SCI

11 June 2024

Discharging Patients Home with a Chest Tube and Digital System after Robotic Lung Resection

(The Annals of Thoracic Surgery; IF:4.6)

  • Corresponding author contact information:Travis C. Geraci, MD，Department of Cardiothoracic Surgery，NYU Langone Health，530 1st Avenue, Suite 9V，New York, NY 10016，Email: travis.geraci@nyulangone.org

  • Geraci TC, McCormack AJ, Cerfolio RJ, Discharging Patients Home with a Chest Tube and Digital System after Robotic Lung Resection, The Annals of Thoracic Surgery (2024), doi: https://doi.org/10.1016/j.athoracsur.2024.05.004.

BACKGROUND: 背景

Our objective is to assess the feasibility, safety, and outcomes for patients discharged home with a chest tube connected to a digital drainage system after robotic pulmonary resection.

我们的目标是评估机器人肺切除术后使用数字引流系统连接胸腔引流管出院患者的可行性、安全性和疗效。

 

METHODS: 方法

A retrospective analysis of a prospectively collected database as a quality improvement initiative. All patients had planned discharge on postoperative day one (POD1) after robotic pulmonary resection. Those with an air leak were discharge home with a chest tube connected to a digital drainage system with daily communication with the surgeon.

作为质量改进举措，对前瞻性收集的数据库进行回顾性分析。所有患者均计划在机器人肺切除术后第1天出院。有漏气的患者出院时带着连接数字引流系统的胸管回家，并与外科医生进行日常沟通。

 

RESULTS: 结果

From January 2019 to February 2023 there were 580 consecutive robotic resections, of which 69 (12%) patients had an air leak on POD1; 38/276 (14%) after lobectomy, 24/226 (11%) after segmentectomy, and 7/78 (9%) after wedge resection. Of these 69 patients, 52 patients (75%) were discharged on POD1, 15 patients (22%) on POD2, and 2 patients (3%) on POD3. Chest tubes were removed a median outpatient chest tube duration was 4 days (IQR 3-5). Of the 69 patients sent home with a digital drainage system, there was one complication requiring readmission for increasing subcutaneous emphysema. Five patients (7%) had system malfunctions that required return to our clinic for problem solving. There were no 30 or 90-day mortalities.

从2019年1月至2023年2月，连续进行了580例机器人手术，其中69例(12%)患者在术后第1天发生气漏;肺叶切除38例(14%)，肺段切除24例(11%)，肺楔形切除7例(9%)。69例患者中，52例(75%)于术后第1天出院，15例(22%)于术后第2天出院，2例(3%)于术后第3天出院。拔除胸管的中位时间为4 天 (IQR 3 ~ 5)。在携带数字引流系统出院的69例患者中，有1例患者因皮下气肿加重而需要再次入院。5例患者(7%)出现系统故障，需要回到我们的诊所解决问题。无30天或90天死亡病例。 

 

CONCLUSIONS: 结论

Patients who undergo robotic pulmonary resection and have an air leak can be safely and effectively discharged on the first post-operative day and managed as an outpatient by using daily texts and or videos with pulse oximetry data on a digital drainage system with limited morbidity.

接受机器人肺切除术并发生漏气的患者可在术后第1天安全有效出院，并作为门诊管理，通过数字引流系统使用每日短信和或视频记录脉搏血氧测定数据，发病率有限。