title: Alternate suction reduces prolonged air leak after pulmonary lobectomy: a randomized comparison versus water seal.
abstract: 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.
authors.affiliation: Unit of Thoracic Surgery, Umberto I Regional Hospital, Ancona, Italy. alexit_2000@yahoo.com
authors.forename: Alessandro
authors.initials: A
authors.lastname: Brunelli
authors.forename: Armando
authors.initials: A
authors.lastname: Sabbatini
authors.forename: Francesco
authors.initials: F
authors.lastname: Xiume'
authors.forename: Majed Al
authors.initials: MA
authors.lastname: Refai
authors.forename: Michele
authors.initials: M
authors.lastname: Salati
authors.forename: Rita
authors.initials: R
authors.lastname: Marasco
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000601:surgery*; D015505:Chest Tubes; D005260:Female; D006331:Heart Diseases / Q000209:etiology; D006801:Humans; D007902:Length of Stay; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D011013:Pneumonectomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D011446:Prospective Studies; D013396:Suction / Q000379:methods; D016896:Treatment Outcome