The evolution of chest tube management following lung cancer surgery: many options, scarce evidence

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. The review emphasizes the need for standardized definitions and removal criteria, and advocates for personalized, evidence-based drainage strategies within ERAS protocols to improve patient outcomes and support minimally invasive approaches.

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