Luca Bertolaccini1, Andrea Viti2, Pietro Bertoglio2, Andrea Imperatori3, Angelo Morelli4, Francesco Zaraca5, Lorenzo Spaggiari1,6, Roberto Crisci7. 1. Department of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy. 2. Division of Thoracic Surgery, IRCCS Sacro Cuore-Don Calabria Hospital, Negrar, Italy. 3. Center for Thoracic Surgery, Department of Medicine and Surgery, University of Insubria, Varese, Italy. 4. Department of Cardiothoracic Surgery, S. Maria della Misericordia University Hospital, Udine, Italy. 5. Department of Vascular and Thoracic Surgery, Regional Hospital, Bolzano, Italy. 6. Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy. 7. Department of Thoracic Surgery, University of L'Aquila, Teramo, Italy.
Abstract
OBJECTIVES: Digital chest drainage systems allow real-time and continuous monitoring and recording of air leak flow rate and intrapleural pressure (IPP) from the immediate postoperative period to the chest drainage removal. A multicentre retrospective observational analysis of consecutive patients undergoing pulmonary lobectomy for lung cancer was performed to evaluate the association between the airflow and IPP digitally recorded during the immediate postoperative period after video-assisted thoracic surgery (VATS) lobectomy for lung cancer. Here, we present a work in progress report. METHODS: All patients treated with VATS lobectomies for lung cancer were included. Multiple airflow measurements and minimum and maximum IPP through the chest tubes were digitally monitored and recorded using microelectronic mechanical sensor technology. The PALs were defined as an air leak lasting >5 days from the conclusion of the surgical procedure. The cessation of air leaks was defined as an airflow <10 ml/min during 6 consecutive hours. RESULTS: This analysis comprised 76 patients who underwent VATS lobectomy for lung cancer. Nineteen patients (25%) showed prolonged air leaks (PAL) (≥5 days). The operative time was higher in the PAL group (mean difference = 44 min) without a statistically significant difference. Before the 7th postoperative hours, there were no statistically significant differences in IPPs. CONCLUSIONS: Patients with PAL showed less negative IPP in the first 24 postoperative hours. Therefore, the 7th-24th postoperative hours were critical in PAL prediction since the mechanism for PAL seems to develop after the 7th postoperative hour.
OBJECTIVES: Digital chest drainage systems allow real-time and continuous monitoring and recording of air leak flow rate and intrapleural pressure (IPP) from the immediate postoperative period to the chest drainage removal. A multicentre retrospective observational analysis of consecutive patients undergoing pulmonary lobectomy for lung cancer was performed to evaluate the association between the airflow and IPP digitally recorded during the immediate postoperative period after video-assisted thoracic surgery (VATS) lobectomy for lung cancer. Here, we present a work in progress report. METHODS: All patients treated with VATS lobectomies for lung cancer were included. Multiple airflow measurements and minimum and maximum IPP through the chest tubes were digitally monitored and recorded using microelectronic mechanical sensor technology. The PALs were defined as an air leak lasting >5 days from the conclusion of the surgical procedure. The cessation of air leaks was defined as an airflow <10 ml/min during 6 consecutive hours. RESULTS: This analysis comprised 76 patients who underwent VATS lobectomy for lung cancer. Nineteen patients (25%) showed prolonged air leaks (PAL) (≥5 days). The operative time was higher in the PAL group (mean difference = 44 min) without a statistically significant difference. Before the 7th postoperative hours, there were no statistically significant differences in IPPs. CONCLUSIONS: Patients with PAL showed less negative IPP in the first 24 postoperative hours. Therefore, the 7th-24th postoperative hours were critical in PAL prediction since the mechanism for PAL seems to develop after the 7th postoperative hour.
Authors: Alessandro Brunelli; Stephen D Cassivi; Michele Salati; Juan Fibla; Cecilia Pompili; Lisa A Halgren; Dennis A Wigle; Luca Di Nunzio Journal: Eur J Cardiothorac Surg Date: 2010-08-30 Impact factor: 4.191