This retrospective cohort study of 476 patients undergoing endoscopic coronary artery bypass grafting (May 2021–January 2025) evaluated the safety of very early postoperative chest drain removal. Despite higher baseline risk in the early‑removal group, these patients experienced significantly shorter drainage duration (5.1 vs. 22.4 hours) and lower total drain output,…
Read more »This prospective quality improvement study evaluated chest tube removal in the operating room after robotic pulmonary resection using digital air‑leak assessment. In selected patients with minimal air leak, immediate removal was feasible, with most discharged on postoperative day 1. Chest tube reinsertion was infrequent and manageable. These results suggest that…
Read more »This large multicenter retrospective study evaluated intercostal chest drain (ICD) removal strategies for spontaneous pneumothorax. Clamping trials were safe but did not reduce pneumothorax recurrence or length of stay compared with direct removal. Recurrent pneumothorax remained common after ICD removal. Use of digital air leak devices combined with clamping showed…
Read more »This retrospective institutional review evaluated routine mediastinal chest drain removal on postoperative day 1 after cardiopulmonary bypass surgery. Among 158 patients, chest drains were typically removed at ~22 hours with minimal output. Early drain removal was associated with low rates of clinically significant pericardial effusion and rare need for reintervention.…
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 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 large retrospective study evaluated a chest drain removal protocol based solely on digital air leak assessment following thoracic surgery. Using a threshold of <20 mL/min for more than 6 hours, chest drains were typically removed after 1 day, with low rates of reintervention (2.1%) despite radiographic pneumothorax or pleural…
Read more »This retrospective study evaluated protocolized chest drain removal in the operating room following thoracoscopic minor thoracic procedures and sublobar lung resections. Using a digital drainage system, chest tubes were removed immediately when air leak was <20 mL/min at the end of surgery. Despite occasional radiographic pneumothoraces, reintervention was rare, hospital…
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
Read more »This narrative review highlights the central role of chest drains in recovery after cardiac surgery while emphasizing the considerable variation in current management practices. Key decisions (including drain type, number, maintenance of patency, and timing of removal) remain largely guided by tradition rather than robust evidence. The authors identify important…
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