2008 Volume 22 Issue 2 Pages 146-150
Previous reports demonstrated that water seal is equivalently efficient or rather superior to continuous suction for the management of postoperative thoracic drainage after pulmonary resection. Although we generally use water seal on chest tube management after lung resection, in case of massive air-leakage, we occasionally need to convert to continuous suction from water seal that is intrinsically efficient to stop air-leakage. Here, we reviewed our chest tube management under a water seal. From January 2006 to October 2006, 90 surgeries were performed for pulmonary resection and the medical records were conducted retrospectively. After closing the chest, −10 cm H2O suction starts and continues by checking expansion of the operated lung, for about 30 minutes. Then, we change the management to a water seal. Nine cases (10%) required conversion from water seal to continuous suction. The reasons to convert to suction were expanded subcutaneous emphysema (n=5), lung collapse (n=3), and retained pleural effusion (n=1). In case of massive air leakage after surgery in water seal, we need careful consideration for subcutaneous emphysema and lung collapse.
