einstein (São Paulo). 25/Jun/2024;22(Suppl 1):STO013.

Postoperative drainage time for air leaks after lung resection for non-small cell lung cancer (NSCLC): a retrospective cohort analysis

Fabio Eiti Nishibe

Minamoto

, Mariana Rodrigues

Cremonese

, Alessandro Wasum

Mariani

, Eserval Rocha

Júnior

, Letícia Leone

Lauricella

, Paulo Manuel

Pêgo-Fernandes

, Ricardo Mingarini

Terra

DOI: 10.31744/einstein_journal/2024ABS_BTS_STO013

Category: Thoracic Surgery

Introduction:

With the advance of minimally invasive thoracic surgical techniques, postoperative hospitalization is shorter, and recovery is faster. However, chest drainage may be a limiting factor for hospital discharge, extending the hospital stay. Therefore, it is vital to understand the elements that could affect it so we can develop ways to prevent it.

Objective:

This study aims to assess the parameters that influence chest drainage for air leaks following anatomical lung resection for lung cancer.

Methods:

We queried our institutional database of lung cancer resection for all patients between June 2009 to December 2022 who underwent lobectomy or anatomical segmentectomy. The primary outcome was chest tube drainage time due to an air leak. We excluded patients who underwent wedge resection and pneumonectomy and those who developed chylothorax or postoperative bleeding. Univariable comparisons were performed with χ², Mann-Whitney, and Kruskal-Wallis tests, and multivariable with logistic regression modeling.

Results:

We analyzed 743 patients, 56.5% women, with a median age of 66.2 years. Most patients (83.7%) had the treatment in the public healthcare system. 72.8% had a positive smoking history. The median overall chest drainage time was 3 days (interquartile range IQR 2-4). Baseline characteristics associated with lower chest drainage time were female and younger patients, private healthcare, negative smoking history, absence of emphysema, and lower body mass index.

Conclusion:

The chest drainage time after anatomical resection was longer in patients with pulmonary emphysema, lobectomy, open approach, and postoperative admission in the intensive care unit. Although VATS and RATS had the same median drainage time, in general the robotic approach had the tendency for a shorter period of chest drainage.