042 * DIGITAL VERSUS ANALOGUE CHEST TUBE DRAINAGE FOLLOWING LOBECTOMY: A RANDOMISED TRIAL

Abstract

Abstract Objectives: Digital drainage systems (DDS) have shown superiority compared with analogue (water seal) drainage systems (ADS) following various lung resections, but the number of studies is limited. As part of a medico‐technical evaluation before switching to DDS for routine thoracic surgery, we conducted a randomised controlled trial (RCT) investigating chest tube duration and length of stay. Methods: Patients undergoing lobectomy for non‐small‐cell lung cancer (NSCLC) were included in a prospective open label RCT. A strict algorithm was designed for early chest tube removal and this decision was delegated to nurses in charge of postoperative care. Kaplan‐Meier survival analysis with log‐rank test was performed on an intention‐to‐treat basis. Time was distinguished as possible (optimal) and actual time for chest tube removal. Results: A total of 105 patients were randomised. We found no significant difference between DDS and ADS in length of hospitalisation (P = 0.84), actual chest tube duration (P = 0.49) or optimal chest tube duration (P = 0.32). No chest tubes had to be reinserted. Conclusion: Digital drainage systems did not reduce length of hospitalisation or chest tube duration significantly compared with standard water seal when a strict algorithm for chest tube removal was used. However, they allowed removal of chest tubes, which could be delegated to staff nurses, and in some patients chest tubes could be removed safely on the day of surgery.