Lars Geenen, Koen C. H. A. Verkoulen, Aimée J. P. M. Franssen, Juliette H. R. J. Degens, Karel W. E. Hulsewé, Yvonne L. J. Vissers, Erik R. de Loos  |  August 31, 2025

This comprehensive review examines current strategies and evidence for chest drainage after lung cancer surgery, highlighting ongoing debates over optimal removal criteria and drainage techniques—including suction versus water seal and digital versus analogue systems. Despite extensive research, no consensus has been reached due to conflicting results and limited high-quality evidence.…

Kazuya Takamochi, Makoto Endo, Kazuhito Funai, Tomohiro Haruki, Morihito Okada, Masahiro Tsuboi, Yoshitaka Kitamura, Shiaki Oh, Shuko Nojiri, Kenji Suzuki, and the Advanced Clinical Trial Chest Surgery Group (ACTG)  |  August 29, 2025

This multicenter, randomized controlled trial compared two intrathoracic pressure settings (−8 cmH₂O vs. −15 cmH₂O) in digital pleural drainage for patients with moderate air leaks after lung resection. No significant differences were found in prolonged air leak rates, air leak duration, chest tube duration, or hospital stay between groups. The…

Conor M. Maxwell, Benny Weksler, Kevin Shahbahrami, Brent Williams, Kurt DeHaven, Pam Kuchta, Kara Specht, and Hiran C. Fernando  |  July 31, 2025

This randomized study compared standard suction (−20 cmH₂O) and low suction (−8 cmH₂O) using digital drainage after minimally invasive lung resection. Both approaches, with a single 24 Fr Blake drain and a removal threshold of 450 mL/24 h, were safe and effective. However, low suction did not shorten air leak…

Wytze S. de Boer, Richard N. Hartman, Quinten S.D. Muller, Mireille A. Edens, Dirk Jan Slebos, Marieke L. Duiverman, Jos A. Stigt  |  March 28, 2025

This single-center, non-inferiority trial assessed whether chest tube removal based solely on digital drainage data is as safe as traditional clamping trials. Among 92 patients—primarily post-lung surgery—no significant difference in chest tube reinsertion rates was observed. Notably, clamping led to pneumothorax progression in over 13% of cases. The findings support…

Alexander Smith, Akshay Patel, Muhammad Mansoor, Raya Almaraihah, Kevin Sales, Khine Wai, Krishna Mani, Adnan Charaf, Marjan Jahangiri  |  May 2, 2025

This study compared digital and underwater seal drainage systems in cardiac surgery patients. After matching patients for comparison, those using digital drainage had a significantly lower risk of post-operative atrial fibrillation. However, there were no differences in other outcomes like bleeding, tamponade, pleural effusion, or drain output. The findings suggest…

Alison Embalabala, Brian Mitzman, Traves Crabtree  |  March 28, 2025

This article identifies and summarizes the current comparative data between digital drains and traditional pleural devices. Some randomized controlled trials found no significant difference between digital and analogue systems. Others reported shorter chest tube duration and length of stay with digital devices. Meta-analyses support these findings, though variations in protocols…

Ashiq Abdul Khader, Eric Lim  |  March 28, 2025

Effective drainology influences hospital stay duration. Enhanced Recovery After Surgery (ERAS) guidelines recommend a single chest tube, digital drainage systems, pain management and improving mobility. However, suction pressure and chest tube removal criteria remain a topic of debate and research. Studies show early drain removal, on POD0, is safe using…

Jurij M Kalisnik , Vitalijs Zujs , Janez Zibert , Islam Batashev , Spela Leiler , Jacob Arne B Carstensen , Jan-Niklas Krohn , Theodor Fischlein  |  March 28, 2025

Different drainage modalities and chest placement strategies significantly affect postoperative outcomes in coronary artery bypass graft patients. This article shows that portable digital drainage system (Thopaz+, Medela) outperformed conventional drainage systems in reducing RBS interventions, supporting early re-exploration for bleeding, and reducing postoperative atrial fibrillation incidence and resource utilization. Digital…

Ashiq Abdul Khader, Aina Pons, Abigail Palmares, Sarah Booth, Alexander Smith, Chiara Proli, Paulo De Sousa and Eric Lim  |  July 10, 2023

Chest drain management is a variable aspect of postoperative care in thoracic surgery, with different opinion for air and drain volume output. The results of our study demonstrate acceptable levels of safety using digital assessment of air leak as the sole criteria for drain removal in selected patients after general…

Ashiq Abdul Khader, Aina Pons, Abigail Palmares, Chiara Proli, Paulo De Sousa and Eric Lim  |  June 2, 2023

Advances in perioperative management for thoracic surgery have accelerated the postoperative recovery of patients by decreasing postoperative pain and the incidence of complications. We aimed to study whether it’s safe to remove chest drains on table in selected cases. Click here to read on JTCVS Open.