A Network Meta-Analysis of Drainage systems and Suction Strategies After Lung Cancer Surgery

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 alternating suction. While complication rates were comparable, heterogeneity limited firm conclusions, underscoring the need for standardized, high‑quality studies to define optimal, safe chest drain protocols.

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