The Society for Translational Medicine: Clinical practice guidelines for the postoperative management of chest tube for patients undergoing lobectomy

S. Gao, Z. Zhang, J. Aragón, A. Brunelli, S. Cassivi, Y. Chai, C. Chen, G. Chen, H. Chen, J.-S. Chen, D.T. Cooke, J.B. Downs, P.-E. Falcoz, W. Fang, P.L. Filosso, X. Fu, S.D. Force, M.I. Garutti, D. Gonzalez-Rivas, D. GossotH.J. Hansen, J. He, B.L. Holbek, J. Hu, Y. Huang, M. Ibrahim, A. Imperatori, M. Ismail, G. Jiang, H. Jiang, Z. Jiang, H.K. Kim, D. Li, G. Li, H. Li, Q. Li, X. Li, Y. Li, Z. Li, E. Lim, C.-C. Liu, D. Liu, L. Liu, Y. Liu, K.W. Lobdell, H. Ma, W. Mao, G. Rocco, M. Salati, G. Veronesi

Research output: Contribution to journalArticlepeer-review


The Society for Translational Medicine and The Chinese Society for Thoracic and Cardiovascular Surgery conducted a systematic review of the literature in an attempt to improve our understanding in the postoperative management of chest tubes of patients undergoing pulmonary lobectomy. Recommendations were produced and classified based on an internationally accepted GRADE system. The following recommendations were extracted in the present review: (I) chest tubes can be removed safely with daily pleural fluid of up to 450 mL (non-chylous and non-sanguinous), which may reduce chest tube duration and hospital length of stay (2B); (II) in rare instances, e.g., persistent abundant fluid production, the use of PrRP/B < 0.5 when evaluating fluid output to determine chest tube removal might be beneficial (2B); (III) it is recommended that one chest tube is adequate following pulmonary lobectomy, except for hemorrhage and space problems (2A); (IV) chest tube clearance by milking and stripping is not recommended after lung resection (2B); (V) chest tube suction is not necessary for patients undergoing lobectomy after first postoperative day (2A); (VI) regulated chest tube suction [-11 (-1.08 kPa) to -20 (1.96 kPa) cmH2O depending upon the type of lobectomy] is not superior to regulated seal [-2 (0.196 kPa) cmH2O] when electronic drainage systems are used after lobectomy by thoracotomy (2B); (VII) chest tube removal recommended at the end of expiration and may be slightly superior to removal at the end of inspiration (2A); (VIII) electronic drainage systems are recommended in the management of chest tube in patients undergoing lobectomy (2B). © Journal of Thoracic Disease.
Original languageEnglish
Pages (from-to)3255-3264
Number of pages10
JournalJournal of Thoracic Disease
Issue number9
Publication statusPublished - 2017


  • Chest tube
  • Drainage system
  • GRADE system
  • Lobectomy
  • Recommendation
  • Article
  • breathing pattern
  • chest tube
  • cost control
  • human
  • length of stay
  • lung lobectomy
  • mortality
  • patient care
  • pleura fluid
  • postoperative care
  • postoperative period
  • practice guideline
  • safety
  • suction
  • suction drain
  • systematic review
  • thoracocentesis
  • thoracotomy
  • thorax pressure
  • tube removal


Dive into the research topics of 'The Society for Translational Medicine: Clinical practice guidelines for the postoperative management of chest tube for patients undergoing lobectomy'. Together they form a unique fingerprint.

Cite this