Skip to main content

Digital Drainage Systems After Major Lung Resection

  • Chapter
  • First Online:
Difficult Decisions in Thoracic Surgery

Part of the book series: Difficult Decisions in Surgery: An Evidence-Based Approach ((DDSURGERY,volume 1))

  • 1332 Accesses

Abstract

Prolonged air leak after lung resection is the most prevalent complication and a source of other morbidities and considerable expenses. Digital pleural drainage systems have appeared in the market claiming to be useful tools for improved postoperative patients’ care and control. To date, there is strong evidence in the literature demonstrating that the use of these devices helps to standardize postoperative care. Other advantages (such are their effect on decreasing hospital staying and costs per procedure or the usefulness of stored data for better understanding the physiology of the pleura after lung resection) are still waiting to be proved.

Disclosures

The author is an advisor for Atrium Medical (Hudson, NH, USA)

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 179.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

Notes

  1. 1.

    Specific characteristics of each commercially available system are neither reviewed nor discussed in this text. The reader can find more information visiting the corporate web pages at: http://old.atmosmed.com/html/seiten/produkte;products;kat,17;910,en.html?PHPSESSID = 49ed7eba9ac21fdb048b52640bc48c32; http://www.redax.it/index.asp?ind = famiglia_2.asp; and http://www.medela.com/US/en/healthcare/products/thoracic-drainage/thopaz.html [cited 19 Aug 2013].

References

  1. Varela G, Jiménez M, Novoa N, Aranda JL. Estimating hospital costs attributable to prolonged air leak in pulmonary lobectomy. Eur J Cardiothorac Surg. 2005;27:329–33.

    Article  PubMed  Google Scholar 

  2. Graham AN, Cosgrove AP, Gibbons JR, McGuigan JA. Randomised clinical trial of chest drainage systems. Thorax. 1992;47:461–2.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  3. Anegg U, Lidemann J, Matzi V, Mujkic D, Maier A, Fritz L, et al. AIRFIX: the first digital postoperative chest tube airflowmetry: a novel method to quantify air leakage after lung resection. Eur J Cardiothorac Surg. 2006;29:867–72.

    Article  PubMed  Google Scholar 

  4. Dernevik L, Belboul A, Rådberg G. Initial experience with the world’s first digital drainage system. The benefits of recording air leaks with graphic representation. Eur J Cardiothorac Surg. 2007;31:209–13.

    Article  PubMed  Google Scholar 

  5. Wennberg JE. Unwarranted variations in healthcare delivery: implications for academic medical centres. BMJ. 2002;325:961–4.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Zehr KJ, Dawsin PB, Yang SC, Heitmiller RF. Standardized clinical care pathways for major thoracic cases reduce hospital costs. Ann Thorac Surg. 1998;63:914–9.

    Article  Google Scholar 

  7. Bardell T, Petsikas D. What keeps postpulmonary resection patients in hospital? Can Respir J. 2003;10:86–9.

    CAS  PubMed  Google Scholar 

  8. Gagarine A, Urschel JD, Miller JC, Bennett WF, Young JEM. Preoperative and intraoperative factors predictive of length of hospital stay after pulmonary lobectomy. Ann Thorac Cardiovasc Surg. 2003;9:222–5.

    PubMed  Google Scholar 

  9. Varela G, Jiménez M, Novoa N, 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.

    Article  PubMed  Google Scholar 

  10. Brunelli A, Salati M, Refai M, Di Nunzio L, Xiumé F, Sabbatini A. Evaluation of a new chest tube removal protocol using digital air leak monitoring after lobectomy: a prospective randomised trial. Eur J Cardiothorac Surg. 2010;37:56–60.

    Article  PubMed  Google Scholar 

  11. Prokakis C, Koletsis EN, Apostolakis E, Panagopoulos N, Kouki HS, Sakellaropoulos GC, Filos K, Dougenis DV. Routine suction of intercostal drains is not necessary after lobectomy: a prospective randomized trial. World J Surg. 2008;32:2336–42.

    Article  PubMed  Google Scholar 

  12. Alphonso N, Tan C, Utley M, Cameron R, Dussek J, Lang-Lazdunski L, Treasure T. A prospective randomized controlled trial of suction versus non-suction to the under-water seal drains following lung resection. Eur J Cardiothorac Surg. 2005;27:391–4.

    Article  CAS  PubMed  Google Scholar 

  13. Brunelli A, Monteverde M, Borri A, Salati M, Marasco RD, Al Refai M, Fianchini A. Comparison of water seal and suction after pulmonary lobectomy: a prospective, randomized trial. Ann Thorac Surg. 2004;77:1932–7.

    Article  PubMed  Google Scholar 

  14. Cerfolio RJ, Bass C, Katholi CR. Prospective randomized trial compares suction versus water seal for air leaks. Ann Thorac Surg. 2001;71:1613–7.

    Article  CAS  PubMed  Google Scholar 

  15. Marshall MB, Deeb ME, Bleier JI, Kucharczuk JC, Friedberg JS, Kaiser LR, Shrager JB. Suction vs water seal after pulmonary resection: a randomized prospective study. Chest. 2002;121:831–5.

    Article  PubMed  Google Scholar 

  16. Leo F, Duranti L, Girelli L, Furia S, Billè A, Garofalo G, Scanagatta P, Giovannetti R, Pastorino U. Does external pleural suction reduce prolonged air leak after lung resection? Results from the AirINTrial after 500 randomized cases. Ann Thorac Surg. 2013;96:1234–9. doi:10.1016/j.athoracsur.2013.04.079.

    Article  PubMed  Google Scholar 

  17. Sanni A, Critchley A, Dunning J. Should chest drains be put on suction or not following pulmonary lobectomy? Interact Cardiovasc Thorac Surg. 2006;5:275–8.

    Article  PubMed  Google Scholar 

  18. Deng B, Tan QY, Zhao YP, Wang RW, Jiang YG. Suction or non-suction to the underwater seal drains following pulmonary operation: meta-analysis of randomised controlled trials. Eur J Cardiothorac Surg. 2010;38:210–5.

    Article  PubMed  Google Scholar 

  19. Coughlin SM, Emmerton-Coughlin HM, Malthaner R. Management of chest tubes after pulmonary resection: a systematic review and meta-analysis. Can J Surg. 2012;55:264–70.

    PubMed Central  PubMed  Google Scholar 

  20. Qiu T, Shen Y, Wang MZ, Wang YP, Wang D, Wang ZZ, Jin XF, Wei YC. External suction versus water seal after selective pulmonary resection for lung neoplasm: a systematic review. PLoS One. 2013;8(7):e68087.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  21. Novoa NM, Ballesteros E, Jiménez MF, Aranda JL, Varela G. Chest physiotherapy revisited: evaluation of its influence on the overall cardio-respiratory morbidity after pulmonary resection. Eur J Cardiothorac Surg. 2011;40:130–4.

    Article  PubMed  Google Scholar 

  22. 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(2):396–401.

    Article  PubMed  Google Scholar 

  23. Filosso PL, Ruffini E, Solidoro P, Molinatti M, Bruna MC, Oliaro A. Digital air leak monitoring after lobectomy for primary lung cancer in patients with moderate COPD: can a fast-tracking algorithm reduce postoperative costs and complications? J Cardiovasc Surg (Torino). 2010;51:429–33.

    CAS  Google Scholar 

  24. 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;37:531–4.

    Article  PubMed  Google Scholar 

  25. Refai M, Brunelli A, Varela G, Novoa N, Pompili C, Jimenez MF, Aranda JL, Sabbatini A. The values of intrapleural pressure before the removal of chest tube in non-complicated pulmonary lobectomy. Eur J Cardiothorac Surg. 2012;41:831–3.

    Article  PubMed  Google Scholar 

  26. Jimenez MF, Varela G, Calvo J, Fuentes MG. Predicting the risk of prolonged air leak after pulmonary lobectomy using intrapleural pressures measured during the first 24 hours. Interact Cardiovasc Thorac Surg. 2012;15 Suppl 1:S55.

    Google Scholar 

  27. Brunelli A, Cassivi SD, Salati M, Fibla J, Pompili C, Halgren LA, Wigle DA, Di Nunzio L. Digital measurements of air leak flow and intrapleural pressures in the immediate postoperative period predict risk of prolonged air leak after pulmonary lobectomy. Eur J Cardiothorac Surg. 2011;39:584–8.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Gonzalo Varela MD, PhD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag London

About this chapter

Cite this chapter

Varela, G. (2014). Digital Drainage Systems After Major Lung Resection. In: Ferguson, M. (eds) Difficult Decisions in Thoracic Surgery. Difficult Decisions in Surgery: An Evidence-Based Approach, vol 1. Springer, London. https://doi.org/10.1007/978-1-4471-6404-3_16

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-6404-3_16

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-6403-6

  • Online ISBN: 978-1-4471-6404-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics