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.	张真发, 岳东升, 王勐, 等. 达芬奇机器人系统与胸腔镜在肺癌根治术中的近期疗效比较及经验探讨. 中国肿瘤临床, 2021, 48(10): 511-515.
3.	王述民, 汪诚风. 浅谈达芬奇机器人手术系统与电视胸腔镜系统在胸外科肺叶切除术中优劣. 临床军医杂志, 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, 蔡绍汉, 蔡恒, 等. 快速康复外科在开胸肺部手术围术期应用的可行性. 临床肺科杂志, 2015, 20(4): 636-638.
7.	沈诚, 李珏, 李鹏飞, 等. 加速康复外科评价指标: 病人报告结局在胸外科的临床应用现状与进展. 中国肺癌杂志, 2019, 22(3): 161-166.
8.	唐善卫, 武强, 束余声. 肺癌术后胸腔闭式引流管理的现状与进展. 中华胸部外科电子杂志, 2019, 6(3): 182-186.
9.	Padilla Alarcón J, Peñalver 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.	时辉, 梅龙勇, 车国卫. 肺癌术后胸腔闭式引流术应用的新观念. 中国肺癌杂志, 2010, 13(11): 999-1003.
16.	茅怡铭, 魏长江, 秦元, 等. 肺叶切除术后单、两根胸腔引流管引流效果比较的Meta分析. 系统医学, 2017, 2(7): 71-74.
17.	杨梅, 樊骏, 周红霞, 等. 胸腔镜肺癌肺叶切除术后16F较28F胸腔引流管应用的临床优势. 中国肺癌杂志, 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.	陈东来, 西尔买买提·卡德尔, 施哲, 等. 数字化胸腔引流系统用于肺部手术后难治性持续性漏气的疗效观察. 中国肺癌杂志, 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. 张真发, 岳东升, 王勐, 等. 达芬奇机器人系统与胸腔镜在肺癌根治术中的近期疗效比较及经验探讨. 中国肿瘤临床, 2021, 48(10): 511-515.
3. 王述民, 汪诚风. 浅谈达芬奇机器人手术系统与电视胸腔镜系统在胸外科肺叶切除术中优劣. 临床军医杂志, 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, 蔡绍汉, 蔡恒, 等. 快速康复外科在开胸肺部手术围术期应用的可行性. 临床肺科杂志, 2015, 20(4): 636-638.
7. 沈诚, 李珏, 李鹏飞, 等. 加速康复外科评价指标: 病人报告结局在胸外科的临床应用现状与进展. 中国肺癌杂志, 2019, 22(3): 161-166.
8. 唐善卫, 武强, 束余声. 肺癌术后胸腔闭式引流管理的现状与进展. 中华胸部外科电子杂志, 2019, 6(3): 182-186.
9. Padilla Alarcón J, Peñalver 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. 时辉, 梅龙勇, 车国卫. 肺癌术后胸腔闭式引流术应用的新观念. 中国肺癌杂志, 2010, 13(11): 999-1003.
16. 茅怡铭, 魏长江, 秦元, 等. 肺叶切除术后单、两根胸腔引流管引流效果比较的Meta分析. 系统医学, 2017, 2(7): 71-74.
17. 杨梅, 樊骏, 周红霞, 等. 胸腔镜肺癌肺叶切除术后16F较28F胸腔引流管应用的临床优势. 中国肺癌杂志, 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. 陈东来, 西尔买买提·卡德尔, 施哲, 等. 数字化胸腔引流系统用于肺部手术后难治性持续性漏气的疗效观察. 中国肺癌杂志, 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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