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M. Suzuki
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P3.02 - Poster Session/ Treatment of Localized Disease – NSCLC (ID 211)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Localized Disease - NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.02-022 - The Digital Monitoring of Postoperative Air Leak Patterns and Air Leak Flow Is Useful for Predicting Prolonged Air Leak after Pulmonary Resection (ID 1092)
09:30 - 09:30 | Author(s): M. Suzuki
- Abstract
Background:
The presence of prolonged air leak (PAL) after pulmonary resection sometimes results in serious complications, such as empyema. Therefore, early prediction and intervention for PAL should be performed. Thopaz[TM] is a digital monitoring thoracic drainage system which enables the objective evaluation of air leak. This study aimed to establish the diagnostic criteria for the early prediction of PAL using the Thopaz[TM ]system.
Methods:
The postoperative data of 150 patients who underwent pulmonary resection and for whom the digital monitoring of thoracic drainage was performed using Thopaz[TM] between December 2013 and January 2015 were prospectively collected. When the air flow level was < 20 mL/min for > 12 hours, the chest tube was removed. We examined the postoperative data, including the chest X-ray findings, the presence of postoperative complications, the duration of air leak, the duration of chest tube placement, the patterns of air leak until 72 hours after operation and the level of peak air flow until 24 hours after operation as determined by Thopaz[TM]. The patterns of air leak were defined as Types A-E (A: No air leak was observed until the removal of the chest tube; B: Air leak flow gradually decreased; C: Although no air leak was observed immediately after operation, air leak occurred postoperatively; D: The repeated exacerbation and remission of air leak was observed; E: Air leak was observed without a trend toward improvement).
Results:
There were 100 men and 50 women; 99 smokers and 51 never-smokers; and 119 cases of lung cancer and 31 cases of other diseases. Their surgeries included 23 wedge resections, 24 segmentectomies and 103 lobectomies. Air leak at the time of the sealing test during the operation was observed in 82 (55%) patients. Air leak was observed in 31 (21%) patients, in whom the mean (± SD) duration of air leak was 3.9 (± 3.7) days. The mean (± SD) duration of chest tube placement was 3.2 (± 1.9) days in the whole study population (n = 150) and 5.2 (± 2.7) days in the 31patients with postoperative air leak. On chest X-ray films, 12 cases of subcutaneous emphysema and 4 cases of atelectasis were observed postoperatively. No complications associated with Thopaz[TM] developed. PAL > 4 days was observed in 10 (6.7%) patients. The frequencies of PAL according to the air leak patterns were 0% (0/119) in type A, 23% (3/13) in type B, 20% (2/10) in type C, 50% (2/4) in type D and 75% (3/4) in type E. The frequencies of PAL according to the peak air flow were 11% (2/18) in < 100 ml/min, 62% (8/13) in ≥ 100 ml/min, 60% (6/10) in ≥ 200 ml/min, 83% (5/6) in ≥ 400 ml/min and 80% (4/5) in ≥ 500ml/min.
Conclusion:
The risk of PAL was higher in patients showing type D and E air leak patterns, and a peak air flow of ≥ 400 ml/min. The results indicate that PAL after pulmonary resection may be predicted by air leak patterns and peak air flow using the Thopaz[TM] system.
