To obtain an objective survey of air leakage after lung resections by a prospective study employing the DigiVentTM system, a digital drain system providing a continue air leakage and pleural pressures assessment.
Since March 2008 to March 2009, we employed 86 digital systems for 80 patients undergone thoracic surgical procedures on our Unit. In 29 patients, we applied sealants or other on destroyed pleural surfaces or above sutured parenchyma: in 25 patients (43.1% between 58 parenchymal resections) was applied a synthetic polyethylene glycole hydrogel (Co-Seal®) on to parenchymal surfaces breaks or over sutured slices; in 4 patients we applied covered charged (Peristrip®) (6.9%). In 18 patients (20.9%) interlobar fissures appeared incomplete, so dissected by mechanical staplers.
There were 13 prolonged air leaks between 350 and 1000 ml/min; 2 late air leaks, predicted by divergent pressure curves before air leakage appearance; 35 progressive curve convergences, meaning total lung expansion. There were no significant differences in employed sealants between patients with and without air leakage.Co-Seal® was otherwise applied in 3/13 patients with an air leak (23.1%) versus 22/70 without air leak (31.4%). An average of 3 single use mechanical staplers loading units was employed for each patient, and a smaller quantity of loading units was employed in air leaks than no air leak ones. There were also wide gradient pressures without air leakage in sclerotic or infiltrated pleural surfaces. Mean length of hospital stay was 6.10 days.
Air leakage represents the most common thoracic surgery complication despite of technical expedients performed to interfere with its appearance. Digital system could allow a safer chest tube management and a precocious patient discharge, with related hospital expenses reduction.
The ability to save data and record curves for the post-operative period could be an advantage for the clinical team. The safe and simple use of the digital drainage system efforts the compliance of the nurse too. There was a remarkable agreement between “DigiVentTM “ downloaded data and chest x-ray evidences.
Cosimo Lequaglie, No Financial Disclosure Information; No Product/Research Disclosure Information