Recommendations for the standardization and management of prolonged air leaks in lung surgery

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 targeted intervention for leaks persisting beyond five days) aims to reduce variability, complications, and prolonged chest drain duration.

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