TY - JOUR
T1 - Digital Drainage System Reduces Hospitalization After Video-Assisted Thoracoscopic Surgery Lung Resection
AU - Miller, Daniel L.
AU - Helms, Gerald A.
AU - Mayfield, William R.
N1 - Publisher Copyright:
© 2016 The Society of Thoracic Surgeons
PY - 2016/9/1
Y1 - 2016/9/1
N2 - Background The purpose of this study was to assess the efficacy of a digital versus traditional drainage system on hospitalization for patients undergoing video-assisted thoracoscopic surgery (VATS) anatomic lung resection. Methods Consecutive patients who underwent VATS anatomic lung resection (July 2014 through January 2015) for lung cancer were analyzed. Patients were managed with overnight suction (−20 cm H2O) followed by gravity drainage (water seal or −8 cm H2O) in both the traditional and digital drainage systems, respectively; the digital system also allowed for continuous monitoring of air leaks. Chest tubes were removed when the air leak was absent for 12 hours and pleural drainage was less than 300 mL/24 h; patient outcomes selected by propensity matching were compared. Results The VATS lung resections (lobectomy or segmentectomy) were performed in 108 patients during the 7-month study period. The pleural cavity was drained with the traditional system in 75 patients and with the digital system in 33 patients. By propensity score matching at a 2:1 ratio, 40 patients were placed in the traditional group and 20 patients, in the digital group for analysis. Demographics, percent predicted forced expiratory volume in 1 second, tumor size, stage, and type of resection were similar between the groups. The majority of patients (85%) underwent a lobectomy. There were no operative deaths. Overall complications were fewer in the digital system group (22%) compared with the traditional system group (35%; p = 0.01). Median air leak days (−1.1), chest tube days (−1.6), and total hospital stay (−1.5) were significantly reduced in the digital drainage system group. Conclusions Patients undergoing VATS lung resections who were managed postoperatively with a digital drainage system experienced less morbidity and decreased hospitalization. A digital drainage system appears to be a safe alternative for management of the pleural cavity after VATS anatomic lung resection.
AB - Background The purpose of this study was to assess the efficacy of a digital versus traditional drainage system on hospitalization for patients undergoing video-assisted thoracoscopic surgery (VATS) anatomic lung resection. Methods Consecutive patients who underwent VATS anatomic lung resection (July 2014 through January 2015) for lung cancer were analyzed. Patients were managed with overnight suction (−20 cm H2O) followed by gravity drainage (water seal or −8 cm H2O) in both the traditional and digital drainage systems, respectively; the digital system also allowed for continuous monitoring of air leaks. Chest tubes were removed when the air leak was absent for 12 hours and pleural drainage was less than 300 mL/24 h; patient outcomes selected by propensity matching were compared. Results The VATS lung resections (lobectomy or segmentectomy) were performed in 108 patients during the 7-month study period. The pleural cavity was drained with the traditional system in 75 patients and with the digital system in 33 patients. By propensity score matching at a 2:1 ratio, 40 patients were placed in the traditional group and 20 patients, in the digital group for analysis. Demographics, percent predicted forced expiratory volume in 1 second, tumor size, stage, and type of resection were similar between the groups. The majority of patients (85%) underwent a lobectomy. There were no operative deaths. Overall complications were fewer in the digital system group (22%) compared with the traditional system group (35%; p = 0.01). Median air leak days (−1.1), chest tube days (−1.6), and total hospital stay (−1.5) were significantly reduced in the digital drainage system group. Conclusions Patients undergoing VATS lung resections who were managed postoperatively with a digital drainage system experienced less morbidity and decreased hospitalization. A digital drainage system appears to be a safe alternative for management of the pleural cavity after VATS anatomic lung resection.
UR - http://www.scopus.com/inward/record.url?scp=84973438932&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84973438932&partnerID=8YFLogxK
U2 - 10.1016/j.athoracsur.2016.03.089
DO - 10.1016/j.athoracsur.2016.03.089
M3 - Article
C2 - 27234573
AN - SCOPUS:84973438932
SN - 0003-4975
VL - 102
SP - 955
EP - 961
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
IS - 3
ER -
