Digital chest drainage system versus traditional chest drainage system after pulmonary resection: a systematic review and meta-analysis

Hong Wang,Liang Ma,Yiran Zhang,Wenbin Hu

doi:10.1186/s13019-019-0842-x

Abstract

BackgroundSeveral randomized controlled trials (RCTs) and observational studies have compared the efficacy of digital chest drainage system versus traditional chest drainage system. However, the results were inconsistent.MethodsWe searched the Web of Science and Pubmed for observational studies and RCTs that compared the effect of digital chest drainage system with traditional chest drainage system after pulmonary resection. Eight studies (5 randomized control trails and 3 observational studies) comprising 1487 patients met the eligibility criteria.ResultsCompared with the traditional chest drainage system, digital chest drainage system reduced the risk of prolonged air leak (PAL) (RR = 0.54, 95%CI 0.40–0.73, p < 0.0001), and shortened the duration of chest drainage (SMD = − 0.35, 95%CI -0.60 - -0.09, p = 0.008) and length of hospital stay (SMD = − 0.35, 95%CI -0.61 - -0.09, p = 0.007) in patients after pulmonary resection.ConclusionsDigital chest drainage system is expected to benefit patients to attain faster recovery and higher life quality as well as to reduce the risk of postoperative complications. Further RCTs with larger sample size are still needed to more clearly elucidate the advantages of digital chest drainage system.

Highlights

Alveolar air leak is one of the most frequent complications after pulmonary resection, which happened in up to 50% patients [1]
Prolonged air leak (PAL), defined as an air leak persisting more than 5 days by the Society of Thoracic Surgeons Database, occurred in approximately 8–15% patients after pulmonary resection [2]
Several randomized controlled trials (RCTs) and observational studies have compared the efficacy of digital chest drainage system versus traditional chest drainage system

Summary

Introduction

Alveolar air leak is one of the most frequent complications after pulmonary resection, which happened in up to 50% patients [1]. Prolonged air leak (PAL), defined as an air leak persisting more than 5 days by the Society of Thoracic Surgeons Database, occurred in approximately 8–15% patients after pulmonary resection [2]. It measures air leak in a subjective manner by observing bubbling in the water chamber, interobserver disagreement is frequent, and small air leaks are difficult to determine. The suction pressure of the traditional chest drainage system may deviate from the set level due to the position of the water chamber. With the digital chest drainage system, the pleural pressure can be constantly maintained by physicians independent of the device position, and postoperative air leak can be evaluated.

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Results

Conclusion