Objective To evaluate whether external suction is more advantageous than water seal in patients undergoing selective pulmonary resection (SPR) for lung neoplasm. Summary of Background Data Whether external suction should be routinely applied in postoperative chest drainage is still unclear, particularly for lung neoplasm patients. To most surgeons, the decision is based on their clinical experience. Methods Randomized control trials were selected. The participants were patients undergoing SPR with lung neoplasm. Lung volume reduction surgery and pneumothorax were excluded. Suction versus non-suction for the intervention. The primary outcome was the incidence of persistent air leak (PAL). The definition of PAL was air leak for more than 3–7 days. The secondary outcomes included air leak duration, time of drainage, postoperative hospital stay and the incidence of postoperative pneumothorax. Studies were identified from literature collections through screening. Bias was analyzed and meta-analysis was used. Results From the 1824 potentially relevant trials, 6 randomized control trials involving 676 patients were included. There was no difference between external suction and water seal in decreasing the incidence of PAL [95% confidence interval (CI) 0.81−2.16; z = 1.10; P = 0.27]. Regarding secondary outcomes, there were no differences in time of drainage (95% CI−0.36−1.56, P = 0.22), postoperative hospital stay (95% CI -.31−.54, P = 0.87) or incidence of postoperative pneumothorax (95% CI 0.18−.02, P = 0.05) between external suction and water seal. Conclusions For participants, no differences are identified in terms of PAL incidence, drainage time, length of postoperative hospital stay or incidence of postoperative pneumothorax between external suction and water seal. The bias analysis should be emphasized. To the limitations of the bias and methodological differences among the included studies, we have no recommendation on whether external suction should be routinely applied after lung neoplasm SPR. More high-quality randomized controlled trials are needed. Systematic Review Registration None.
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机译：目的评估在接受肺肿瘤选择性肺切除术（SPR）的患者中，外部抽吸是否比水封更有利。背景数据摘要尚不清楚术后胸腔引流是否应常规应用外部抽吸，尤其是对于肺肿瘤患者。对于大多数外科医生而言，决定取决于他们的临床经验。方法选择随机对照试验。参加者是接受肺肿瘤SPR治疗的患者。排除肺减容术和气胸。抽吸与不抽吸进行干预。主要结果是持续漏气（PAL）的发生率。 PAL的定义是漏气超过3–7天。次要结果包括漏气持续时间，引流时间，术后住院时间和术后气胸发生率。通过筛选从文献收藏中鉴定研究。分析偏差并使用荟萃分析。结果从1824项潜在的相关试验中，纳入了6项涉及676例患者的随机对照试验。在降低PAL发生率方面，外部抽吸和水封之间没有差异[95％置信区间（CI）0.81-2.16; z = 1.10; P ＝ 0.27]。关于次要结局，引流时间（95％CI-0.36-1.56，P = 0.22），术后住院时间（95％CI -.31-.54，P = 0.87）或术后气胸发生率均无差异（外部抽吸和水封之间的95％CI 0.18−.02，P = 0.05）。结论对于参与者，在外部吸引和水封之间在PAL发生率，引流时间，术后住院时间或术后气胸发生率方面没有差异。应强调偏见分析。由于所纳入研究的偏倚和方法学差异的局限性，我们不建议在肺肿瘤SPR后是否应常规应用外部抽吸。需要更多高质量的随机对照试验。系统审查注册无。
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