Digital chest drain in paediatric surgical patients

Journal article

Purpose: Chest drains used after thoracoscopic and open surgery traditionally rely on underwater drain (UWD). While Thopaz+ digital chest drain is NICE-recommended for adults, its usage in paediatric populations is underreported. This quality improvement project (QIP) evaluated the efficacy and safety of adopting Thopaz + in paediatric surgical patients. Methods: Thopaz + was introduced in the Paediatric surgery department. Retrospective data were collected for patients undergoing thoracic operations between 10/2022 and 07/2025, including demographics, chest drain indication, drain duration, and complications. Results: Of forty-nine patients (aged 1 day to 17 years; median age: 2.34 years, IQR 0.29–13.19), 55.10% (N = 27) used Thopaz + and 44.90% (N = 22) used UWD. Thopaz+ group was significantly older (median 12.2 years-old (2.3, 15.1), 95% CI: 6.7–12.0) and heavier (median 44 kg (16,55), 95% CI: 29–47) than UWD group (median 0.3years-old (0.0, 1.9), 95% CI: 0.73–5.6; median 12 kg (9,16), 95% CI: 11–26), reflecting absence of Thopaz+ adoption for neonates within the trust (p < 0.001 for age; p = 0.002 for weight). Thopaz+ trended towards a shorter chest drainage duration, with a median of 2 days (1.0, 6.0; 95% CI 2.1–5.9), vs. median of 3.5 days (2.0, 7.0; 95% CI 1.2–16) with UWD, although not statistically different (p = 0.088). Complication rate was not significantly different: 22.2% (N = 6/27; 95% CI 9.4–43) with Thopaz + vs. 9.1% (N = 2/22; 95% CI 1.6–31) with UWD. Satisfaction survey heavily favoured Thopaz+. Conclusion: This study shows Thopaz + can be safely and feasibly implemented in paediatric surgical practice. Larger, multicentre studies are needed to define the cost-effectiveness and develop paediatric clinical protocol.

Authors: Yoon, H; McHoney, M

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Springer
• Journal: Journal of Pediatric Endoscopic Surgery
• Volume: 8
• Issue: 2
• Pages: 93-99
• Publication date: 2026-04-15
• Acceptance date: 2026-03-19
• DOI: 10.1007/s42804-026-00308-z
• EISSN: 2524-7883
• ISSN: 2524-7875
• Language: English
• Keywords: Digital chest drainage; Perioperative patient safety; Thopaz; Paediatric thoracic surgery