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Open AccessArticle

Complications after Chest Tube Removal and Reinterventions in Patients with Digital Drainage Systems

Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, and School of Medicine, National Yang-Ming University, Taipei 100116, Taiwan
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J. Clin. Med. 2019, 8(12), 2092; https://doi.org/10.3390/jcm8122092
Received: 12 October 2019 / Revised: 17 November 2019 / Accepted: 26 November 2019 / Published: 1 December 2019
(This article belongs to the Section Pulmonology)
Introduction: Digital thoracic drainage systems are a new technology in minimally invasive thoracic surgery. However, the criteria for chest tube removal in digital thoracic drainage systems have never been evaluated. We aim to investigate the incidence and predictive factors of complications and reinterventions after drainage tube removal in patients with a digital drainage system. Method: Patients who received lung resection surgery and had their chest drainage tubes connected with a digital drainage system were retrospectively reviewed. Results: A total of 497 patients were monitored with digital drainage systems after lung resection surgery. A total of 175 (35.2%) patients had air leak-related complications after drainage tube removals, whereas 25 patients (5.0%) required reintervention. We identified that chest drainage duration of five days was an optimal cut-off value in predicting air leak-related complications and reinterventions. In multiple logistic regression analysis, previous chest surgery history; small size (16 Fr.) drainage tubes; the presence of initial air leaks, defined as air leaks recorded by the digital drainage system immediately after operation; and duration of chest drainage ≥5 days were independent factors of air leak-related complications, whereas the presence of initial air leaks and duration of chest drainage ≥5 days were independent predictive factors of reintervention after drainage tube removal. Conclusion: Air leak-related complications and reinterventions after drainage tube removals happened in 35.2% and 5.0% of patients with digital thoracic drainage systems. The management of chest drainage tubes in patients with predictive factors, i.e., the presence of initial air leaks and duration of chest drainage of more than five days, should be treated with caution. View Full-Text
Keywords: complication; digital drainage system; minimally invasive thoracic surgery complication; digital drainage system; minimally invasive thoracic surgery
MDPI and ACS Style

Lee, Y.-Y.; Hsu, P.-K.; Huang, C.-S.; Wu, Y.-C.; Hsu, H.-S. Complications after Chest Tube Removal and Reinterventions in Patients with Digital Drainage Systems. J. Clin. Med. 2019, 8, 2092.

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