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Postoperative management using a digital drainage system for massive air leakage after pulmonary resection

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Abstract

Purpose

To elucidate clinical outcomes using a digital drainage system (DDS) for massive air leakage (MAL) after pulmonary resection.

Methods

A total of 135 consecutive patients with pulmonary resection air leakage of > 100 ml/min on the DDS were evaluated retrospectively. In this study, MAL was defined as ≥ 1000 ml/min on the DDS. We analyzed the clinical characteristics and surgical outcomes of patients with MAL compared with non-MAL (101–999 ml/min). Using the DDS data, the duration of the air leak was plotted with the Kaplan‒Meier method and compared using the log-rank test.

Results

MAL was detected in 19 (14%) patients. The proportions of heavy smokers (P = 0.04) and patients with emphysematous lung (P = 0.03) and interstitial lung disease (P < 0.01) were higher in the MAL group than in the non-MAL group. The MAL group had a higher persistence rate of air leakage at 120 h after surgery than the non-MAL group (P < 0.01) and required significantly more frequent pleurodesis (P < 0.01). Drainage failure occurred in 2 (11%) and 5 (4%) patients from the MAL and non-MAL groups, respectively. Neither reoperation nor 30-day surgical mortality was observed in patients with MAL.

Conclusions

MAL was able to be treated conservatively without surgery using the DDS.

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Authors and Affiliations

  1. Department of General Thoracic Surgery, Juntendo University School of Medicine, 3-1-3, Hongo, Bunkyo-ku, Tokyo, 113-8431, Japan

    Takuya Ueda, Kazuya Takamochi, Aritoshi Hattori, Mariko Fukui, Takeshi Matsunaga & Kenji Suzuki

Authors
  1. Takuya Ueda
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  2. Kazuya Takamochi
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  3. Aritoshi Hattori
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  4. Mariko Fukui
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  5. Takeshi Matsunaga
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  6. Kenji Suzuki
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Contributions

TU contributed to the design and coordination of the study, conducted research, prepared the manuscript, and read and approved the final version of the manuscript. KT and AH contributed to the design and coordination of the study, revised the manuscript for important intellectual content, and read and approved the final version. MF, TM, and KS contributed to the preparation of the manuscript and read and approved the final version.

Corresponding author

Correspondence to Takuya Ueda.

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Ueda T. and other coauthors have no conflicts of interest.

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Ueda, T., Takamochi, K., Hattori, A. et al. Postoperative management using a digital drainage system for massive air leakage after pulmonary resection. Surg Today 54, 130–137 (2024). https://doi.org/10.1007/s00595-023-02703-y

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  • DOI: https://doi.org/10.1007/s00595-023-02703-y

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