胸腔镜肺切除术后胸腔引流管理的新范例？

-8 cm H O, the new paradigm in chest drain management following thoracoscopic lung resection?

机构信息

Department of Cardiothoracic Surgery, Royal Melbourne Hospital, Melbourne, Australia.

Department of Surgery, University of Melbourne, Melbourne, Australia.

出版信息

ANZ J Surg. 2022 May;92(5):1056-1059. doi: 10.1111/ans.17645. Epub 2022 Mar 30.

DOI:10.1111/ans.17645

PMID:35352444

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9310860/

Abstract

BACKGROUND

Chest drain suction of -20 cm H O has been used universally after lung resection. After introducing new guidelines,-8 cm H O was used routinely for all non-pneumonectomy, thoracoscopic lung resections. We conducted a review to determine outcomes and safety.

METHODS

After introduction of the guidelines data were collected in the study institutions' thoracic surgical database and subsequently analysed.

RESULTS

A total of 155 patients underwent thoracoscopic lung resection. Mean patient age was 61.5 ± 13.6 years. Video-assisted thoracoscopic surgery was performed in 92.2% (144/155) of patients and robotically-assisted thoracoscopic surgery was performed in 7.8% (12/155) of patients. Lobectomy was performed in 56.8% (88/155) of patients, segmentectomy was performed in 11.6% (18/155) of patients and wedge resection was performed in 31.6% (49/155) of patients. Median ICC duration time was 1 day (IQR 1-3). Median length of stay was 3 days (IQR 2-6). For patients undergoing lobectomy median ICC time was 2 days (IQR 1-4.5) and median length of stay was 3.5 days (IQR 2-7), for segmentectomy median ICC time was 1 day (IQR 1-5) and median length of stay was 2 days (IQR 1-5) and for wedge resection median ICC time was 1 day (IQR 1-1) and median admission time was 2 days (IQR 1-4).

CONCLUSION

A suction level -8 cm H O is safe to use for thoracoscopic lung resections from day 0 post-operatively. A dedicated, prospective study comparing levels of suction should be performed.

摘要

背景

肺切除术后，胸腔引流通常采用 -20cmH2O 的负压吸引。在引入新指南后，所有非全肺切除术、胸腔镜肺切除术常规采用 -8cmH2O 的负压吸引。我们进行了一项回顾性研究，以确定结果和安全性。

方法

在指南引入后，研究机构的胸外科数据库中收集了数据，并随后进行了分析。

结果

共 155 例患者接受了胸腔镜肺切除术。患者平均年龄为 61.5±13.6 岁。92.2%（144/155）的患者行电视胸腔镜手术，7.8%（12/155）的患者行机器人辅助胸腔镜手术。肺叶切除术 56.8%（88/155），肺段切除术 11.6%（18/155），楔形切除术 31.6%（49/155）。中位 ICC 持续时间为 1 天（IQR 1-3）。中位住院时间为 3 天（IQR 2-6）。肺叶切除术患者中位 ICC 时间为 2 天（IQR 1-4.5），中位住院时间为 3.5 天（IQR 2-7）；肺段切除术患者中位 ICC 时间为 1 天（IQR 1-5），中位住院时间为 2 天（IQR 1-5）；楔形切除术患者中位 ICC 时间为 1 天（IQR 1-1），中位住院时间为 2 天（IQR 1-4）。