[Application of Digital Drainage System in Postoperative Refractory Prolonged Air Leaks after Pulmonary Surgery].

BACKGROUND: Postoperative prolonged air leaks is one of the most common complications secondary to pulmonary resections. Digital drainage system (DDS) is considered as an accurate and objective device which has been found to be comfortable and well tolerated by patients, economical as well. The aim of this study is to explore the application of DDS in patients with postoperative refractory prolonged air leaks after pulmonary surgery.

METHODS: Prolonged air leak (PAL) is defined as air leaks lasting for more than 5 d after video-assisted surgery or more than 7 d after thoracotomy. Postoperative refractory prolonged air leak is defined as a kind of air leak lasting for twice than PAL with grade 2 or 3 air leak, or air leak with severe complications such as subcutaneous or mediastinal emphysema in our study. A total of 8 patients who had postoperative refractory prolonged air leaks after pulmonary resection were treated with digital drainage system combined with pleurodesis from January to December in 2016 in Department of Thoracic Surgery, Shanghai Pulmonary Hospital. All the relevant clinical data of patients were collected for analysis.

RESULTS: In our study, 6 patients accepted lobectomy, the other 2 patients underwent segmentectomy. The average air leak and chest tube duration of the patients with postoperative refractory prolonged air leaks after pulmonary resection was (17.3±5.1) d. The average postoperative DDS duration was (5.6±3.7) d. The mean drainage volume of the patients was (2,615.6±1,741.2) mL and (935.0±242.7) mL before and after the application of DDS. The average length of hospital stay was (18.1±5.0) d.

CONCLUSIONS: It is safe and feasible to apply digital drainage system to patients with postoperative refractory prolonged air leaks after pulmonary resection. Compared with the conventional drainage system, digital drainage system is more accurate and objective which can offer a larger suction pressure and promote lung recruitment maneuver for pleurodesis, shortening the drainage time and length of hospital stay.