{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T04:25:37Z","timestamp":1772166337848,"version":"3.50.1"},"reference-count":6,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T00:00:00Z","timestamp":1721174400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T00:00:00Z","timestamp":1721174400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Cardiothorac Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The principles of chest drainage have not changed significantly since 1875 when B\u00fclau introduced the idea of underwater drainage tube which became a trademark of thoracic surgery. We performed a prospective, randomized trial comparing omitting pleural drain (drainless group) versus drainage with small low suction drain (drainage group) strategies of thoracic surgery when the visceral pleura remains intact. Aiming to investigate whether these approaches represent safe treatment options.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A multi-center, prospective, parallel group, randomized, controlled trial enrolling patients after thoracic procedures in which visceral pleura remained intact at the end of surgery between August 2020 and September 2023. After completion of the procedure a suction-seal test was conducted on all patients. If suction-seal test was positive to confirm absence of air leak, patients were randomized to either receive low auto-suction drain as a solo pleural drain (drainage group) or not to receive drain (drainless group).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      During the study period, 111 patients were recruited. Eleven patients had negative Suction-seal test and were excluded by inserting a traditional underwater seal. The remaining 100 patients were randomly assigned to either drainage group with low suction drain (Fig.\u00a01) (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200950) or drainless group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200950).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The results of this study suggest that either omitting drain or inserting a low auto suction drain safely substitutes the one-way valve when the visceral pleura remains intact. Omitting drain or inserting portable small caliber drain encourages early mobilization and is associated with shorter hospital stay.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13019-024-02824-6","type":"journal-article","created":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T06:01:59Z","timestamp":1721196119000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes after 4 years\u2019 experience with low suction drains. Would it be safe to go drainless or low suction?"],"prefix":"10.1186","volume":"19","author":[{"given":"Mithat","family":"Fazlioglu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walid","family":"Hammad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deniz","family":"Piyadeoglu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cemal Asim","family":"Kutlu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,7,17]]},"reference":[{"key":"2824_CR1","doi-asserted-by":"publisher","first-page":"887","DOI":"10.1016\/j.athoracsur.2019.10.048","volume":"109","author":"HC Liao","year":"2020","unstructured":"Liao HC, Yang SM, Hung MH, Cheng YJ, Hsu HH, Chen JS. Drainage Tube Placement for Peripheral Lung nodules. Ann Thorac Surg. 2020;109:887\u201393.","journal-title":"Ann Thorac Surg"},{"key":"2824_CR2","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1007\/978-1-4614-2074-3_7","volume-title":"The SAGES manual on the fundamental use of surgical energy (FUSE)","author":"JGIV Bittner","year":"2012","unstructured":"Bittner JGIV, Varela JE, Herron D. Ultrasonic energy systems. In: Feldman LS, Fuchshuber PR, Jones DB, editors. The SAGES manual on the fundamental use of surgical energy (FUSE). New York, NY: Springer; 2012. pp. 123\u201332."},{"key":"2824_CR3","first-page":"15","volume":"6","author":"M Fazlioglu","year":"2024","unstructured":"Fazlioglu M, Hammad W, Piyadeoglu D, Kutlu CA. Have water seal drainage systems come to an end? The Egyptian Cardiothoracic Surgeon J. 2024; 6:15\u201319.","journal-title":"The Egyptian Cardiothoracic Surgeon J"},{"issue":"1","key":"2824_CR4","first-page":"35","volume":"28","author":"M Castro","year":"2021","unstructured":"Castro M, Lareiro P, Rei S, Miranda J, Neves J, Guerra F. Video assisted thoracoscopic surgery without chest drain placement. Rev Port Cir Cardiotorac Vasc. 2021;28(1):35\u20138. Published 2021 Apr 8.","journal-title":"Rev Port Cir Cardiotorac Vasc"},{"issue":"10","key":"2824_CR5","doi-asserted-by":"publisher","first-page":"612","DOI":"10.1007\/s11748-016-0692-6","volume":"64","author":"BL Holbek","year":"2016","unstructured":"Holbek BL, Hansen HJ, Kehlet H, Petersen RH. Thoracoscopic pulmonary wedge resection without post-operative chest drain: an observational study. Gen Thorac Cardiovasc Surg. 2016;64(10):612\u20137. https:\/\/doi.org\/10.1007\/s11748-016-0692-6","journal-title":"Gen Thorac Cardiovasc Surg"},{"issue":"5","key":"2824_CR6","doi-asserted-by":"publisher","first-page":"1618","DOI":"10.1016\/S0022-5223(03)00592-0","volume":"126","author":"M Marcello Migliore","year":"2003","unstructured":"Marcello Migliore M. Efficacy and safety of single-trocar technique for minimally invasive surgery of the chest in the treatment of noncomplex pleural disease. J Thorac Cardiovasc Surg. 2003;126(5):1618\u201323.","journal-title":"J Thorac Cardiovasc Surg"}],"container-title":["Journal of Cardiothoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13019-024-02824-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13019-024-02824-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13019-024-02824-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T06:08:35Z","timestamp":1721196515000},"score":1,"resource":{"primary":{"URL":"https:\/\/cardiothoracicsurgery.biomedcentral.com\/articles\/10.1186\/s13019-024-02824-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,17]]},"references-count":6,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["2824"],"URL":"https:\/\/doi.org\/10.1186\/s13019-024-02824-6","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-4159894\/v1","asserted-by":"object"}]},"ISSN":["1749-8090"],"issn-type":[{"value":"1749-8090","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,17]]},"assertion":[{"value":"25 March 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 May 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 July 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This statement confirming the approval of the study by the ethical committee of Tekirdag Namik Kemal University on 29th November 2022, ID number 2022.216.11.17. All patients were consented for the participation in the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"456"}}