Skip to main content
Log in

Management of chest drainage tubes after lung surgery

  • Current Topics Review Article
  • Published:
General Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Since chest tubes have been routinely used to drain the pleural space, particularly after lung surgery, the management of chest tubes is considered to be essential for the thoracic surgeon. The pleural drainage system requires effective drainage, suction, and water-sealing. Another key point of chest tube management is that a water seal is considered to be superior to suction for most air leaks. Nowadays, the most common pleural drainage device attached to the chest tube is the three-bottle system. An electronic chest drainage system has been developed that is effective in standardizing the postoperative management of chest tubes. More liberal use of digital drainage devices in the postoperative management of the pleural space is warranted. The removal of chest tubes is a common procedure occurring almost daily in hospitals throughout the world. Extraction of the tube is usually done at the end of full inspiration or at the end of full expiration. The tube removal technique is not as important as how it is done and the preparation for the procedure. The management of chest tubes must be based on careful observation, the patient’s characteristics, and the operative procedures that had been performed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Cerfolio RJ. Closed drainage and suction systems. In: Patterson GA et al., editors. Pearson’s thoracic and esophageal surgery. 3rd ed. Philadelphia: Churchill Livingstone, Elsevier; 2008. pp. 1147–55.

  2. Knobloch K. eComment: a tribute to Gotthard Bulau and Vincenzo Monaldi. Interact CardioVasc Thorac Surg. 2008;7:1159. doi:10.1510/icvts.2008.181750A.

    Article  PubMed  Google Scholar 

  3. Cerfolio RJ, Tummala RP, Holman WL, Zorn GL, Kirklin JK, McGiffin DC, et al. A prospective algorithm for the management of air leaks after pulmonary resection. Ann Thorac Surg. 1998;66:1726–31.

    Article  CAS  PubMed  Google Scholar 

  4. Cerfolio RJ, Bass C, Katholi CR. Prospective randomized trial compares suction versus water seal for air leaks. Ann Thorac Surg. 2001;71:1613–7.

    Article  CAS  PubMed  Google Scholar 

  5. Marshall MB, Deeb ME, Bleier JI, Kucharczuk JC, Friedberg JS, Kaiser LR, et al. Suction vs water seal after pulmonary resection: a randomized prospective study. Chest. 2002;121:831–5.

    Article  PubMed  Google Scholar 

  6. Dawson AG, Hosmane S. Should you place one or two chest drains in patients undergoing lobectomy? Interact CardioVasc Thorac Surg. 2010;11:178–81.

    Article  PubMed  Google Scholar 

  7. Pompili C, Detterbeck F, Papagiannopoulos K, Sihoe A, Vachlas K, Maxfield MW, et al. Multicenter international randomized comparison of objective and subjective outcomes between electronic and traditional chest drainage systems. Ann Thorac Surg. 2014;98:490–7.

    Article  PubMed  Google Scholar 

  8. Varela G, Jiménez MF, Novoa NM, Aranda JL. Postoperative chest tube management: measuring air leak using an electronic device decreases variability in the clinical practice. Eur J Cardiothorac Surg. 2009;35:28–31.

    Article  PubMed  Google Scholar 

  9. Gilbert S, McGuire AL, Maghera S, Sundaresan SR, Seely AJ, Maziak DE, et al. Randomized trial of digital versus analog pleural drainage in patients with or without a pulmonary air leak after lung resection. J Thorac Cardiovasc Surg. 2015;150:1243–9.

    Article  PubMed  Google Scholar 

  10. Brunelli A, Monteverde M, Borri A, Salati M, Marasco RD, Al Refai M, et al. Comparison of water seal and suction after pulmonary lobectomy: a prospective, randomized trial. Ann Thorac Surg. 2004;77:1932–7.

    Article  PubMed  Google Scholar 

  11. Refai M, Brunelli A, Salati M, Xiumè F, Pompili C, Sabbatini A. The impact of chest tube removal on pain and pulmonary function after pulmonary resection. Eur J Cardiothorac Surg. 2012;41:820–3.

    Article  PubMed  Google Scholar 

  12. Cerfolio RJ, Bryant AS. The management of chest tubes after pulmonary resection. Thorac Surg Clin. 2010;20:399–405.

    Article  PubMed  Google Scholar 

  13. Coughlin SM, Emmerton-Coughlin HM, Malthaner R. Management of chest tubes after pulmonary resection: a systematic review and meta-analysis. Can J Surg. 2012;55:264–70.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Antanavicius G, Lamb J, Papasavas P, Caushaj P. Initial chest tube management after pulmonary resection. Am Surg. 2005;71:416–9.

    CAS  PubMed  Google Scholar 

  15. Cerfolio RJ, Bryant AS, Skylizard L, Minnich DJ. Optimal technique for the removal of chest tubes after pulmonary resection. J Thorac Cardiovasc Surg. 2013;145:1535–9.

    Article  PubMed  Google Scholar 

  16. Bell RL, Ovadia P, Abdullah F, Spector S, Rabinovici R. Chest tube removal: end-inspiration or end-expiration? J Trauma. 2001;50:674–7.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yukitoshi Satoh.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Satoh, Y. Management of chest drainage tubes after lung surgery. Gen Thorac Cardiovasc Surg 64, 305–308 (2016). https://doi.org/10.1007/s11748-016-0646-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11748-016-0646-z

Keywords

Navigation