title: Suction or Nonsuction: How to Manage a Chest Tube After Pulmonary Resection.
abstract: Despite several randomized trials and meta-analyses, the dilemma as to whether to apply suction after subtotal pulmonary resection has not been solved. The combination of a poorly understood pathophysiology of the air leak phenomenon and the inadequate quality of the published randomized trials is actually preventing thoracic surgeons from abandoning an empirical management of chest drains. Even digital systems do not seem to have made the difference so far. Based on the evidence of the literature, the authors propose a new air leak predictor score (ALPS) as a contributing step toward appropriateness in using intraoperative sealants, opting for an external suction and managing and chest tubes.
authors.affiliation: Division of Thoracic Surgical Oncology, Department of Thoracic Surgical and Medical Oncology, Istituto Nazionale Tumori, Pascale Foundation, IRCCS, Naples, Italy. Electronic address: g.rocco@istitutotumori.na.it.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Rocco
authors.affiliation: Department of Thoracic Surgery, St. James's University Hospital, Leeds, UK.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Brunelli
authors.affiliation: Section of Thoracic Surgery, University Campus Biomedico, Rome, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Rocco
mesh_terms: D015505:Chest Tubes; D006801:Humans; D011013:Pneumonectomy; D011030:Pneumothorax / Q000503:physiopathology / Q000628:therapy*; D011182:Postoperative Care / Q000295:instrumentation / Q000379:methods*; D013396:Suction / Q000295:instrumentation / Q000379:methods*
keywords: Air leak; Chest drain; Chest tube; Lobectomy; Suction