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Ann Thorac Surg 2005;80:1052-1055
© 2005 The Society of Thoracic Surgeons

Original article: General thoracic

Alternate Suction Reduces Prolonged Air Leak After Pulmonary Lobectomy: A Randomized Comparison Versus Water Seal

Alessandro Brunelli, MD * , Armando Sabbatini, MD, Francesco Xiume’, MD, Majed Al Refai, MD, Michele Salati, MD, Rita Marasco, MD

Unit of Thoracic Surgery, "Umberto I°" Regional Hospital, Ancona, Italy

Accepted for publication March 18, 2005.

* Address reprint requests to Dr Brunelli, Via S. Margherita 23, Ancona 60129, Italy (Email: alexit_2000{at}yahoo.com).

BACKGROUND: The objective of the present study was to compare in a prospective randomized fashion two different management schemes for chest tubes after lobectomy: water seal versus alternate suction (suction overnight and water seal during the day).

METHODS: Ninety-four patients with air leak on the morning of the first postoperative day were randomly assigned to two groups: group 1 (water seal alone), 47 patients; or group 2 (alternate suction), 47 patients. The groups were then compared in terms of preoperative, operative, and postoperative variables.

RESULTS: Alternate suction patients showed a reduced incidence of air leak longer than 4 days (p = 0.04) and longer than 7 days (p = 0.02), a shorter duration of chest tubes in place (p = 0.002), and a shorter postoperative hospital stay (p = 0.004).

CONCLUSIONS: Alternate suction was superior to water seal alone in reducing the incidence of prolonged air leak and postoperative hospital stay after lobectomy. As suction was applied only overnight, this modality has the same advantage of water seal in terms of early mobilization of patients.




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A. Brunelli, F. Xiume, M. Al Refai, M. Salati, R. Marasco, and A. Sabbatini
Air leaks after lobectomy increase the risk of empyema but not of cardiopulmonary complications: a case-matched analysis.
Chest, October 1, 2006; 130(4): 1150 - 1156.
[Abstract] [Full Text] [PDF]

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 Ann. Thorac. Surg.Home page
M. B. Marshall
Invited commentary
Ann. Thorac. Surg., September 1, 2005; 80(3): 1055 - 1055.
[Full Text] [PDF]


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