Digital chest drainage systems are beneficial for robotic-assisted lung resections.
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ABSTRACT:
SUBMITTER: Lau C
PROVIDER: S-EPMC7330775 | biostudies-literature | 2020 Jun
REPOSITORIES: biostudies-literature
Publications
Digital chest drainage systems are beneficial for robotic-assisted lung resections.
Lau Christopher C Harrison Sebron S
Journal of thoracic disease 20200601 6
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Project description: Not available
| S-EPMC7330785 | biostudies-literature
Project description:BackgroundDespite advances in chest drainage technology, such as the use of digital drainage systems (DDS), there is still no consensus on the most effective method for reducing air leaks after lung resection. To evaluate the optimal drainage method, we compared traditional water seal with low suction pressure settings on DDS.MethodsWe retrospectively analyzed the postoperative data of patients between August 2015 and April 2023 who underwent anatomical lung resection at our hospital and who had postoperative chest drains managed with either a water seal or DDS set to low suction pressure. We excluded cases without air leak on the first postoperative morning from the consideration in this study. We divided the patients into two groups according to the chest drainage method on the first postoperative morning and we compared air leak and chest drainage durations of both groups.ResultsWe retrospectively analyzed 116 patients. The groups (water seal: 59 patients; low suction: 57 patients) were well balanced for baseline and degree of air leakage on the first operative morning. The water seal group showed significantly shorter air leak duration (2 vs. 3 days, P<0.001) and chest drainage duration (3 vs. 5 days, P<0.001) compared with the low suction group. Pleurodesis (P=0.002) and conversion (P=0.001) were higher in the low suction group, with no significant differences in drain reinsertion.ConclusionsWater seal management was suggested to be safe and comparably effective to low suction on DDS in reducing air leak and chest drainage durations after lung resection.
| S-EPMC11565295 | biostudies-literature
Project description:BACKGROUND:A new, self-contained, digital, continuous pump-driven chest drainage system is compared in a randomized control trial to a traditional wall-suction system in cardiac surgery. METHODS:One hundred and twenty adult elective cardiac patients undergoing coronary artery bypass graft and/or valve surgery were randomized to the study or control group. Both groups had similar pre/intra-operative demographics: age 67.8 vs 67.0 years, Euroscore 2.3 vs 2.2, and body surface area 1.92 vs 1.91 m2 . Additionally, a satisfaction assessment score (0-10) was performed by 52 staff members. RESULTS:Given homogenous intra-operative variables, total chest-tube drainage was comparable among groups (566 vs 640 mL; ns), but the study group showed more efficient fluid collection during the early postoperative phase due to continuous suction (P = .01). Blood, cell saver transfusions and postoperative hemoglobin values were similar in both groups. The study group experienced drain removal after 29.8 vs 38.4 hours in the control group (ns). Seven crossovers from the Study to the Control group were registered but no patient had drain-related complications. The Personnel Satisfaction Assessment scored above 5 for all questions asked. CONCLUSIONS:The new, digital, chest drainage system showed better early drainage of the chest cavity and was as reliable as conventional systems. Quicker drain removal might impact on intensive care unit (ICU) stay and reduce costs. Additional advantages are portable size, battery operation, patient mobility, noiseless function, digital indications and alarms. The satisfaction assessment of the new system by the staff revealed a higher score when compared to the traditional wall suction chest drainage system.
| S-EPMC7383877 | biostudies-literature
Project description:Minimally invasive thoracoscopic surgical techniques have grown increasingly popular due to improved outcome measures compared to conventional rib-spreading thoracotomy. However, video-assisted thoracoscopic surgery (VATS) presents with unique technical challenges that have limited its role in certain cases. Here, we discuss our perspectives on the implementation of a successful robotic thoracic program. We will then present the case for how the adoption of robotic assisted thoracic surgery (RATS) provides the benefits of minimally invasive VATS while still retaining the technical finesse of bimanual articulating instruments and 3-dimensional imaging that is a universal component of any open surgery. We will also discuss how to overcome some of the perceived disadvantages to RATS in regard to the higher cost, lack of tactile feedback and potential safety concerns.
| S-EPMC7061192 | biostudies-literature
Project description: Not available
| S-EPMC9562539 | biostudies-literature
Project description:This report describes our technical methods of robotic-assisted chest wall resection concomitant with lobectomy, which did not require the division of major extrathoracic muscles and spreading of the ribs. In both cases, the patients were able to raise their arms on the affected side immediately after surgery, without any shoulder dysfunction. This robotic-assisted muscle-sparing chest wall resection without thoracotomy technique enables preservation of the extrathoracic muscles and allows patients to maintain their quality of life, thus making it possible for patients to promptly receive adjuvant therapy.
| S-EPMC11910818 | biostudies-literature
Project description:BackgroundThe sensitivity of postoperative pleural air leakage (PAL) after pulmonary resection is evaluated by a simple subjective grading method in clinical practice. A new electronic digital chest drainage evaluation system (DCS) recently became clinically available. This study was designed to evaluate the clinical application of the DCS in monitoring the airflow volume and managing postoperative PAL.MethodsWe prospectively enrolled 25 patients who underwent pulmonary resection. Postoperative PAL was evaluated using both conventional PAL grading based on the physician's visual judgment (analog chest drainage evaluation system [ACS]: Level 0 = no leakage to 4 = continuous leakage) and the DCS. The DCS digital measurement was recorded as the flow volume (ml/min), which was taken once daily from postoperative day 1 to the day of chest drainage tube removal.ResultsIn total, 45 measurements were performed on 25 patients during the evaluation period. Postoperative PAL was observed in five patients (20.0%) and judged as ACS Level >1. The mean DCS values corresponding to ACS Levels 0, 1, 2, and 3 were 2.42 (0.0-11.3), 48.6 (35.4-67.9), 95.6 (79.7-111.5), and 405.3 (150.3-715.6), respectively. The Spearman correlation test showed a significant positive correlation between the ACS PAL level and DCS flow volume (R = 0.8477, p < 0.001).ConclusionsA relationship between the visual PAL level by the ACS and the digital value by the DCS was identified in this study. The numeric volume obtained by the DCS has been successful in information-sharing with all staff. The digital PAL value evaluated by the DCS is appropriate, and the use of the DCS is promising in the treatment of postoperative PAL after pulmonary resection.
| S-EPMC5673177 | biostudies-literature
Project description:The aim of the study was to assess the degree of aerosolisation in different chest drainage systems according to different air leak volumes, in a simulated environment. This novel simulation model was designed to produce an air leak by passing air through and agitating a fluorescent fluid. The air leak volume and amount of fluorescent fluid were tested in various combinations and aerosolisation was assessed at 10-minute intervals using the ultraviolet light. The following chest drainage systems were compared: (1) single-chamber chest drainage system, (2) 3-compartment wet-dry suction chest drainage system, (3) digital drainage and monitoring system. The impact of suction (-2 and -4 kPa) in generating aerosolised particles was tested as well. A total number of 187 of 10-minute interval measurements were performed. The single-chamber chest drainage system generated the largest number of aerosolised particles at different air leak volumes and drainage output. The 3-compartment wet-dry suction system and the digital drainage and monitoring system did not generate any identifiable aerosolised particles at any of the air leak or drain output volumes considered. Suction applied to the chest drainage systems did not have an effect on aerosolisation. Aerosol generation in the simulated air-leak model demonstrated the potential risk of SARS-CoV-2 spread in the clinical setting. Full personal protective equipment must be used in patients with an air leak. Single-chamber chest drainage system generates the highest rate of aerosolised particles and it should not be used as an open system in patients with an air leak.
| S-EPMC7833832 | biostudies-literature
Project description: Not available
| S-EPMC10944780 | biostudies-literature
Project description:ObjectivesThe objective of this study was to determine the variation in intrapleural pressure (IPP) with and without air leakage using a digital chest drainage system (DCS) for each pressure setting.MethodsIn this retrospective single-centre study, we analysed 49,553 h of air leakage after anatomical lung resection in 714 patients between 2018 and 2020. The transition of mean IPP and mean air leak flow was monitored using DCS, and the association between mean IPP and mean air leak flow was examined. The relationship between the transition of mean IPP and air leakage according to the varying suction pressures on DCS was also investigated.ResultsOverall, 272 patients (38.1%) showed air leakage after surgery. The mean IPP in patients without air leakage was -12.0 ± 2.9 cmH2O and maintained at about -12 cmH2O constantly, while the mean IPP in patients with air leakage was -8.3 ± 1.9 cmH2O, which changed to -12 cmH2O instantly if air leakage disappeared (P < 0.001). Among patients with air leakage, the mean IPP changed more distinctly in patients with mild suction management than in those with conventional suction management (-5.0 ± 2.6 to -11.5 ± 4.2 and -8.8 ± 1.3 to -12.1 ± 2.5 cmH2O, respectively; P < 0.001).ConclusionsThe change in IPP on a DCS is useful for detecting air leakage. Furthermore, management with a mild suction setting on DCS makes it easy to recognize the disappearance of postoperative air leakage.
| S-EPMC8759466 | biostudies-literature