Suction or Nonsuction: How to Manage a Chest Tube After Pulmonary

Thoracic surgery clinics · Feb 2017

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Suction or Nonsuction: How to Manage a Chest Tube After Pulmonary Resection.

Despite several randomized trials and meta-analyses, the dilemma as to whether to apply suction after subtotal pulmonary resection has not been solved. The combination of a poorly understood pathophysiology of the air leak phenomenon and the inadequate quality of the published randomized trials is actually preventing thoracic surgeons from abandoning an empirical management of chest drains. Even digital systems do not seem to have made the difference so far. Based on the evidence of the literature, the authors propose a new air leak predictor score (ALPS) as a contributing step toward appropriateness in using intraoperative sealants, opting for an external suction and managing and chest tubes.

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- Gaetano Rocco, Alessandro Brunelli, and Raffaele Rocco.
- Division of Thoracic Surgical Oncology, Department of Thoracic Surgical and Medical Oncology, Istituto Nazionale Tumori, Pascale Foundation, IRCCS, Naples, Italy. Electronic address: g.rocco@istitutotumori.na.it.
- Thorac Surg Clin. 2017 Feb 1; 27 (1): 35-40.
AbstractDespite several randomized trials and meta-analyses, the dilemma as to whether to apply suction after subtotal pulmonary resection has not been solved. The combination of a poorly understood pathophysiology of the air leak phenomenon and the inadequate quality of the published randomized trials is actually preventing thoracic surgeons from abandoning an empirical management of chest drains. Even digital systems do not seem to have made the difference so far. Based on the evidence of the literature, the authors propose a new air leak predictor score (ALPS) as a contributing step toward appropriateness in using intraoperative sealants, opting for an external suction and managing and chest tubes.Copyright © 2016 Elsevier Inc. All rights reserved.

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Suction or Nonsuction: How to Manage a Chest Tube After Pulmonary Resection.

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