Application of digital drainage system after da Vinci robot-assisted lobectomy: A retrospective cohort study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

CHENG Ming , DING Renquan , XU Wei , WANG Xilong ,  WANG Shumin

1. Department of Thoracic Surgery, General Hospital of Northern Theater Command, Shenyang, 110016, P. R. China;

Corresponding?author：

WANG Shumin, Email: sureman2003congo@163.com

Keywords：

Digital drainage system; da Vinci robot; lobectomy; enhanced recovery after surgery

DOI：

10.7507/1007-4848.202207010

Video：

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Objective To investigate the clinical effect of digital drainage system (DDS) in patients after robot-assisted lobectomy. Methods The clinical data of the patients who underwent da Vinci robot-assisted lobectomy from August 2020 to December 2021 were retrospectively analyzed. The patients were divided into a DDS group and a conventional group (using traditional single thoracic drainage tube device) according to different drainage devices used after operation. The preoperative data, intraoperative blood loss, total drainage volume within 48 h after operation, postoperative extubation time and postoperative hospital stay were compared between the two groups. Results Finally, 170 patients were collected, including 76 males and 94 females with an average age of 61.8±8.7 years. Postoperative extubation time [5.53 (6.00, 7.00) days vs. 6.36 (6.00, 8.00) days, Z=–2.467, P=0.014] and postoperative hospital stay [7.80 (8.00, 10.00) days vs. 8.94 (9.00, 10.00) days, Z=–2.364, P=0.018] in the DDS group were shorter than those in the conventional group. For patients with postoperative persistent air leak, postoperative extubation time (Z=–2.786, P=0.005) and postoperative hospital stay (Z=–2.862, P=0.003) in the DDS group were also shorter than those in the conventional group. Conclusion DDS has a positive effect on enhanced recovery after robot-assisted lobectomy, which is safe and stable, and is beneficial to postoperative rehabilitation and shortening the average hospital stay.

Citation： CHENG Ming, DING Renquan, XU Wei, WANG Xilong, WANG Shumin. Application of digital drainage system after da Vinci robot-assisted lobectomy: A retrospective cohort study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2024, 31(3): 403-407. doi: 10.7507/1007-4848.202207010 Copy

1.	Louie BE, Wilson JL, Kim S, et al. Comparison of video-assisted thoracoscopic surgery and robotic approaches for clinical stageⅠ and stageⅡ non-small cell lung cancer using The Society of Thoracic Surgeons Database. Ann Thorac Surg, 2016, 102(3): 917-924.
2.	張真發, 岳東升, 王勐, 等. 達芬奇機器人系統與胸腔鏡在肺癌根治術中的近期療效比較及經驗探討. 中國腫瘤臨床, 2021, 48(10): 511-515.
3.	王述民, 汪誠風. 淺談達芬奇機器人手術系統與電視胸腔鏡系統在胸外科肺葉切除術中優劣. 臨床軍醫雜志, 2016, 44(6): 551-555.
4.	Liang H, Liang W, Zhao L, et al. Robotic versus video-assisted lobectomy/segmentectomy for lung cancer: A meta-analysis. Ann Surg, 2018, 268(2): 254-259.
5.	Casiraghi M, Galetta D, Borri A, et al. Ten years' experience in robotic-assisted thoracic surgery for early stage lung cancer. Thorac Cardiovasc Surg, 2019, 67(7): 564-572.
6.	林峰, 蔡紹漢, 蔡恒, 等. 快速康復外科在開胸肺部手術圍術期應用的可行性. 臨床肺科雜志, 2015, 20(4): 636-638.
7.	沈誠, 李玨, 李鵬飛, 等. 加速康復外科評價指標: 病人報告結局在胸外科的臨床應用現狀與進展. 中國肺癌雜志, 2019, 22(3): 161-166.
8.	唐善衛, 武強, 束余聲. 肺癌術后胸腔閉式引流管理的現狀與進展. 中華胸部外科電子雜志, 2019, 6(3): 182-186.
9.	Padilla Alarcón J, Pe?alver Cuesta JC. Experience with lung resection in a fast-track surgery program. Arch Bronconeumol, 2013, 49(3): 89-93.
10.	Wehberg KE, Jackson D, Walters J, et al. Fast track minimally invasive transmyocardial revascularization. Innovations (Phila), 2009, 4(4): 217-220.
11.	Porcel JM. Chest tube drainage of the pleural space: A concise review for pulmonologists. Tuberc Respir Dis (Seoul), 2018, 81(2): 106-115.
12.	Brunelli A, Beretta E, Cassivi SD, et al. Consensus definitions to promote an evidence-based approach to management of the pleural space. A collaborative proposal by ESTS, AATS, STS, and GTSC. Eur J Cardiothorac Surg, 2011, 40(2): 291-297.
13.	Miller DL, Helms GA, Mayfield WR. Digital drainage system reduces hospitalization after video-assisted thoracoscopic surgery lung resection. Ann Thorac Surg, 2016, 102(3): 955-961.
14.	Pompili C, Detterbeck F, Papagiannopoulos K, et al. Multicenter international randomized comparison of objective and subjective outcomes between electronic and traditional chest drainage systems. Ann Thorac Surg, 2014, 98(2): 490-496.
15.	時輝, 梅龍勇, 車國衛. 肺癌術后胸腔閉式引流術應用的新觀念. 中國肺癌雜志, 2010, 13(11): 999-1003.
16.	茅怡銘, 魏長江, 秦元, 等. 肺葉切除術后單、兩根胸腔引流管引流效果比較的Meta分析. 系統醫學, 2017, 2(7): 71-74.
17.	楊梅, 樊駿, 周紅霞, 等. 胸腔鏡肺癌肺葉切除術后16F較28F胸腔引流管應用的臨床優勢. 中國肺癌雜志, 2015, 18(8): 512-517.
18.	Pompili C, Miserocchi G. Air leak after lung resection: Pathophysiology and patients' implications. J Thorac Dis, 2016, 8(Suppl 1): S46-S54.
19.	Okereke I, Murthy SC, Alster JM, et al. Characterization and importance of air leak after lobectomy. Ann Thorac Surg, 2005, 79(4): 1167-1173.
20.	Liang S, Ivanovic J, Gilbert S, et al. Quantifying the incidence and impact of postoperative prolonged alveolar air leak after pulmonary resection. J Thorac Cardiovasc Surg, 2013, 145(4): 948-954.
21.	Takamochi K, Nojiri S, Oh S, et al. Comparison of digital and traditional thoracic drainage systems for postoperative chest tube management after pulmonary resection: A prospective randomized trial. J Thorac Cardiovasc Surg, 2018, 155(4): 1834-1840.
22.	Miserocchi G, Beretta E, Rivolta I. Respiratory mechanics and fluid dynamics after lung resection surgery. Thorac Surg Clin, 2010, 20(3): 345-357.
23.	Brunelli A, Cassivi SD, Halgren L. Risk factors for prolonged air leak after pulmonary resection. Thorac Surg Clin, 2010, 20(3): 359-364.
24.	陳東來, 西爾買買提·卡德爾, 施哲, 等. 數字化胸腔引流系統用于肺部手術后難治性持續性漏氣的療效觀察. 中國肺癌雜志, 2017, 20(12): 833-836.
25.	Zhou J, Lyu M, Chen N, et al. Digital chest drainage is better than traditional chest drainage following pulmonary surgery: A meta-analysis. Eur J Cardiothorac Surg, 2018, 54(4): 635-643.

1. Louie BE, Wilson JL, Kim S, et al. Comparison of video-assisted thoracoscopic surgery and robotic approaches for clinical stageⅠ and stageⅡ non-small cell lung cancer using The Society of Thoracic Surgeons Database. Ann Thorac Surg, 2016, 102(3): 917-924.
2. 張真發, 岳東升, 王勐, 等. 達芬奇機器人系統與胸腔鏡在肺癌根治術中的近期療效比較及經驗探討. 中國腫瘤臨床, 2021, 48(10): 511-515.
3. 王述民, 汪誠風. 淺談達芬奇機器人手術系統與電視胸腔鏡系統在胸外科肺葉切除術中優劣. 臨床軍醫雜志, 2016, 44(6): 551-555.
4. Liang H, Liang W, Zhao L, et al. Robotic versus video-assisted lobectomy/segmentectomy for lung cancer: A meta-analysis. Ann Surg, 2018, 268(2): 254-259.
5. Casiraghi M, Galetta D, Borri A, et al. Ten years' experience in robotic-assisted thoracic surgery for early stage lung cancer. Thorac Cardiovasc Surg, 2019, 67(7): 564-572.
6. 林峰, 蔡紹漢, 蔡恒, 等. 快速康復外科在開胸肺部手術圍術期應用的可行性. 臨床肺科雜志, 2015, 20(4): 636-638.
7. 沈誠, 李玨, 李鵬飛, 等. 加速康復外科評價指標: 病人報告結局在胸外科的臨床應用現狀與進展. 中國肺癌雜志, 2019, 22(3): 161-166.
8. 唐善衛, 武強, 束余聲. 肺癌術后胸腔閉式引流管理的現狀與進展. 中華胸部外科電子雜志, 2019, 6(3): 182-186.
9. Padilla Alarcón J, Pe?alver Cuesta JC. Experience with lung resection in a fast-track surgery program. Arch Bronconeumol, 2013, 49(3): 89-93.
10. Wehberg KE, Jackson D, Walters J, et al. Fast track minimally invasive transmyocardial revascularization. Innovations (Phila), 2009, 4(4): 217-220.
11. Porcel JM. Chest tube drainage of the pleural space: A concise review for pulmonologists. Tuberc Respir Dis (Seoul), 2018, 81(2): 106-115.
12. Brunelli A, Beretta E, Cassivi SD, et al. Consensus definitions to promote an evidence-based approach to management of the pleural space. A collaborative proposal by ESTS, AATS, STS, and GTSC. Eur J Cardiothorac Surg, 2011, 40(2): 291-297.
13. Miller DL, Helms GA, Mayfield WR. Digital drainage system reduces hospitalization after video-assisted thoracoscopic surgery lung resection. Ann Thorac Surg, 2016, 102(3): 955-961.
14. Pompili C, Detterbeck F, Papagiannopoulos K, et al. Multicenter international randomized comparison of objective and subjective outcomes between electronic and traditional chest drainage systems. Ann Thorac Surg, 2014, 98(2): 490-496.
15. 時輝, 梅龍勇, 車國衛. 肺癌術后胸腔閉式引流術應用的新觀念. 中國肺癌雜志, 2010, 13(11): 999-1003.
16. 茅怡銘, 魏長江, 秦元, 等. 肺葉切除術后單、兩根胸腔引流管引流效果比較的Meta分析. 系統醫學, 2017, 2(7): 71-74.
17. 楊梅, 樊駿, 周紅霞, 等. 胸腔鏡肺癌肺葉切除術后16F較28F胸腔引流管應用的臨床優勢. 中國肺癌雜志, 2015, 18(8): 512-517.
18. Pompili C, Miserocchi G. Air leak after lung resection: Pathophysiology and patients' implications. J Thorac Dis, 2016, 8(Suppl 1): S46-S54.
19. Okereke I, Murthy SC, Alster JM, et al. Characterization and importance of air leak after lobectomy. Ann Thorac Surg, 2005, 79(4): 1167-1173.
20. Liang S, Ivanovic J, Gilbert S, et al. Quantifying the incidence and impact of postoperative prolonged alveolar air leak after pulmonary resection. J Thorac Cardiovasc Surg, 2013, 145(4): 948-954.
21. Takamochi K, Nojiri S, Oh S, et al. Comparison of digital and traditional thoracic drainage systems for postoperative chest tube management after pulmonary resection: A prospective randomized trial. J Thorac Cardiovasc Surg, 2018, 155(4): 1834-1840.
22. Miserocchi G, Beretta E, Rivolta I. Respiratory mechanics and fluid dynamics after lung resection surgery. Thorac Surg Clin, 2010, 20(3): 345-357.
23. Brunelli A, Cassivi SD, Halgren L. Risk factors for prolonged air leak after pulmonary resection. Thorac Surg Clin, 2010, 20(3): 359-364.
24. 陳東來, 西爾買買提·卡德爾, 施哲, 等. 數字化胸腔引流系統用于肺部手術后難治性持續性漏氣的療效觀察. 中國肺癌雜志, 2017, 20(12): 833-836.
25. Zhou J, Lyu M, Chen N, et al. Digital chest drainage is better than traditional chest drainage following pulmonary surgery: A meta-analysis. Eur J Cardiothorac Surg, 2018, 54(4): 635-643.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Application of digital drainage system after da Vinci robot-assisted lobectomy: A retrospective cohort study

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