Francesco Zaraca, Marco Damiano Pipitone, Florian Augustin, Amr Abdellateef, Marcelo Jiménez, Andreas Kirschbaum, Calvin S. H. Ng, Dania Nachira, Isabelle Opitz, Clarissa Uslenghi, Marco Lucchi, Roberto Crisci, Reinhold Perkmann, Lorenzo Spaggiari & Luca Bertolaccini  |  December 6, 2025

This GRADE‑based consensus provides evidence‑informed recommendations for managing postoperative prolonged air leaks after lung surgery. Key guidance includes standardized air‑leak assessment, preference for digital drainage systems, and individualized selection between water seal and suction based on leak severity and clinical context. A stepwise framework (digital monitoring, tailored drainage strategy, and…

Quirine van Steenwijk, Marcel GW Dijkgraaf, Wolter Oosterhuis, Denis Susa, Matthijs DM Bolmers, Robert TJ Kortekaas, Chris Dickhoff, Jerry Braun, Frank JC van den Broek  |  March 26, 2026

This multicenter retrospective study compared progressive versus conservative chest tube management after surgical pleurodesis for primary spontaneous pneumothorax. Early chest tube removal shortly after cessation of air leak significantly reduced chest tube duration, length of stay, and complications without increasing recurrence rates. Progressive protocols using lower pressure levels and rapid…

Lars Geenen, Koen C. H. A. Verkoulen, Iris E. W. G. Laven, Jean H.T. Daemen, Lori M. van Roozendaal, Chiel J. Franssen, Aimée J. P. M. Franssen, Juliette H.R.J. Degens, Karel W. E. Hulsewé, Yvonne L. J. Vissers, Joel Dunning, Alessandro Brunelli, and Erik R. de Loos  |  March 16, 2026

This systematic review and network meta‑analysis evaluated chest drain management strategies after anatomical lung resection. Among eight approaches, digital drainage – particularly with alternating suction- – was associated with shorter drainage duration and length of hospital stay compared with analogue systems. Continuous suction appeared less effective than water seal or…

Nestor J. Martinez-Hernandez; Alberto Cabanero-Sanchez; Juan Manuel Corcoles-Padilla; Elisabet Chacon-del Pino; Carlos Fraile-Olivero; Esther Gimenez-Moolhuyzen; Encarna Minana-Aragon; Maria Gorina; Nadia Pires; Maria Alvarez-Orozco; Ignacio Garutti  |  February 17, 2026

This Delphi consensus study established evidence‑based ERAS recommendations for lung resection surgery. Strong agreement was reached on early chest drain removal and the use of digital drainage systems to standardize decision‑making and reduce drainage duration. Integrated with opioid‑sparing analgesia, minimally invasive surgery, and early mobilization, optimized chest drain management was…

Marta Fuentes, María Teresa Gómez-Hernández, Andrea Peñaherrera Cepeda, Cristina Rivas, Jose Luis Aranda, Oscar Colmenares, Mario Manama, Felipe Gómez-Caminero, Pilar Tamayo and Marcelo F. Jiménez  |  February 24, 2026

This prospective cohort study evaluated the impact of preoperative ventilation single-photon emission computed tomography combined with computed tomography (vSPECT/CT) for surgical management of prolonged air leak. vSPECT/CT accurately localized air leaks and was associated with significantly shorter chest tube duration and hospital stay compared with matched controls. By enabling targeted…

Seha Ahn, Youngkyu Moon  |  October 31, 2025

This retrospective learning‑curve study evaluated early independent practice outcomes of a junior thoracic surgeon performing major pulmonary resections. Procedural efficiency and outcomes improved steadily without increased complications. Standardized chest drain management using digital drainage, stepwise suction reduction, and objective air leak criteria supported safe recovery and timely discharge. These findings…

Federico Vaisitti, Simona Sobrero, Stefano Rudella, Alessandra Russo, Marco Marcaccini, Luca Errico, Francesco Leo  |  February 13, 2026

This randomized trial compared fissure‑last versus fissure‑first techniques for NSCLC resection using digital air‑leak assessment. The fissure‑last approach did not reduce air leaks at 48 hours, prolonged air leak rates, chest drain duration, or hospital stay, even in patients with incomplete fissures. Standardized chest drain management with digital monitoring guided…

Erik Stiles, Ricky Harika,Madhan Kuppusamy, Joel Sternbach, Donald E. Low, Michal Hubka  |  January 3, 2025

This retrospective ERAS cohort study evaluated factors enabling early discharge after robotic lobectomy. Over half of patients were discharged on postoperative day 1 without increased complications. Early ambulation and resolution or removal of chest drains were key modifiable drivers of POD 1 discharge, while persistent air leak delayed discharge. These…

Nina Maksimovic, Kirill Neumann, Henrik Aamodt, Rune Eggum, Frode Reier-Nilsen, Jarlis Wesche, Knut Stavem  |  August 31, 2025

This retrospective learning‑curve analysis evaluated the transition from VATS to robotic lobectomy for early‑stage lung cancer. Surgical proficiency improved over time, with decreasing operative duration and complications after approximately 90–120 cases. Conversion and reoperation rates were low, and overall complication rates were acceptable throughout implementation. These findings suggest that adoption…

Imran Jamal Iversen, Finn Amundsen Dittberner, Anni Germann Najbjerg, Marie Øbo Larsen & Bo Laksáfoss Holbek  |  November 5, 2025

This national Delphi study established expert consensus on readiness-for-discharge criteria after pulmonary surgery in Denmark. Thoracic surgeons agreed on 23 endpoints spanning key recovery domains, including clear criteria for chest drain removal. Standardizing chest drain–related endpoints alongside respiratory function, pain control, and mobilization helps distinguish clinical readiness for discharge from…