Evaluation of Postoperative Air Leak and Chest Tube Drainage Systems after Pulmonary Resection

Postoperative air leaks are the most common complication after a pulmonary resection. There is no data in the literature comparing the traditional and digital chest drainage system after a robotic-assisted pulmonary lobectomy. In 182 eligible patients, this retrospective study evaluated the association between digital and traditional drainage systems with postoperative chest tube days, hospital length of stay, chest tube reinsertion during hospitalization, and 30-day readmission for pneumothorax following a robotic-assisted lobectomy. The groups did not differ significantly in terms of age, gender, BMI, smoking, adhesions or neoadjuvant therapy. Patients with the digital drainage system had a mean chest tube duration of 2.07 days compared with 2.73 days for the traditional drainage system (p = 0.003). Hospital length of stay was also significantly reduced with the digital drainage system. Patients using the digital drainage system had a mean hospital length of stay of 4.02 days compared with 5.06 days with the traditional drainage system (p = 0.010). Although chest tube reinsertion occurred four times more frequently with traditional drainage system, the difference did not achieve the level of statistical significance (p = 0.059). The frequency of readmission due to pneumothorax was very low (1 patient per group), which prevented comparative statistical analysis. In the digital drainage system there are shorter chest tube days and hospital length of stay after a robotic-assisted lobectomy. The decision to remove chest tubes in the traditional drainage system is burdened with uncertainty. The digital drainage system reduces intraobserver variability allowing for improved decision making in chest tube removal.