Original article: general thoracicProspective randomized trial compares suction versus water seal for air leaks
Section snippets
Patients and methods
Between August 1, 1997 and June 1, 1998, 140 consecutive patients underwent elective pulmonary resection by a single surgeon (R.J.C.) at The University of Alabama at Birmingham. Exclusion criteria included any patient who had pulmonary resection performed exclusively by video-assisted thoracoscopy, had lung volume reduction surgery, pneumonectomy or any type of broncho-plastic procedure (i.e., sleeve resection). No patients refused entry into this trial secondary due to its safe design.
Standard
Suction versus water seal
The median age at the time of pulmonary resection in these 140 patients (96 men, 44 women) was 54 years (range 3 years to 83 years). Forty-one patients had a previous history of cardiac disease (either coronary artery bypass surgery, balloon angioplasty, or exertional angina), 28 had insulin-dependent diabetes mellitus, 13 had chronic renal failure (on dialysis), 7 had a previous ipsilateral thoracotomy, and 6 were on chronic steroids (at least 20 mg of prednisone per day). Twelve patients had
Comment
The decision to place chest tubes on suction versus water seal for many surgeons is based more on when, where, and how he or she trained as opposed to any scientific data. Because of this fact, we have performed several studies on air leaks and developed a classification system. This is an attempt to bring science to this common problem. Our previous trial [1] showed that water seal was safe for patients with air leaks. It enabled us to perform this prospective randomized trial with both IRB
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