F-057DOES THE USAGE OF A DIGITAL CHEST DRAINAGE SYSTEM REDUCE PLEURAL INFLAMMATION AND VOLUME OF PLEURAL EFFUSION AFTER MAJOR LUNG RESECTIONS FOR CANCER? A PROSPECTIVE, RANDOMIZED STUDY

Objectives: Excessive amounts of pleural effusion are a common cause for delay in chest tube removal following lung resection. Digital pleural drainage systems are increasingly used, with assumed superiority over traditional analogue systems in the management of postoperative air leak. The effect of the system type on pleural effusion and inflammation has not been studied. We hypothesized that digital systems, introducing intermittent, balanced suction would be associated with less pleural inflammation and effusion formation. Methods: One hundred and three patients, enrolled in a prospective, randomized controlled study, received either analogue (n = 50) or digital (n = 53) drainage systems following lung resection for malignancy. Chest tubes were removed according to an a priori defined protocol. Inflammatory mediators (interleukin-6, 8, 10, 1Ra, TNF-α) in pleural fluid and sputum were collected and analysed. The primary outcome was to observe differences in pleural effusion volume. Secondary outcomes were duration of chest tube in situ, air-leak incidence, length of hospital stay and degree of pleural inflammation. Results: Mean age was 66.7 years, 50.5% male. A trend for shorter chest tube duration was found with the digital system (P = 0.055). There was no difference in total amount of fluid drained or length of hospital stay. Incidence of prolonged postoperative air leak was significantly higher when using the analogue system (9 vs 2; P = 0.025). Video-assisted procedures were superior to open on all outcomes (P < 0.001). Lobectomy was associated with longer chest tube duration (P = 0.001) and increased fluid drainage when compared to sublobar resection (P < 0.001), regardless of drainage system. Comparison of inflammatory mediator levels revealed no difference. Conclusions: Digital drainage systems are superior in regards to incidence of postoperative air leak and chest tube duration. Inflammatory mediators and total pleural effusion volume are not correlated with the type of drainage system utilized. Minimally invasive procedures and sublobar resections have less effusion formation and shorter duration of chest tube. Disclosure: No significant relationships.