Filosso P L, Ruffini E, Solidoro P, Molinatti M, Bruna M C, Oliaro A
Department of Thoracic Surgery, University of Turin, Turin, Italy.
J Cardiovasc Surg (Torino). 2010 Jun;51(3):429-33.
Prolonged air leaks remain one of the most important complication after pulmonary resection. The aim of this study was to test a new fast-track chest tube removal protocol using a new drainage system, which digitally records postoperative air leaks, compared to the traditional one, with subjective visual air leak assessment.
Patients with moderate COPD undergoing lobectomy for primary lung cancer at the Department of Thoracic Surgery of the University of Torino were randomised in two groups with different chest drainage systems and different removal protocols: in Group A the drainage was removed after digitally recordered measurement of air leaks; in Group B the tube was removed according to the air leaks visualization by bubbling in the water column. The following variables were evaluated: first and second drainage removal day; overall hospital length of stay; overall hospitalization costs.
First and second drainages were removed sooner in those patients with the digital drainage system. An earlier drainage removal is associated with significative reduction in hospital length of stay and overall hospitalization costs.
The digital and continuous air leak measurement reduces the hospital length of stay by a more accurate and reproductive air leaks measurement. Further studies are mandatory to corroborate our preliminary results.
持续性漏气仍然是肺切除术后最重要的并发症之一。本研究的目的是测试一种使用新型引流系统的快速拔除胸管新方案，该系统能数字记录术后漏气情况，并与传统的通过主观视觉评估漏气的方案进行比较。
在都灵大学胸外科接受原发性肺癌肺叶切除术的中度慢性阻塞性肺疾病（COPD）患者被随机分为两组，采用不同的胸腔引流系统和不同的拔除方案：A组在数字记录漏气测量后拔除引流管；B组根据水柱中气泡情况通过可视化评估漏气来拔除胸管。评估以下变量：首次和第二次拔除引流管的日期；总住院天数；总住院费用。
使用数字引流系统的患者首次和第二次引流管拔除时间更早。更早拔除引流管与住院天数和总住院费用的显著降低相关。
数字式连续漏气测量通过更准确和可重复的漏气测量减少了住院天数。需要进一步研究来证实我们的初步结果。
