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

Authors

Keywords:

Pleural cavity, Thoracic surgical procedures, Lung, Pleural effusion, Postoperative period, Time in hospital

Abstract

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

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Author Biographies

Rodrigo Caetano de Souza, Hospital do Servidor Público Estadual de São Paulo Francisco Morato Oliveira, São Paulo, São Paulo, Brazil

MD, MSc. Thoracic surgeon, Preceptor of the Residency Program in Thoracic Surgery, Hospital
do Servidor Público Estadual de São Paulo (IAMSPE) Francisco Morato Oliveira, São Paulo
(SP), Brazil.

Lilianne Louise Silva de Morais, Hospital do Servidor Público Estadual de São Paulo Francisco Morato Oliveira, São Paulo, São Paulo, Brazil

MD, Thoracic surgeon, Hospital do Servidor Público Estadual de São Paulo (IAMSPE) Francisco Morato Oliveira, São Paulo (SP), Brazil.

Mario Claudio Ghefter, Hospital do Servidor Público Estadual de São Paulo Francisco Morato Oliveira, São Paulo, São Paulo, Brazil

MD. Thoracic surgeon, Director of the Thoracic Surgery Service, Hospital do Servidor Público
Estadual de São Paulo (IAMSPE) Francisco Morato Oliveira, São Paulo (SP), Brazil.

Juliana Pereira Franceschini, ProAR Foundation, São Paulo, São Paulo, Brazil

PhD. Physiotherapist, Project Leader, ProAR Foundation, São Paulo (SP), Brazil.

Fernando Campos Gomes Pinto, Universidade de São Paulo, São Paulo, São Paulo, Brazil


MD, PhD. Neurosurgeon, Head of the Cerebral Hydrodynamics Group, Functional Neurosurgery Division, Institute of Psychiatry, Hospital das Clínicas, Faculty of Medicine, Universidade de São Paulo (USP), São Paulo (SP), Brazil.

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Published

2025-04-23

How to Cite

1.
Souza RC de, Morais LLS de, Ghefter MC, Franceschini JP, Pinto FCG. 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 [Internet]. 2025 Apr. 23 [cited 2025 May 12];142(5):1-6. Available from: https://periodicosapm.emnuvens.com.br/spmj/article/view/3097

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