Comparison between use of a pleural drainage system with flutter valve and a conventional water-seal drainage system after lung resection: a randomized prospective study

Sao Paulo Med J. 2024 Apr 22;142(5):e2023224. doi: 10.1590/1516-3180.2023.0224.R1.08022024. eCollection 2024.

Abstract

Background: There is still a debate regarding the most appropriate pleural collector model to ensure a short hospital stay and minimum complications.

Objectives: To study aimed to compare the time of air leak, time to drain removal, and length of hospital stay between a standard water-seal drainage system and a pleural collector system with a unidirectional flutter valve and rigid chamber.

Design and setting: A randomized prospective clinical trial was conducted at a high-complexity hospital in São Paulo, Brazil.

Methods: Sixty-three patients who underwent open or video-assisted thoracoscopic lung wedge resection or lobectomy were randomized into two groups, according to the drainage system used: the control group (WS), which used a conventional water-seal pleural collector, and the study group (V), which used a flutter valve device (Sinapi® Model XL1000®). Variables related to the drainage system, time of air leak, time to drain removal, and time spent in hospital were compared between the groups.

Results: Most patients (63%) had lung cancer. No differences were observed between the groups in the time of air leak or time spent hospitalized. The time to drain removal was slightly shorter in the V group; however, the difference was not statistically significant. Seven patients presented with surgery-related complications: five and two in the WS and V groups, respectively.

Conclusions: Air leak, time to drain removal, and time spent in the hospital were similar between the groups. The system used in the V group resulted in no adverse events and was safe.

Registration: RBR-85qq6jc (https://ensaiosclinicos.gov.br/rg/RBR-85qq6jc).

Publication types

  • Randomized Controlled Trial
  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Drainage* / instrumentation
  • Drainage* / methods
  • Equipment Design
  • Female
  • Humans
  • Length of Stay*
  • Lung Neoplasms / surgery
  • Male
  • Middle Aged
  • Pneumonectomy* / adverse effects
  • Pneumonectomy* / instrumentation
  • Pneumonectomy* / methods
  • Postoperative Complications / etiology
  • Prospective Studies
  • Thoracic Surgery, Video-Assisted / instrumentation
  • Thoracic Surgery, Video-Assisted / methods
  • Time Factors
  • Treatment Outcome