottle. The drain was withdrawn when the daily volume did not exceed 350 ml and there was no air leakage for at least 6 hours.

Results: The patients from the study and the control groups did not significantly differ with regard to the following parameters: mean age, physiological test results, presence of concomitant diseases, and surgical access to the chest. During the postoperative period, no significant differences in the drainage duration were found (Thopaz: 4 days, controls: 4 days, p = 0.919). Similarly, the period of hospitalization did not differ significantly. The general complication rate was 37%, with common complications including: atrial fibrillation (19%), atelectasis requiring bronchial aspiration (9%), and prolonged air leak (8%). The complication rate in the Thopaz group was significantly lower (25%) than in the control group (50%) (p = 0.039). There was no mortality in either group during the postoperative period.

Conclusions: Withdrawing the drainage device at the daily volume of 350 ml together with the implementation of a light and compact digital chest drainage kit significantly reduces the complication rates after lobectomy.

lobectomy, pleural drainage, complications

Brunelli A, Beretta E, Cassivi SD, Cerfolio RJ, Detterbeck F, Kiefer T, Miserocchi G, Shrager J, Singhal S, Van Raemdonck D, Varela G. Consensus definitions to promote an evidence-based approach to management of the pleural space. A collaborative proposal by ESTS, AATS, STS, and GTSC. Eur J Cardiothorac Surg 2011; 40: 291-297.
Bryant AS, Cerfolio RJ. The influence of preoperative risk stratification on fast-tracking patients after pulmonary resection. Thorac Surg Clin 2008; 18: 113-118.
Cerfolio RJ, Bryant AS. Results of a prospective algorithm to remove chest tubes after pulmonary resection with high output. J Thorac Cardiovasc Surg 2008; 135: 269-273.
Varela G, Jiménez MF, Novoa NM, Aranda JL. Postoperative chest tube management: measuring air leak using an electronic device decreases variability in the clinical practice. Eur J Cardiothorac Surg 2009; 35: 28-31.
Cerfolio RJ, Bryant AS. The benefits of continuous and digital air leak assessment after elective pulmonary resection: a prospective study. Ann Thorac Surg 2008; 86: 396-401.
Varela G, Brunelli A, Jiménez MF, Di Nunzio L, Novoa N, Aranda JL, Sabbatini A. Chest drainage suction decreases differential pleural pressure after upper lobectomy and has no effect after lower lobectomy. Eur J Cardiothorac Surg 2010; 37: 531-534.
Brunelli A, Charloux A, Bolliger CT, Rocco G, Sculier JP, Varela G, Licker M, Ferguson MK, Faivre-Finn C, Huber RM, Clini EM, Win T, De Ruysscher D, Goldman L. The European Respiratory Society and European Society of Thoracic Surgeons clinical guidelines for evaluating fitness for radical treatment (surgery and chemoradiotherapy) in patients with lung cancer. Eur J Cardiothorac Surg 2009; 36: 181-184.
Marjanski T, Sternau A, Pawlak K, Gasiorowski L, Rzyman W. Conservative drain removal protocol does not favor digital chest drainage after lobectomy: multicenter randomized trial. Interact Cardiovasc Thorac Surg 2011; 13 suppl. 1: S27.
Nakanishi R, Fujino Y, Yamashita T, Oka S. A prospective study of the association between drainage volume within 24 hours after thoracoscopic lobectomy and postoperative morbidity. J Thorac Cardiovasc Surg. 2009; 137: 1394-1399.
Brunelli A, Salati M, Refai M, Di Nuncio L, Xiume F, Sabbatini A. Evaluation of a new chest tube removal protocol using digital air leak monitoring after lobectomy: a prospective randomized trial. Eur J Cardiothorac Surg 2010; 37: 56-60.
Göttgens KW, Siebenga J, Belgers EH, van Huijstee PJ, Bollen EC. Early removal of the chest tube after complete video-assisted thoracoscopic lobectomies. Eur J Cardiothorac Surg 2011; 39: 575-578.
Rzepecki W, Langer J. Chirurgia układu oddechowego. PZWL, Warszawa 1979.
Gosselink R, Bott J, Johnson M, Dean E, Nava S, Norrenberg M, Schonhofer B, Stiller K, van de Leur H, Vincent JL. Physiotherapy for adult patients with critical illness: recommendations of the European Respiratory Society and European Society of Intensive Care Medicine Task Force on Physiotherapy for Critically Ill Patients. Intensive Care Med 2008; 34: 1188-1199.
Kim DK. Postoperative Early Ambulation with Thopaz. Presented at ATCSA, Seoul 25-28th of October 2009.
Quick links
© 2019 Termedia Sp. z o.o. All rights reserved.
Developed by Bentus.
PayU - płatności internetowe