Prediction of prolonged air leak after lung resection using continuous log data of flow by digital drainage system

  • Masaki Goto
  • Keiju AokageEmail author
  • Keigo Sekihara
  • Tomohiro Miyoshi
  • Kenta Tane
  • Kohei Yokoi
  • Masahiro Tsuboi
Original Article



The aim of this study was to extract predictive factors of prolonged air leak (PAL) including air flow data as objective parameter by digital drainage system (DDS).


The 372 patients who underwent lung resection and had continuous log data of air flow by DDS were reviewed. PAL was defined as the air leak which was exceeding 20 ml/min and lasting 5 days or more. The 69 patients (18.5%) showed air leak and were divided into PAL group (n = 21) and non-PAL group (n = 48). The average flow per hour was calculated at 0, 12, and 24 postoperative hours (POH) and the residual ratio of flow at 12, 24, and 36 POH to that at the time after surgery was analyzed with clinical factors. Area under the receiver-operating characteristic curve (ROC-AUC) was calculated to determine optimal cut-off value of PAL predictors.


ROC-AUC for flow at 36 POH was 0.88. Sensitivity and specificity were 0.91 and 0.73 when cut-off value was set at 20 mL/min at 36 POH. ROC-AUC for residual ratio at 36 POH was 0.82. Sensitivity and specificity were 0.81 and 0.79 when cut-off value of residual ratio was set at 0.20.


The air flow and the residual ratio measured by DDS will be useful predictors of postoperative PAL after lung resection.


Prolonged air leak Digital drainage system Perioperative management 



This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

Compliance with ethical standards

Conflict of interest

The authors have no conflicts of interest to declare.

Supplementary material

11748_2019_1073_MOESM1_ESM.pdf (144 kb)
Supplementary material 1 (PDF 144 KB)
11748_2019_1073_MOESM2_ESM.pdf (121 kb)
Supplementary material 2 (PDF 121 KB)


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Copyright information

© The Japanese Association for Thoracic Surgery 2019

Authors and Affiliations

  • Masaki Goto
    • 1
    • 2
  • Keiju Aokage
    • 1
    Email author
  • Keigo Sekihara
    • 1
  • Tomohiro Miyoshi
    • 1
  • Kenta Tane
    • 1
  • Kohei Yokoi
    • 2
  • Masahiro Tsuboi
    • 1
  1. 1.Department of Thoracic SurgeryNational Cancer Center Hospital EastKashiwaJapan
  2. 2.Department of Thoracic SurgeryNagoya University Graduate School of MedicineNagoyaJapan

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