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…

Tzu-Yi Yang, Ching-Yang Wu, Ming-Ju Hsieh, Yin-Kai Chao, Ching-Feng Wu  |  July 23, 2025

This prospective, randomized controlled trial compared digital (DCD) and traditional (TCD) chest drainage systems in postoperative care. Among over 250 patients, the DCD system was associated with shorter chest tube duration, reduced hospital stays, improved sleep quality, and greater postoperative mobility, without increasing complications. The study concludes that digital chest…

Eric Lim, Shanda H. Blackmon, Lieven Depypere, Michel Gonzalez, Brian Mitzman, Brendan M. Stiles, Nuria Novoa  |  August 31, 2025

This narrative review analyzed high-quality trials comparing digital and traditional chest drain systems after thoracic surgery. Among five randomized studies, all reported a reduction in hospital stay by one day with digital drains, though statistical significance varied. The review highlights that digital drains are consistently associated with shorter hospital stays,…

Fabrizio Minervini, Pietro Bertoglio, Alessandro Brunelli, Yaron Shargall  |  March 28, 2025

Persistent air leaks (PAL) and excess fluid drainage prolong hospital stays after lung surgery. Studies support outpatient PAL management, reducing costs but posing risks like empyema and readmission. Segmentectomy increases PAL risks, requiring further study. Outpatient pneumothorax treatment is feasible but has mixed results. Structured post-discharge care, including monitoring, is…

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…

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…