This narrative review highlights the role of ERAS in cardiothoracic transplantation, emphasizing standardized chest drain management as a key enabler of recovery. Evidence supports early chest tube removal, avoidance of routine suction, and use of digital drainage systems to objectively monitor air leaks and output, facilitating early mobilization and reduced…
Read more »This phase 1 single-institution trial assessed the safety and feasibility of same-day discharge after video-assisted thoracoscopic surgery (VATS) lung resection. Nineteen patients underwent VATS lobectomy, segmentectomy, or wedge resection and were discharged home with a chest tube. Same-day discharge was achieved in 95% of cases, with a median chest tube…
Read more »This retrospective study evaluated a revised chest tube management protocol allowing removal at fluid outputs up to 500 mL/24 h after anatomic lung resection, compared to the standard 200 mL/24 h threshold. The new protocol enabled earlier chest tube removal (median 2 vs. 3.5 days) without increasing complications, pain, or…
Read more »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.…
Read more »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…
Read more »This review highlights that chest drain duration is a key determinant of recovery after anatomical lung resection and that considerable variation remains in drain removal practices. Evidence suggests that digital drainage systems combined with objective air leak–based protocols can safely expedite chest tube removal, often by postoperative day 1. The…
Read more »This review introduces the concept of “Drainology” – the science of chest drain management – and highlights the significant variation in postoperative drainage practices across cardiothoracic surgery. Drawing on expert discussions from the AATS Drainology symposium and subsequent research, the authors identify chest drain management as a critical yet under‑standardized…
Read more »This review from Tim Batchelor highlights importance of a focus on proactive chest tube management (single tube, no routine suction, use of digital drains, early removal) for superior patient outcomes. Link to publication
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